Prediction of Liver Complications in Patients With Hepatitis C Virus-Related Cirrhosis With and Without HIV Coinfection: Comparison of Hepatic Venous Pressure Gradient and Transient Elastography

Pérez‐Latorre, Leire; Sánchez-Conde, Matilde; Rincón, Diego; Miralles, Pilar; Aldámiz‐Echevarría, Teresa; Carrero, Ana; Tejerina, Francisco; Díez, Cristina; Bellón, José María; Bañares, Rafael; Berenguer, Juan

doi:10.1093/cid/cit768

Cited by 36 publications

(24 citation statements)

References 32 publications

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“…Our results are largely consistent with those of Pérez-Latorre et al [14], which also confirm an excellent correlation between the value of the hepatic venous pressure gradient and LSM. The authors report 2 cut-offs for predicting absence of liver events (<25 kPa) and presence of liver events (>40 kPa) (first to occur of decompensation or HCC).…”

Section: Prior Studies Of Lsm For Predicting Liver Eventssupporting

confidence: 93%

“…This study also showed for the first time that LSM has proven very useful for predicting the development of HCC [14].…”

Section: Introductionmentioning

confidence: 55%

“…These new data are from very different patient populations, whose liver disease had diverse etiologies and characteristics. HIV coinfection is one of the areas where new evidence is similar to that reported for non-HIV-infected persons [9,[12][13][14]18].…”

Section: Introductionmentioning

confidence: 75%

“…We believe this difference is due to the characteristics of the study patients [12][13][14]. The patients analyzed had liver cirrhosis caused by long-standing viral hepatitis.…”

Section: Lsm<25 Lsm ≥ 25mentioning

confidence: 97%

“…Despite its small sample size, our study has features that add particular interest with respect to other published studies [12][13][14]. First, patients with a sustained virological response to hepatitis C were excluded.…”

Section: Lsm<25 Lsm ≥ 25mentioning

confidence: 99%

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Transient Elastography for Predicting Liver-Related Events in Cirrhotic HIV-Infected Patients

Montes¹,

Berenguer²,

Jm³

et al. 2017

J AIDS Clin Res

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Aim : We assessed liver stiffness measurement (LSM) for the prediction of mortality and decompensation in HIVinfected patients with compensated liver cirrhosis. Method:A prospective cohort study of HIV-infected patients with confirmed liver cirrhosis from 9 hospitals in Spain. LSM was undertaken for each patient; clinical events were collected prospectively after the baseline visit, and patients were followed until death or the censoring date. We used univariate/multivariate Cox proportional hazard models to evaluate the utility of LSM for predicting the first hepatic decompensation or overall mortality. The sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+) and negative likelihood ratio (LR-) were calculated. The LSM cutoff was selected using ROC curves. Results:We included 102 patients with compensated liver cirrhosis; median [interquartile, (IQR)] follow-up was 36 (21-46) months, median (IQR) CD4+ cell count was 415 cells/μL (307-624) and 94% were receiving antiretroviral therapy. The median (IQR) LSM was 17 kPa (11.7-26). Nineteen events were recorded during follow-up. Multivariate analysis showed that time to hepatic decompensation was associated with CD4+ <200 cells/μL (HR, 26; 95% CI, 1.8-377; p<0.02) and LSM ≥ 25 kPa (HR, 7.2; 95% CI, 1.1-47; p=0.04) and that time to overall mortality was associated with LSM ≥ 25 kPa (HR, 14.3; 95% CI, 1.5-138; p=0.02). The predictive values for decompensation (LSM ≥ 25 kPa) were as follows: SEN, 67%; SPE, 78%; NPV, 96%; PPV, 23%; LR+, 3; LR-, 0.4. The predictive values for overall mortality with this LSM cutoff were as follows: SEN, 86%; SPE, 79%; NPV, 99%; PPV, 23%; LR+, 4; LR-, 0.2. Conclusion:Our data suggest that LSM is an accurate method for the prediction of mortality and decompensation in HIV-infected patients with liver cirrhosis.

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Section: Prior Studies Of Lsm For Predicting Liver Eventssupporting

confidence: 93%

“…This study also showed for the first time that LSM has proven very useful for predicting the development of HCC [14].…”

Section: Introductionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 75%

“…We believe this difference is due to the characteristics of the study patients [12][13][14]. The patients analyzed had liver cirrhosis caused by long-standing viral hepatitis.…”

Section: Lsm<25 Lsm ≥ 25mentioning

confidence: 97%

Section: Lsm<25 Lsm ≥ 25mentioning

confidence: 99%

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