OBJECTIVES: Noninvasive markers of liver fibrosis correlate with the stage of liver fibrosis, but have not been widely applied to predict liver-related mortality. METHODS: We assessed the ability of two indices of liver fibrosis, aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and Fib-4, and two markers of extracellular matrix metabolism, hyaluronic acid (HA) and YKL40, to predict liver mortality in a prospective cohort of hepatitis C virus (HCV)-infected individuals with and without HIV coinfection. These were compared with two established prognostic scores, the Child-Pugh-Turcotte (CPT) and model of end-stage liver disease (MELD) scores. RESULTS: A total of 303 subjects, of whom 207 were HIV positive at study entry, were followed up for a mean period of 3.1 years. There were 33 deaths due to liver disease. The ability of each test and score to predict 3-year liver mortality was expressed as the area under the receiver operator curve. The area under the receiver operator curve 95% confidence intervals were: HA 0.92 (0.86-0.96), CPT 0.91 (0.79-0.96), APRI 0.88 (0.80-0.93), Fib-4 0.87 (0.77-0.92), MELD 0.84 (71-0.91). In multivariate analyses HA, APRI, and fib-4 were independent predictors of mortality when included in models with MELD or CPT. CONCLUSION: Noninvasive markers of liver fibrosis are highly predictive of liver outcome in HCV-infected individuals with and without HIV coinfection. These markers seem to have a prognostic value independent of CPT and MELD.
OBJECTIVES: Noninvasive markers of liver fibrosis correlate with the stage of liver fibrosis, but have not been widely applied to predict liver-related mortality. METHODS: We assessed the ability of two indices of liver fibrosis, aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and Fib-4, and two markers of extracellular matrix metabolism, hyaluronic acid (HA) and YKL40, to predict liver mortality in a prospective cohort of hepatitis C virus (HCV)-infected individuals with and without HIV coinfection. These were compared with two established prognostic scores, the Child-Pugh-Turcotte (CPT) and model of end-stage liver disease (MELD) scores. RESULTS: A total of 303 subjects, of whom 207 were HIV positive at study entry, were followed up for a mean period of 3.1 years. There were 33 deaths due to liver disease. The ability of each test and score to predict 3-year liver mortality was expressed as the area under the receiver operator curve. The area under the receiver operator curve 95% confidence intervals were: HA 0.92 (0.86-0.96), CPT 0.91 (0.79-0.96), APRI 0.88 (0.80-0.93), Fib-4 0.87 (0.77-0.92), MELD 0.84 (71-0.91). In multivariate analyses HA, APRI, and fib-4 were independent predictors of mortality when included in models with MELD or CPT. CONCLUSION: Noninvasive markers of liver fibrosis are highly predictive of liver outcome in HCV-infected individuals with and without HIV coinfection. These markers seem to have a prognostic value independent of CPT and MELD.
Authors: Heidi M Crane; Robin M Nance; Susan R Heckbert; Corey Ritchings; Lisa Rosenblatt; Matthew Budoff; Brian R Wood; David L Tirschwell; H Nina Kim; William C Mathews; Elvin Geng; Richard D Moore; Peter W Hunt; Joseph J Eron; Greer A Burkholder; Daniel R Drozd; Felicia C Chow; Kyra J Becker; Joseph R Zunt; Emily L Ho; Rizwan Kalani; Andrew Huffer; Bridget M Whitney; Michael S Saag; Mari M Kitahata; Joseph A C Delaney Journal: J Acquir Immune Defic Syndr Date: 2019-08-15 Impact factor: 3.731
Authors: Joseph K Lim; Janet P Tate; Shawn L Fultz; Joseph L Goulet; Joseph Conigliaro; Kendall J Bryant; Adam J Gordon; Cynthia Gibert; David Rimland; Matthew Bidwell Goetz; Marina B Klein; David A Fiellin; Amy C Justice; Vincent Lo Re Journal: Clin Infect Dis Date: 2014-02-25 Impact factor: 9.079
Authors: Daniel Fuster; Judith I Tsui; Debbie M Cheng; Emily K Quinn; Kaku A Armah; David Nunes; Matthew S Freiberg; Jeffrey H Samet Journal: AIDS Res Hum Retroviruses Date: 2013-05-17 Impact factor: 2.205