2007
Al-Mohri, Huda; Murphy, Tanya; Lu, Ying; Lalonde, Richard G.; Klein, Marina B.
Evaluating liver fibrosis progression and the impact of antiretroviral therapy in HIV and Hepatitis C coinfection using a noninvasive marker Journal Article
In: JAIDS, vol. 44, no. 4, pp. 463-469, 2007.
Abstract | Links | BibTeX | Tags: Alanine aspartyl transferase-to-platelet ratio index, Antiretroviral therapy, HCV, Hepatic Fibrosis, HIV
@article{Al-Mohri2007,
title = {Evaluating liver fibrosis progression and the impact of antiretroviral therapy in HIV and Hepatitis C coinfection using a noninvasive marker},
author = {Huda Al-Mohri and Tanya Murphy and Ying Lu and Richard G. Lalonde and Marina B. Klein},
url = {https://www.ncbi.nlm.nih.gov/pubmed/17211282},
doi = {10.1097/QAI.0b013e318030ff8e},
year = {2007},
date = {2007-04-01},
journal = {JAIDS},
volume = {44},
number = {4},
pages = {463-469},
abstract = {The effects of highly active antiretroviral therapy (HAART) on progression of hepatic fibrosis in hepatitis C virus (HCV) coinfection with HIV are not well understood and are difficult to measure because of the need for repeated liver biopsy. We evaluated the evolution of a noninvasive measure of liver fibrosis, the alanine aspartyl transferase (AST)-to-platelet ratio index (APRI), longitudinally and determined its predictive value for hepatic outcomes in HIV-positive patients with and without HCV coinfection. A total of 673 HIV-positive patients without liver complications at baseline (540 with HIV only, 133 with HIV-HCV coinfection) were followed between 1991 and 2004 for a median of 4.6 years (3524 person-years). At baseline, HIV-HCV coinfection had a higher median APRI compared with HIV infection alone (0.59 vs. 0.33; P < 0.0001). The natural logarithm of the APRI [ln(APRI)] changed significantly over time, particularly among patients with HIV-HCV coinfection. The baseline ln(APRI) was predictive of liver complications (hazard ratio [HR] = 4.0, 95% confidence interval [CI]: 2.5 to 6.4 per log), as was HCV (HR = 4.5, 95% CI: 1.5 to 14). Cumulative HAART did not protect against liver complications, although it was significantly associated with progression of APRI scores in HIV-HCV coinfection and in HIV alone. In conclusion, the APRI may be a useful marker for longitudinal evaluation of the progression of liver disease in HIV-HCV coinfection.},
keywords = {Alanine aspartyl transferase-to-platelet ratio index, Antiretroviral therapy, HCV, Hepatic Fibrosis, HIV},
pubstate = {published},
tppubtype = {article}
}
The effects of highly active antiretroviral therapy (HAART) on progression of hepatic fibrosis in hepatitis C virus (HCV) coinfection with HIV are not well understood and are difficult to measure because of the need for repeated liver biopsy. We evaluated the evolution of a noninvasive measure of liver fibrosis, the alanine aspartyl transferase (AST)-to-platelet ratio index (APRI), longitudinally and determined its predictive value for hepatic outcomes in HIV-positive patients with and without HCV coinfection. A total of 673 HIV-positive patients without liver complications at baseline (540 with HIV only, 133 with HIV-HCV coinfection) were followed between 1991 and 2004 for a median of 4.6 years (3524 person-years). At baseline, HIV-HCV coinfection had a higher median APRI compared with HIV infection alone (0.59 vs. 0.33; P < 0.0001). The natural logarithm of the APRI [ln(APRI)] changed significantly over time, particularly among patients with HIV-HCV coinfection. The baseline ln(APRI) was predictive of liver complications (hazard ratio [HR] = 4.0, 95% confidence interval [CI]: 2.5 to 6.4 per log), as was HCV (HR = 4.5, 95% CI: 1.5 to 14). Cumulative HAART did not protect against liver complications, although it was significantly associated with progression of APRI scores in HIV-HCV coinfection and in HIV alone. In conclusion, the APRI may be a useful marker for longitudinal evaluation of the progression of liver disease in HIV-HCV coinfection.
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