Elastometry in complex assessment of hepatic fibrosis in patients with HIV and HIV/VHC coinfected patients
Abstract314 HIV-infected patients were examined in this trial including 281 patients with HIV/HCV co-infection and 33 patients with HIV mono-infection. Anti-HCV therapy and HAART (Highly Active Antiretroviral Therapy) wasn`t prescribed to the all patients earlier. Fibrosis was assessed by transient elastometry for the all patients using FibroScan® based on the METAVIR scale.
Patients with HIV/HCV co-infection didn`t have fibrosis in 39,1 %, 22,4 % of the patients had F1 fibrosis stage, 18,2 % of the patients had F2 – F3 stages. The percentage of patients with cirrhosis was 20,3 % and 35,1 % from these patients had newly diagnosed cirrhosis revealed by transient elastometry with the FibroScan. Patients with the HIV mono-infection didn`t have any fibrosis at 84,8 % of all cases and 15,2 % of the patients was diagnosed F1 stage.
Significant positive correlation of the liver fibrosis stages based on the fibroelastometry and FIB-4 data and also based on the fibroelastometry and APRI data at the patients co-infected with HIV/HCV has been revealed with the correlation analysis. Additionally, the term of HCVinfection has positive correlation with the fibrosis stage and CD4-level had negative correlation with the fibrosis stage at the patients with HIV/HCV co-infection.
It was no any statistical correlation between liver fibrosis stage and sex at the patients. Viremia level didn`t correlate with the fibrosis stage also.
Stage F1 liver fibrosis based on the METAVIR scale was diagnosed at 9,1 % HIV mono-infected patients (3 patients from 33) with the permanently normal transaminases level and without any viral and toxic liver lesions. As the result of this study it was shown that transient elastography can diagnose liver fibrosis (F1) at the patients with permanently normal liver enzyme level in the some cases. These data must be considered for the appropriate antiretroviral therapy prescription.
Keywords:liver fibrosis, liver elastometry, chronic hepatitis C, HIVinfection