Transient elastography: A non-invasive tool for assessing liver fibrosis in HIV/HCV patients

Valentina Li Vecchi, Maurizio Soresi, Claudia Colomba, Giovanni Mazzola, Pietro Colletti, Maurizio Mineo, Paola di Carlo, Emanuele la Spada, Giovanni Vizzini, Giuseppe Montalto

Research output: Contribution to journalArticle

Abstract

AIM: To assess the prevalence of advanced liver fibrosis (ALF) in human immunodeficiency virus (HIV), hepatitis C virus (HCV) and HIV/HCV patients using transient elastography, and to identify factors associated with ALF. METHODS: Between September 2008 and October 2009, 71 HIV mono-infected, 57 HIV/HCV co-infected and 53 HCV mono-infected patients on regular follow-up at our Center were enrolled in this study. Alcohol intake, the main parameters of liver function, presence of HCVRNA, HIV-RNA, duration of highly active anti-retroviral therapy (HAART) and CD4 cell count were recorded. ALF was defined as liver stiffness (LS) ≥ 9.5 kPa. To estimate liver fibrosis (LF) a further 2 reliable biochemical scores, aspartate aminotransferase platelet ratio index (APRI) and FIB-4, were also used. RESULTS: LS values of co-infected patients were higher than in either HIV or HCV mono-infected patients (χ2 MH = 4, P <0.04). In fact, LS ≥ 9.5 was significantly higher in co-infected than in HIV and HCV mono-infected patients (χ2 = 5, P <0.03). Also APRI and the FIB-4 index showed more LF in co-infected than in HIV mono-infected patients (P <0.0001), but not in HCV mono-infected patients. In HIV/HCV co-infected patients, the extent of LS was significantly associated with alcohol intake (P <0.04) and lower CD4+ cell count (P <0.02). In HCV patients, LS was correlated with alcohol intake (P <0.001) and cholesterol levels (P <0.03). Body mass index, diabetes, HCV- and HIV-viremia were not significantly correlated with LS. In addition, 20% of co-infected patients had virologically unsuccessful HAART; in 50% compliance was low, CD4+ levels were <400 cells/mm3 and LS was > 9.5 kPa. There was no significant correlation between extent of LF and HAART exposure or duration of HAART exposure, in particular with specific dideoxynucleoside analogues. CONCLUSION: ALF was more frequent in co-infected than mono-infected patients. This result correlated with lower CD4 levels. Protective immunological effects of HAART on LF progression outweigh its hepatotoxic effects.

Original languageEnglish
Pages (from-to)5225-5232
Number of pages8
JournalWorld Journal of Gastroenterology
Volume16
Issue number41
DOIs
Publication statusPublished - Nov 7 2010

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Elasticity Imaging Techniques
Hepacivirus
Liver Cirrhosis
HIV
Implosive Therapy
Liver
Dideoxynucleosides
CD4 Lymphocyte Count
Aspartate Aminotransferases
Blood Platelets
Alcohols
RNA
Therapeutics

Keywords

  • Aspartate aminotransferase platelet ratio index
  • FIB-4 test
  • Fibrosis evaluation
  • Hepatitis C virus infection
  • Human immunodeficiency virus infection
  • Liver fibrosis
  • Transient elastography

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Vecchi, V. L., Soresi, M., Colomba, C., Mazzola, G., Colletti, P., Mineo, M., ... Montalto, G. (2010). Transient elastography: A non-invasive tool for assessing liver fibrosis in HIV/HCV patients. World Journal of Gastroenterology, 16(41), 5225-5232. https://doi.org/10.3748/wjg.v16.i41.5225

Transient elastography : A non-invasive tool for assessing liver fibrosis in HIV/HCV patients. / Vecchi, Valentina Li; Soresi, Maurizio; Colomba, Claudia; Mazzola, Giovanni; Colletti, Pietro; Mineo, Maurizio; di Carlo, Paola; la Spada, Emanuele; Vizzini, Giovanni; Montalto, Giuseppe.

In: World Journal of Gastroenterology, Vol. 16, No. 41, 07.11.2010, p. 5225-5232.

Research output: Contribution to journalArticle

Vecchi, VL, Soresi, M, Colomba, C, Mazzola, G, Colletti, P, Mineo, M, di Carlo, P, la Spada, E, Vizzini, G & Montalto, G 2010, 'Transient elastography: A non-invasive tool for assessing liver fibrosis in HIV/HCV patients', World Journal of Gastroenterology, vol. 16, no. 41, pp. 5225-5232. https://doi.org/10.3748/wjg.v16.i41.5225
Vecchi, Valentina Li ; Soresi, Maurizio ; Colomba, Claudia ; Mazzola, Giovanni ; Colletti, Pietro ; Mineo, Maurizio ; di Carlo, Paola ; la Spada, Emanuele ; Vizzini, Giovanni ; Montalto, Giuseppe. / Transient elastography : A non-invasive tool for assessing liver fibrosis in HIV/HCV patients. In: World Journal of Gastroenterology. 2010 ; Vol. 16, No. 41. pp. 5225-5232.
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AU - Colletti, Pietro

AU - Mineo, Maurizio

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N2 - AIM: To assess the prevalence of advanced liver fibrosis (ALF) in human immunodeficiency virus (HIV), hepatitis C virus (HCV) and HIV/HCV patients using transient elastography, and to identify factors associated with ALF. METHODS: Between September 2008 and October 2009, 71 HIV mono-infected, 57 HIV/HCV co-infected and 53 HCV mono-infected patients on regular follow-up at our Center were enrolled in this study. Alcohol intake, the main parameters of liver function, presence of HCVRNA, HIV-RNA, duration of highly active anti-retroviral therapy (HAART) and CD4 cell count were recorded. ALF was defined as liver stiffness (LS) ≥ 9.5 kPa. To estimate liver fibrosis (LF) a further 2 reliable biochemical scores, aspartate aminotransferase platelet ratio index (APRI) and FIB-4, were also used. RESULTS: LS values of co-infected patients were higher than in either HIV or HCV mono-infected patients (χ2 MH = 4, P <0.04). In fact, LS ≥ 9.5 was significantly higher in co-infected than in HIV and HCV mono-infected patients (χ2 = 5, P <0.03). Also APRI and the FIB-4 index showed more LF in co-infected than in HIV mono-infected patients (P <0.0001), but not in HCV mono-infected patients. In HIV/HCV co-infected patients, the extent of LS was significantly associated with alcohol intake (P <0.04) and lower CD4+ cell count (P <0.02). In HCV patients, LS was correlated with alcohol intake (P <0.001) and cholesterol levels (P <0.03). Body mass index, diabetes, HCV- and HIV-viremia were not significantly correlated with LS. In addition, 20% of co-infected patients had virologically unsuccessful HAART; in 50% compliance was low, CD4+ levels were <400 cells/mm3 and LS was > 9.5 kPa. There was no significant correlation between extent of LF and HAART exposure or duration of HAART exposure, in particular with specific dideoxynucleoside analogues. CONCLUSION: ALF was more frequent in co-infected than mono-infected patients. This result correlated with lower CD4 levels. Protective immunological effects of HAART on LF progression outweigh its hepatotoxic effects.

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