Cross-sectional study to determine prevalence of significant liver fibrosis (F2–F4) in HIV/HCV co-infected patients: GRAFIHCO study

Tural, Cristina; Ortega, Enrique; Pineda, JA; González‐García, Juan; Griffa, L; Cabrero, Esther; Burgos, Aurora

doi:10.1186/1758-2652-11-s1-p264

Cited by 3 publications

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“…The GRAFIHCO study was a cross-sectional multicenter retrospective survey, carried out from January 2007 to February 2008. It was aimed to assess the prevalence of significant fibrosis, as measured by the AST to platelet ratio index (APRI) and the Forns index in a large population of HIV/HCV-coinfected patients in Spain [14]. The study included 8829 HIV/ HCV-coinfected patients followed in 95 health care facilities from Spain, with at least one visit in the previous year and available data to calculate the APRI and Forns indices (age, AST, GGT, platelet count and total cholesterol).…”

Section: Study Design and Patientsmentioning

confidence: 99%

Prevalence and factors associated with significant liver fibrosis assessed by transient elastometry in HIV/hepatitis C virus-coinfected patients

Pineda

González

Ortega

et al. 2009

Journal of Viral Hepatitis

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Transient elastometry (TE) could provide a more accurate evaluation of the frequency and risk factors of liver fibrosis in hepatitis C virus (HCV) infection than that based on biopsy. The aim of this study was to assess the prevalence of and factors associated with significant liver fibrosis in a large population of HIV/HCV-coinfected patients. HIV/HCV-coinfected patients, who had participated in a cross-sectional, multicenter, retrospective study of liver fibrosis using noninvasive markers and in whom a determination of liver stiffness (LS) by TE was available, were included in this analysis. Factors potentially associated with significant fibrosis (LS ≥ 9 kPa) were analyzed. One thousand three hundred and ten patients fulfilled the inclusion criteria, 526 (40%) of them showed LS ≥ 9 kPa and 316 (24%) cirrhosis (LS ≥ 14 kPa). The factors independently associated with significant fibrosis [adjusted odds ratio (95% confidence interval, P value) were the following: older age [1.04 (1.01-1.07), 0.002], daily alcohol intake > 50 g/day [1.58 (1.10-2.27), 0.013] and the length of HCV infection [1.03 (1.00-1.06), 0.023]]. A CD4 cell count lower than < 200 per mm(3) [1.67 (0.99-2.81), 0.053] and HCV genotype 4 [0.66 (0.42-1.02), 0.066] were marginally associated with LS ≥ 9 kPa. In conclusion, the prevalence of cirrhosis in HIV/HCV-coinfected patients seems to be higher than previously reported in studies based on liver biopsy. Older age, alcohol consumption and lower CD4 cell counts are related with significant fibrosis. The latter association supports an earlier starting of antiretroviral therapy in this setting.

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Section: Study Design and Patientsmentioning

confidence: 99%

Prevalence and factors associated with significant liver fibrosis assessed by transient elastometry in HIV/hepatitis C virus-coinfected patients

Pineda

González

Ortega

et al. 2009

Journal of Viral Hepatitis

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“…The aim of the study was to evaluate the prevalence of liver fibrosis using simple noninvasive blood tests. Eligible patients were those coinfected with HIV and HCV who had available data recorded at their last clinical visit for calculation of the APRI and the FI [20]. Clinical, biochemical and haematological data were collected from databases or the records of the patients at each centre.…”

Section: Methodsmentioning

confidence: 99%

Use of simple noninvasive biomarkers to predict liver fibrosis in HIV/HCV coinfection in routine clinical practice

et al. 2010

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Simple noninvasive tests to predict fibrosis, as an alternative to liver biopsy (LB), are needed. Of these, the aspartate aminotransferase (AST) to platelet ratio index (APRI) and the Forns index (FI) have been validated in HIV/hepatitis C virus (HCV) coinfection. However, these indexes may have lower diagnostic value in situations other than the circumscribed conditions of validation studies. We therefore examined the value of the APRI and FI in HIV/HCV-coinfected patients for the detection of significant fibrosis in real-life conditions. Patients and methodsHIV/HCV-coinfected patients who had participated in a multicentre cross-sectional retrospective study were selected if they had undergone an LB within 24 months before the last visit. The predictive accuracy of the APRI and FI was measured using the areas under receiver-operatingcharacteristic curves (AUROCs). Diagnostic accuracy was determined using the positive (PPV) and negative (NPV) predictive values. ResultsA total of 519 coinfected individuals were included in the study. The AUROC [95% confidence interval (95% CI)] of the APRI was 0.67 (0.66-0.71) and that of the FI was 0.67 (0.62-0.71). The PPV of the APRI was 79% and its NPV was 66%. The PPV of the FI was 74% and its NPV was 64%. LB length was available and was ! 15 mm in 120 individuals. In this group, the PPV of the APRI was 85%, and that of the FI was 81%. Using these indexes, 22% of patients could be spared LB. Applying both models sequentially, 30% of patients could be spared LB. ConclusionsIn HIV/HCV-coinfected patients, the diagnostic accuracy of the APRI in real-life conditions was similar to that in the validation studies. The FI performed less well. However, combining the two indexes to make decisions on anti-HCV therapy may prevent a significant proportion of patients from having to undergo LB.

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Evaluación económica de la elastografía de transición (FibroScan®) en el diagnóstico de fibrosis hepática en pacientes con hepatitis C coinfectados con VIH

García-Jurado

Oyagüez

Tural

et al. 2012

Enfermedades Infecciosas y Microbiología Clínica

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Cross-sectional study to determine prevalence of significant liver fibrosis (F2–F4) in HIV/HCV co-infected patients: GRAFIHCO study

Cited by 3 publications

References 0 publications

Prevalence and factors associated with significant liver fibrosis assessed by transient elastometry in HIV/hepatitis C virus-coinfected patients

Prevalence and factors associated with significant liver fibrosis assessed by transient elastometry in HIV/hepatitis C virus-coinfected patients

Use of simple noninvasive biomarkers to predict liver fibrosis in HIV/HCV coinfection in routine clinical practice

Evaluación económica de la elastografía de transición (FibroScan®) en el diagnóstico de fibrosis hepática en pacientes con hepatitis C coinfectados con VIH

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