Aspartate transaminase–platelet ratio and Fibrosis‐4 indices as effective markers for monitoring esophageal varices in HIV/hepatitis C virus co‐infected patients due to contaminated blood products for hemophilia

Aim We aimed to compare the well‐established liver fibrosis (LF) markers in Japanese patients with chronic hepatitis B (CHB, n = 331) and chronic hepatitis C (CHC, n = 886) and to discuss possible causes of differences in results between CHB patients and CHC patients. Methods Virtual touch quantification (VTQ) in acoustic radiation force impulse, Fibrosis‐4 (Fib‐4) index, aspartate aminotransferase to platelet ratio index (APRI), and hyaluronic acid (HA) were compared between the two cohorts. As an additional investigation, total collagen proportional area (TCPA, %) was tested using liver pathological samples (n = 83). Results Significant LF (F2 or greater) and advanced LF (F3 or greater) were identified in 153 (46.2%) and 76 (23.0%) patients in the CHB cohort and 579 (65.3%) and 396 (44.7%) patients in the CHC cohort. The median VTQ, Fib‐4 index, APRI, and HA values in the CHB cohort were 1.20 m/s, 1.36, 0.44, and 25 ng/mL; those in the CHC cohort were 1.32 m/s, 2.60, 0.74, and 65.5 ng/mL (P‐values, all <0.0001). Similar tendencies were noted by F stage‐based stratification. The median TCPA in the CHB cohort and the CHC cohort were 8.5% and 12.7% (P < 0.0006). The TCPA values in the CHC cohort were higher than those in the CHB cohort regardless of LF stage. Conclusion Values of LF markers in CHB patients can differ from those in CHC patients even in the same LF stage. Difference in total amount of collagen fiber in CHB and CHC appears to be linked to the difference.

Section: Introductionmentioning

confidence: 99%

Liver fibrosis markers as assessed by ultrasound elastography and serum samples: A large comparative study in hepatitis virus B and C liver diseases

Nishimura

Iijima

Nishikawa

et al. 2019

“…reported that the APRI and FIB‐4 score are effective to detect esophageal varices in HIV/HCV coinfection . They concluded that even though a patient is apparently doing well with good liver function as Child–Pugh grade A, their physician should consider consulting a hepatologist to rule out esophageal varices when the patient shows high APRI/FIB‐4 values . Furthermore, Yoshimoto et al .…”

Section: Discussionmentioning

confidence: 99%

Wisteria floribunda agglutinin‐positive human Mac‐2‐binding protein as a predictive marker of liver fibrosis in human immunodeficiency virus/hepatitis C virus coinfected patients

Takatsuki

Yamasaki

Natsuda

et al. 2020

Self Cite

Aim: In human immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfected patients, the progression of liver failure is reported to be more aggressive than that in HCV monoinfected patients. Wisteria floribunda agglutinin-positive human Mac-2-binding protein (WFA + -M2BP) is well recognized as a liver fibrosis glycobiomarker with a unique fibrosis-related glycoalteration. We analyzed HIV/HCV coinfected patients' M2BP levels as a possible marker for predicting liver fibrosis.Methods: M2BP was measured in 31 HIV/HCV coinfected patients, and we analyzed the correlation between WFA + -M2BP and several markers of fibrosis, liver function, and tumor markers. We compared the WFA + -M2BP levels in HIV/HCV coinfected patients with those of HCV mono-infected patients by performing a propensity score matching analysis.Results: In the HIV/HCV coinfected patients, the serum level of WFA + -M2BP was well correlated with the markers type IV collagen, hyaluronic acid, and alpha-fetoprotein, but not protein induced by vitamin K absence-II. In the propensity score matching with HCV mono-infected patients, the WFA + -M2BP levels were significantly higher in the HIV/HCV coinfected patients compared with the levels in the HCV mono-infected patients. Conclusion:In conclusion, WFA + -M2BP might be a feasible predictive marker of fibrosis in HIV/HCV coinfected patients.

“…In fact, it is known that compensated cirrhosis in co‐infected patients may progress rapidly to decompensated liver cirrhosis (liver failure) by an episode of liver encephalopathy, 7 and difficulties when LT is considered involve judgment of the timing of surgery as well as perioperative management 8 . In view of the current situation as mentioned above, our research group has examined the liver function of the co‐infected patients from various viewpoints and suggested inclusion criteria for DDLT 9,10 …”

Section: Introductionmentioning

confidence: 99%

Indications and waiting list priority for deceased donor liver transplantation in HIV/HCV co‐infected hemophilic patients in Japan through contaminated blood product

Eguchi

Egawa

Eguchi

et al. 2021

Self Cite

HIV/HCV co‐infection from blood products for hemophilia has been a social problem in Japan. Liver transplantation (LT) is an important treatment option for hepatic failure and cirrhosis of the liver in co‐infected patients, and appropriate indications for LT, especially organ form deceased donors, are required by society. The aim is to propose priority status for the waiting list for deceased donor (DD) LT in HIV/HCV co‐infected patients in Japan based on medical and scientific considerations. Since 2009, we have been working on the subject in research projects under grants‐in‐aid for health and labour sciences research on AIDS measures provided by the Ministry of Health, Labour and Welfare (the Kanematsu project and Eguchi project). Our research showed that hepatic fibrosis is advanced in HIV/HCV co‐infected Japanese patients, especially those with hemophilia who became infected from blood products at a faster rate than HCV mono‐infected patients. In addition, those patients who developed portal hypertension had a poor prognosis at a young age. The results of our research contributed to increasing the priority score of those patients on the deceased donor liver transplantation (DDLT) waiting list in 2013 and to establishing a scoring system for DDLT corresponding to the Model for End‐stage Liver disease (MELD) score in 2019. This paper introduces changes in priority and the current state of priority of the DDLT waiting list for HIV/HCV co‐infected patients in Japan.