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Liver stiffness and aspartate aminotransferase levels predict the risk for liver fibrosis progression in hepatitis C virus/ HIV ‐coinfected patients
Author(s) -
Gonzalez FA,
Van den Eynde E,
PerezHoyos S,
Navarro J,
Curran A,
Burgos J,
Falcó V,
Ocaña I,
Ribera E,
Crespo M
Publication year - 2015
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12197
Subject(s) - medicine , transient elastography , gastroenterology , cirrhosis , fibrosis , hepatitis c virus , confidence interval , hepatitis c , liver fibrosis , immunology , virus
Objectives The aim of the study was to investigate liver fibrosis outcome and the risk factors associated with liver fibrosis progression in hepatitis C virus ( HCV )/ HIV ‐coinfected patients. Methods We prospectively obtained liver stiffness measurements by transient elastography in a cohort of 154 HCV / HIV ‐coinfected patients, mostly C aucasian men on suppressive antiretroviral treatment, with the aim of determining the risk for liver stiffness measurement ( LSM ) increase and to identify the predictive factors for liver fibrosis progression. To evaluate LSM trends over time, a linear mixed regression model with LSM level as the outcome and duration of follow‐up in years as the main covariate was fitted. Results After a median follow‐up time of 40 months, the median increase in LSM was 1.05 kPa/year [95% confidence interval ( CI ) 0.72–1.38 kPa/year]. Fibrosis stage progression was seen in 47% of patients, and 17% progressed to cirrhosis. Aspartate aminotransferase ( AST ) levels and liver fibrosis stage at baseline were identified as independent predictors of LSM change. Patients with F3 ( LSM 9.6–14.5 kPa) or AST levels ≥ 64 IU / L at baseline were at higher risk for accelerated LSM increase (ranging from 1.45 to 2.61 kPa/year), whereas LSM change was very slow among patients with both F 0− F 1 ( LSM ≤ 7.5 kPa) and AST levels ≤ 64 IU / L at baseline (0.34 to 0.58 kPa/year). An intermediate risk for LSM increase (from 0.78 to 1.03 kPa/year) was seen in patients with F 2 ( LSM 7.6–9.5 kPa) and AST baseline levels ≤ 64 IU / L . Conclusions AST levels and liver stiffness at baseline allow stratification of the risk for fibrosis progression and might be clinically useful to guide HCV treatment decisions in HIV ‐infected patients.