Liver stiffness and fibrosis-4 alone better predict liver events compared with aspartate aminotransferase to platelet ratio index in a cohort of human immunodeficiency virus and hepatitis C virus co-infected patients from ANRS CO13 HEPAVIH cohort

被引：3

作者：

Chalouni, Mathieu ^{[1
]}

Sogni, Philippe ^{[6
]}

Miailhes, Patrick ^{[17
]}

Lacombe, Karine ^{[7
,8
,43
]}

Poizot-Martin, Isabelle ^{[18
,19
,34
]}

Chas, Julie ^{[9
,35
]}

Vittecoq, Daniel ^{[10
,11
,45
]}

Neau, Didier ^{[2
,3
,47
]}

Aumaitre, Hugues ^{[20
]}

Alric, Laurent ^{[21
,22
,36
]}

Piroth, Lionel ^{[25
,26
]}

Bouchaud, Olivier ^{[27
,28
,39
]}

Katlama, Christine ^{[12
,32
]}

Morlat, Philippe ^{[3
,4
]}

Lascoux-Combe, Caroline ^{[13
,42
]}

Gervais, Anne ^{[14
,41
]}

Naqvi, Alissa ^{[29
,38
]}

Rosenthal, Eric ^{[30
,37
]}

Garipuy, Daniel ^{[23
,40
]}

Barange, Karl ^{[24
,36
]}

Esterle, Laure ^{[1
]}

Salmon, Dominique ^{[15
,16
,31
]}

Wittkop, Linda ^{[1
,5
]}

Trimoulet, P. ^{[48
,50
]}

Izopet, J.

Serfaty, L.

Paradis, V.

Spire, B.

Carrieri, P.

Valantin, M. A. ^{[32
]}

Pialoux, G. ^{[35
]}

Bicart-See, A. ^{[40
]}

Goujard, C. ^{[44
]}

Duvivier, C. ^{[46
]}

Morlat, P. ^{[49
]}

Bani-Sadr, F. ^{[57
]}

Meyer, L.

Boufassa, F.

Dominguez, S.

Autran, B.

Roque, A. M.

Solas, C.

Fontaine, H.

Costagliola, D.

Piroth, L. ^{[55
]}

Simon, A. ^{[33
]}

Zucman, D. ^{[51
]}

Boue, F. ^{[52
]}

Miailhes, P. ^{[54
]}

Billaud, E. ^{[53
]}

机构：

[1] Bordeaux Univ, INSERM, Bordeaux Populat Hlth Res Ctr, ISPED,Team MORPH3EUS,UMR 1219, Bordeaux, France

[2] Bordeaux Univ Hosp Ctr, Pellegrin Hosp, Infect & Trop Dis Unit, Bordeaux, France

[3] UniveBordeaux Univ, Bordeaux, France

[4] Bordeaux Univ Hosp Ctr, St Andre Hosp, Internal Med Unit, Bordeaux, France

[5] Bordeaux Univ Hosp Ctr, Publ Hlth Pole, Med Informat Unit, Bordeaux, France

[6] Paris Descartes Univ, Cochin Hosp, Paris Publ Hosp, Pasteur Inst,Liver Unit,INSERM,U1223, Paris, France

[7] St Antonius Hosp, Paris Publ Hosp, Infect & Trop Dis Unit, Paris, France

[8] Pierre & Marie Curie Univ, UMR S1136, Pierre Louis Epidemiol & Publ Hlth Inst, Paris, France

[9] Tenon Hosp, Paris Publ Hosp Paris, Infect & Trop Dis Unit, Paris, France

[10] Univ Hosp Paris Sud, Bicetre Hosp, Paris Publ Hosp, Infect & Trop Dis Unit, Paris, France

[11] Paris Sud Univ, Paris, France

[12] Hop La Pitie Salpetriere, Paris Publ Hosp, Dept Internal Med & Clin Immunol, Paris, France

[13] St Louis Hosp, Paris Publ Hosp, Infect & Trop Dis Unit, Paris, France

[14] Bichat Claude Bernard Hosp, AP HP, Infect & Trop Dis Unit, Paris, France

[15] Cochin Hosp, Paris Publ Hosp, Infect & Trop Dis Unit, Paris, France

[16] Paris Descartes Univ, Paris, France

[17] Univ Hosp Ctr Lyon, Croix Rousse Hosp, Infect & Trop Dis Unit, Lyon, France

[18] Reg Hlth Observ Prov Alpes Cote dAzur, INSERM, IRD, U912 SE4S,UMR S912 ORS PACA, Marseille, France

[19] Aix Marseille Univ, APHM St Marguerite, Clin Immunohematol Unit, Marseille, France

