Discordant liver fibrosis predictors in virologically suppressed people living with hiv without hepatitis virus infection

Barbara Rossetti, Valentina Borgo, Arianna Emiliozzi, Marta Colaneri, Giacomo Zanelli, Miriana D’alessandro, Davide Motta, Laura Maiocchi, Francesca Montagnani, Maria Cristina Moioli, Chiara Baiguera, Margherita Sambo, Teresa Chiara Pieri, Pietro Valsecchi, Raffaele Bruno, Massimo Puoti, Massimiliano Fabbiani

Research output: Contribution to journalArticlepeer-review


Severe liver fibrosis (LF) is associated with poor long-term liver-related outcomes in people living with HIV (PLWH). The study aimed to explore the prevalence and predictors of LF and the concordance between different non-invasive methods for the estimation of LF in HIV-infected individuals without hepatitis virus infection. We enrolled PLWH with HIV-1-RNA <50 copies/mL for >12 months, excluding individuals with viral hepatitis. LF was assessed by transient elastography (TE) (significant >6.65 kPa), fibrosis-4 (FIB-4) (significant >2.67), and AST-to-platelet ratio index (APRI) (significant >1.5). We included 234 individuals (67% males, median age 49 years, median time from HIV diagnosis 11 years, 38% treated with integrase strand transfer inhibitors). In terms of the TE, 13% had ≥F2 stage; FIB-4 score was >1.5 in 7%; and APRI > 0.5 in 4%. Higher body mass index, diabetes mellitus, detectable baseline HIV-1 RNA and longer atazanavir exposure were associated with higher liver stiffness as per TE. Predictors of higher APRI score were CDC C stage and longer exposure to tenofovir alafenamide, while HBcAb positivity and longer exposure to tenofovir alafenamide were associated to higher FIB-4 scores. Qualitative agreement was poor between FIB-4/TE and between APRI/TE by non-parametric Spearman correlation and kappa statistic. In our study, in the group of PLWH without viral hepatitis, different non-invasive methods were discordant in predicting liver fibrosis.

Original languageEnglish
Article number14
Issue number1
Publication statusPublished - Jan 2022


  • ART
  • HIV
  • Liver fibrosis

ASJC Scopus subject areas

  • Clinical Biochemistry


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