Liver fibrosis progression in a cohort of young HIV and HIV/ HBV co-infected patients: A longitudinal study using non-invasive APRI and Fib-4 scores
BackgroundThe risk of liver fibrosis increases over time in HIV and HIV-HBV individuals even under antiretroviral treatment (ART), warranting a rigorous and periodic monitorization. Given the lower availability of transient elastography, we aimed to assess the longitudinal variation of two non-invas...
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| Format: | Article |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.888050/full |
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| author | Diana Gabriela Iacob Diana Gabriela Iacob Monica Luminos Monica Luminos Otilia Elisabeta Benea Otilia Elisabeta Benea Ana-Maria Tudor Ana-Maria Tudor Cristina Mihaela Olariu Cristina Mihaela Olariu Simona Alexandra Iacob Simona Alexandra Iacob Simona Ruta Simona Ruta |
| author_facet | Diana Gabriela Iacob Diana Gabriela Iacob Monica Luminos Monica Luminos Otilia Elisabeta Benea Otilia Elisabeta Benea Ana-Maria Tudor Ana-Maria Tudor Cristina Mihaela Olariu Cristina Mihaela Olariu Simona Alexandra Iacob Simona Alexandra Iacob Simona Ruta Simona Ruta |
| author_sort | Diana Gabriela Iacob |
| collection | DOAJ |
| description | BackgroundThe risk of liver fibrosis increases over time in HIV and HIV-HBV individuals even under antiretroviral treatment (ART), warranting a rigorous and periodic monitorization. Given the lower availability of transient elastography, we aimed to assess the longitudinal variation of two non-invasive liver fibrosis scores, APRI and Fib-4, in cases with HIV monoinfection, HIV-HBV co-infection and individuals with HBsAg-seroclearance.MethodsWe performed an observational retrospective study between 2013 and 2019 on 212 HIV patients including 111 individuals with HIV mono-infection, 62 individuals with HIV-HBV co-infection and positive HBsAg and 39 cases with HIV-HBV infection and HBsAg-loss. The groups were followed at 36, 48, and 60 months. Liver fibrosis was indicated by an APRI >0.5 or Fib-4≥1.45 score and advanced fibrosis by an APRI score >1.5 or Fib-4 >3.25. Logistic regression with generalized estimating equations (GEE) was used to assess the predictors for the presence of liver fibrosis over time.ResultsDuring a median follow-up of 58.5 months the prevalence of liver fibrosis in all patients increased with 0.5% reaching 11.3% using an APRI score and with 0.9% reaching 10.8% using the Fib-4 score. At the visit corresponding to 60 months the prevalence of liver fibrosis was higher in all HIV-HBV patients compared with individuals with HIV mono-infection, namely: 16.1% on APRI and 12.9% on the Fib-4 score in HIV-HBV/HBsAg-positive individuals, 12.8% on both APRI and Fib-4 scores in HIV-HBV/HBsAg-negative individuals vs. 8.1 and 9%, respectively in HIV mono-infection. The presence of liver fibrosis over the study period was independently associated with plasma HIV RNA, CD4+T cell counts, HIV-HBV co-infection (for APRI >0.5) and ART non-adherence (for Fib-4 >1.45). At the final visit, non-adherence to ART and CD4+T cell counts remained associated with liver fibrosis.ConclusionsThe study found a slow progression of APRI and Fib-4 scores over time in young PLWH with extensive ART. Liver fibrosis scores continued to increase in patients with HIV mono-infection yet remained lower than in HIV-HBV patients irrespective on the presence of HBsAg. The periodic follow-up using non-invasive scores on the long-term could help improve the surveillance in low-income settings and high scores should be followed by additional diagnostic methods. |
| first_indexed | 2024-04-14T07:26:36Z |
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| id | doaj.art-92ba80e2ccb44435ab7d82d439c8453f |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-14T07:26:36Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-92ba80e2ccb44435ab7d82d439c8453f2022-12-22T02:05:59ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-07-01910.3389/fmed.2022.888050888050Liver fibrosis progression in a cohort of young HIV and HIV/ HBV co-infected patients: A longitudinal study using non-invasive APRI and Fib-4 scoresDiana Gabriela Iacob0Diana Gabriela Iacob1Monica Luminos2Monica Luminos3Otilia Elisabeta Benea4Otilia Elisabeta Benea5Ana-Maria Tudor6Ana-Maria Tudor7Cristina Mihaela Olariu8Cristina Mihaela Olariu9Simona Alexandra Iacob10Simona Alexandra Iacob11Simona Ruta12Simona Ruta13Department of Infectious Diseases, Emergency University Hospital, Bucharest, RomaniaDepartment of Infectious Diseases and Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Infectious Diseases and Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Infectious Diseases, National Institute of Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest, RomaniaDepartment of Infectious Diseases and Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Infectious Diseases, National Institute of Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest, RomaniaDepartment of Infectious Diseases and Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Infectious Diseases, National Institute of Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest, RomaniaDepartment of Infectious Diseases and Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Infectious Diseases, National Institute of Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest, RomaniaDepartment of Infectious Diseases and Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Infectious Diseases, National Institute of Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest, RomaniaDepartment of Infectious Diseases and Virology, Carol Davila University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Emerging Viral Infections and HIV/AIDS International Research Center, Stefan S. Nicolau Institute of Virology, Bucharest, RomaniaBackgroundThe risk of liver fibrosis increases over time in HIV and HIV-HBV individuals even under antiretroviral treatment (ART), warranting a rigorous and periodic monitorization. Given the lower availability of transient elastography, we aimed to assess the longitudinal variation of two non-invasive liver fibrosis scores, APRI and Fib-4, in cases with HIV monoinfection, HIV-HBV co-infection and individuals with HBsAg-seroclearance.MethodsWe performed an observational retrospective study between 2013 and 2019 on 212 HIV patients including 111 individuals with HIV mono-infection, 62 individuals with HIV-HBV co-infection and positive HBsAg and 39 cases with HIV-HBV infection and HBsAg-loss. The groups were followed at 36, 48, and 60 months. Liver fibrosis was indicated by an APRI >0.5 or Fib-4≥1.45 score and advanced fibrosis by an APRI score >1.5 or Fib-4 >3.25. Logistic regression with generalized estimating equations (GEE) was used to assess the predictors for the presence of liver fibrosis over time.ResultsDuring a median follow-up of 58.5 months the prevalence of liver fibrosis in all patients increased with 0.5% reaching 11.3% using an APRI score and with 0.9% reaching 10.8% using the Fib-4 score. At the visit corresponding to 60 months the prevalence of liver fibrosis was higher in all HIV-HBV patients compared with individuals with HIV mono-infection, namely: 16.1% on APRI and 12.9% on the Fib-4 score in HIV-HBV/HBsAg-positive individuals, 12.8% on both APRI and Fib-4 scores in HIV-HBV/HBsAg-negative individuals vs. 8.1 and 9%, respectively in HIV mono-infection. The presence of liver fibrosis over the study period was independently associated with plasma HIV RNA, CD4+T cell counts, HIV-HBV co-infection (for APRI >0.5) and ART non-adherence (for Fib-4 >1.45). At the final visit, non-adherence to ART and CD4+T cell counts remained associated with liver fibrosis.ConclusionsThe study found a slow progression of APRI and Fib-4 scores over time in young PLWH with extensive ART. Liver fibrosis scores continued to increase in patients with HIV mono-infection yet remained lower than in HIV-HBV patients irrespective on the presence of HBsAg. The periodic follow-up using non-invasive scores on the long-term could help improve the surveillance in low-income settings and high scores should be followed by additional diagnostic methods.https://www.frontiersin.org/articles/10.3389/fmed.2022.888050/fullliver fibrosisAPRI scoreFib-4 scoreHIVHIV/HBV co-infectionnon-invasive score |
| spellingShingle | Diana Gabriela Iacob Diana Gabriela Iacob Monica Luminos Monica Luminos Otilia Elisabeta Benea Otilia Elisabeta Benea Ana-Maria Tudor Ana-Maria Tudor Cristina Mihaela Olariu Cristina Mihaela Olariu Simona Alexandra Iacob Simona Alexandra Iacob Simona Ruta Simona Ruta Liver fibrosis progression in a cohort of young HIV and HIV/ HBV co-infected patients: A longitudinal study using non-invasive APRI and Fib-4 scores Frontiers in Medicine liver fibrosis APRI score Fib-4 score HIV HIV/HBV co-infection non-invasive score |
| title | Liver fibrosis progression in a cohort of young HIV and HIV/ HBV co-infected patients: A longitudinal study using non-invasive APRI and Fib-4 scores |
| title_full | Liver fibrosis progression in a cohort of young HIV and HIV/ HBV co-infected patients: A longitudinal study using non-invasive APRI and Fib-4 scores |
| title_fullStr | Liver fibrosis progression in a cohort of young HIV and HIV/ HBV co-infected patients: A longitudinal study using non-invasive APRI and Fib-4 scores |
| title_full_unstemmed | Liver fibrosis progression in a cohort of young HIV and HIV/ HBV co-infected patients: A longitudinal study using non-invasive APRI and Fib-4 scores |
| title_short | Liver fibrosis progression in a cohort of young HIV and HIV/ HBV co-infected patients: A longitudinal study using non-invasive APRI and Fib-4 scores |
| title_sort | liver fibrosis progression in a cohort of young hiv and hiv hbv co infected patients a longitudinal study using non invasive apri and fib 4 scores |
| topic | liver fibrosis APRI score Fib-4 score HIV HIV/HBV co-infection non-invasive score |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.888050/full |
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