[20] Perpignan Hosp Ctr, Infect & Trop Dis Unit, Perpignan, France

[21] Toulouse Univ Hosp Ctr, Purpan Hosp, Internal Med, Toulouse, France

[22] Toulouse III Univ, Toulouse, France

[23] Joseph Ducuing Hosp, Med Unit, Toulouse, France

[24] Toulouse Univ Hosp Ctr, Purpan Hosp, Gastroenterol & Hepatol Unit, Toulouse, France

[25] Dijon Univ Hosp Ctr, Dept Infectiol, Dijon, France

[26] Bourgogne Univ, Dijon, France

[27] Avicenne Hosp, Paris Publ Hosp, Infect & Trop Dis Unit, Bobigny, France

[28] Paris 13 Nord Univ, Bobigny, France

[29] Nice Univ Hosp Ctr, Infectiol Ctr, Archet 1 Hosp, Nice, France

[30] Nice Sophia Antipolis Univ, Nice, France

[31] APHP Cochin, Med Interne & Malad Infect, Paris, France

[32] APHP Pitie Salpetriere, Malad Infect & Trop, Paris, France

[33] APHM St Marguerite, Med Interne, Marseille, France

[34] APHP Tenon, Serv Immunohematol Clin, Paris, France

[35] CHU Purpan, Toulouse, France

[36] CHU Archet, Hepatogastroenterol, Nice, France

[37] APHP Avicenne, Med Interne, Bobigny, France

[38] APHP Avicenne, Infectiol, Bobigny, France

[39] Hop Joseph Ducuing, Med Interne Unite VIH, Toulouse, France

[40] APHP Bichat Claude Bernard, Med Interne, Paris, France

[41] APHP St Louis, Malad Infect, Paris, France

[42] APHP St Antoine, Malad Infect, Paris, France

[43] APHP Bicetre, Malad Infect & Trop, Paris, France

[44] APHP Necker, Med Interne, Paris, France

[45] APHP Necker, Malad Infect, Paris, France

[46] CHU Pellegrin, Malad Infect & Trop, Bordeaux, France

[47] Hop St Andre, Bordeaux Malad Infect & Trop, Bordeaux, France

[48] Hop St Andre, Virol, Bordeaux, France

[49] Hop Haut Leveque, Med Interne & Malad Infect, Bordeaux, France

[50] Hop Foch, Virol, Suresnes, France

来源：

EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY | 2019年 / 31卷 / 11期

关键词：

human immunodeficiency virus; hepatitis C virus co-infection; liver-related events; noninvasive markers; prediction; SIMPLE NONINVASIVE INDEX; TRANSIENT ELASTOGRAPHY; HEPATOCELLULAR-CARCINOMA; HIV; BIOPSY; INDIVIDUALS; MORTALITY; DIAGNOSIS; CIRRHOSIS; COINFECTION;

D O I：

10.1097/MEG.0000000000001408

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objectives HIV/hepatitis C virus (HCV) co-infection leads to major complications, and noninvasive markers developed to stage liver fibrosis could be used as prognostic markers. We aimed to compare the performances of liver stiffness (LS), fibrosis-4 (FIB-4), and aspartate aminotransferase to platelet ratio index (APRI) to predict liver-related events in HIV/HCV co-infected patients. Patients and methods HIV/HCV co-infected patients from the ANRS CO13 HEPAVIH cohort were included if they had LS, FIB-4, and APRI measurements done in a window of 3 months. Primary outcome was the time between inclusion and occurrence of a liver-related event. Univariable and multivariable Fine and Gray models were performed. Predictive performances were compared by the area under the receiver operating characteristic (AUROC) differences after correction of optimistic by bootstrap samples. Best cutoffs to predict liver-related events were estimated by sensitivity and specificity maximization. Results A total of 998 patients were included. Overall, 70.7% were men. Their median age was 46.8 years. According to LS value, 204 (20.4%) patients had cirrhosis. Overall, 39 patients experienced at least one liver-related event. In univariable analysis, LS AUROC curve was significantly superior to FIB-4 and APRI AUROC curves, being 87.9, 78.2, and 75.0%, respectively. After adjustment on age, CD4 levels, and insulin resistance, no differences were observed. The best cutoffs to identify patients at low or high risk of liver-related events were below 8.5, 1.00, and 0.35 and above 16.5, 4.00, and 1.75 for LS, FIB-4, and APRI, respectively. Conclusion To predict HCV-related events, APRI had lower performance than LS and FIB-4. FIB-4 is as good as LS to predict HCV-related events, suggesting that it can be used for the management of HIV/HCV co-infected patients and replace LS.

引用

页码：1387 / 1396

页数：10

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