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Comparison of transient elastography, APRI, FORNS, and FIB-4 for the assessment of liver fibrosis in HIV/HCV-coinfected patients M Sánchez-Conde 1 , M Montes-Ramírez 2 , JM Bellón 1 , JM Castro Alvarez 2 , M Ramírez 1 , JR Arribas Lopez 2 , I Gutiérrez 1 , P Miralles 1 , E Alvarez 1 ,
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Comparison of transient elastography, APRI, FORNS, and FIB-4 for the assessment of liver fibrosis in HIV/HCV-coinfected patients
M Sánchez-Conde1, M Montes-Ramírez2, JM Bellón1, JM Castro Alvarez2, M Ramírez1, JR Arribas Lopez2, I Gutiérrez1, P Miralles1, E Alvarez1,
J González-Garcia2, and J Berenguer1. 1Hospital Gregorio Marañón, Madrid, Spain, 2Hospital La Paz, Madrid, Spain. [email protected]
OBJECTIVES: To determine the diagnostic accuracy of TE in predicting fibrosis in HIV/HCV-coinfected patients, and to compare it with published non-invasive serum markers.
Fibrosis Score (METAVIR)
Table 1: characteristics and the distribution for fibrosis stage and activity grade
Liver stiffness measurements ranged from 2.7 to 43.5 kPa. The median (IQR) of liver stiffness according to the different stages of fibrosis (in kPa) was as follows: F0, 4.9 (4.1-6.5); F1, 6.1 (5.3-8.6); F2, 8.4 (5.8-10.5); F3, 11.9 (8.8-16.6); and F4, 31.4 (22.5-40.3) (Fig.1)
We assessed the diagnostic accuracy of TE for different categories of fibrosis. Based on the AUROC curves, three cut-off values were chosen to identify F≤1 (<7 kPa), F≥3 (≥ 11.5 kPa), and F4 (≥ 14 kPa). Table 2.
Table 2: Accuracy of transient elastography for fibrosis staging
Abbreviations: NLR, NPV, negative predictive value; PLR, PPV, positive predictive value.
Figure 1: Median (IQR) liver stiffness according to the different stages of fibrosis
*N and percentage **Median and IQR
Table 3: AUROCs for non-invasive markers and transient elastography for the diagnosis of advanced fibrosis.
TE accurately identified patients with advanced liver fibrosis and cirrhosis, and patients with mild fibrosis
We found that TE outperformed other noninvasive indexes in the diagnosis of liver fibrosis in HIV/HCV-coinfected patients.
Our results suggest that TE is a safe, rapid, and accurate tool that can help guide treatment decisions in HIV/HCV-coinfected patients.
Figure 2: AUROCs for non-invasive markers and transient elastography for the diagnosis of advanced fibrosis.