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Enhanced liver fibrosis marker as a non-invasive predictor of mortality in HIV/HCV-coinfected women from the women's Interagency HIV study

Enhanced liver fibrosis marker as a non-invasive predictor of mortality in HIV/HCV-coinfected women from the women's Interagency HIV study
Enhanced liver fibrosis marker as a non-invasive predictor of mortality in HIV/HCV-coinfected women from the women's Interagency HIV study


Objective: Coinfection with hepatitis C virus (HCV) is a major cause of morbidity and mortality among individuals with HIV. Our objective was to assess the prognostic performance of noninvasive measures of liver fibrosis in predicting all-cause mortality in women with HIV/HCV coinfection.

Design: We studied HCV/HIV coinfected women enrolled in the prospective, multicenter Women's Interagency HIV Study. Aspartate aminotransferase to platelet ratio and FIB-4 were used to identify women without fibrosis at all visits and women who progressed to severe fibrosis.

Methods: Enhanced liver fibrosis (ELF), which utilizes direct measures of fibrosis, hyaluronic acid, procollagen III aminoterminal peptide and tissue inhibitor of matrix metalloproteinase was performed.

Results: Included were 381 women with 2296 ELF measurements, with mean follow-up 8.3?±?3.3 years. There were 134 deaths (60% with severe liver fibrosis). Receiver operator characteristic curves at fixed time windows prior to death or at end of follow-up showed that ELF was best at predicting mortality when tested within a year of death (area under the curve for ELF 0.85 vs. APRI 0.69, P?<?0.0001 and vs. FIB-4 0.75, P?=?0.0036); and 1–3 years prior (ELF 0.71 vs. APRI 0.61, P?=?0.005 and vs. FIB-4 0.65, P?=?0.06). Use of all three measures did not improve on ELF alone. In multivariate logistic regression models controlling for CD4+ cell count, HIV viral load, antiretroviral use and age, ELF continued to perform better than APRI and FIB-4.

Conclusion: ELF predicted all-cause mortality and was superior to APRI and FIB-4 in HIV/HCV coinfected women.
723-729
Peters, Marion G.
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Bacchetti, Peter
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Boylan, Ross
e6618110-3ac1-4512-9e17-100ebf1b8b6c
French, Audrey L.
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Tien, Phyllis C.
8125670d-a86a-4ac2-bfec-d4f88a37a2c6
Plankey, Michael W.
ac6b21aa-56d8-467d-a004-db1615c1824f
Glesby, Marshall J.
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Augenbraun, Michael
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Golub, Elizabeth T.
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Karim, Roksana
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Parkes, Julie
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Rosenberg, William
cea47565-06a3-4622-931c-aa5a7686865c
Peters, Marion G.
3e3f5449-af51-4c42-b95f-1bbbfb62a18f
Bacchetti, Peter
9ea638c0-1a8c-4608-b2b8-2d656ffbd300
Boylan, Ross
e6618110-3ac1-4512-9e17-100ebf1b8b6c
French, Audrey L.
146042ff-c52d-4570-8061-7a83b8d62291
Tien, Phyllis C.
8125670d-a86a-4ac2-bfec-d4f88a37a2c6
Plankey, Michael W.
ac6b21aa-56d8-467d-a004-db1615c1824f
Glesby, Marshall J.
1340e9e4-e423-46c1-8661-7848efb1f850
Augenbraun, Michael
bc365bc8-e372-4825-9022-7b5c1f8687c3
Golub, Elizabeth T.
5e98aea1-e97b-4626-a5a8-36e2de9f3887
Karim, Roksana
e1d3b3d1-c5c1-4140-9f64-92d836c5ca39
Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984
Rosenberg, William
cea47565-06a3-4622-931c-aa5a7686865c

Peters, Marion G., Bacchetti, Peter, Boylan, Ross, French, Audrey L., Tien, Phyllis C., Plankey, Michael W., Glesby, Marshall J., Augenbraun, Michael, Golub, Elizabeth T., Karim, Roksana, Parkes, Julie and Rosenberg, William (2016) Enhanced liver fibrosis marker as a non-invasive predictor of mortality in HIV/HCV-coinfected women from the women's Interagency HIV study. AIDS, 30 (5), 723-729. (doi:10.1097/QAD.0000000000000975). (PMID:26595542)

Record type: Article

Abstract



Objective: Coinfection with hepatitis C virus (HCV) is a major cause of morbidity and mortality among individuals with HIV. Our objective was to assess the prognostic performance of noninvasive measures of liver fibrosis in predicting all-cause mortality in women with HIV/HCV coinfection.

Design: We studied HCV/HIV coinfected women enrolled in the prospective, multicenter Women's Interagency HIV Study. Aspartate aminotransferase to platelet ratio and FIB-4 were used to identify women without fibrosis at all visits and women who progressed to severe fibrosis.

Methods: Enhanced liver fibrosis (ELF), which utilizes direct measures of fibrosis, hyaluronic acid, procollagen III aminoterminal peptide and tissue inhibitor of matrix metalloproteinase was performed.

Results: Included were 381 women with 2296 ELF measurements, with mean follow-up 8.3?±?3.3 years. There were 134 deaths (60% with severe liver fibrosis). Receiver operator characteristic curves at fixed time windows prior to death or at end of follow-up showed that ELF was best at predicting mortality when tested within a year of death (area under the curve for ELF 0.85 vs. APRI 0.69, P?<?0.0001 and vs. FIB-4 0.75, P?=?0.0036); and 1–3 years prior (ELF 0.71 vs. APRI 0.61, P?=?0.005 and vs. FIB-4 0.65, P?=?0.06). Use of all three measures did not improve on ELF alone. In multivariate logistic regression models controlling for CD4+ cell count, HIV viral load, antiretroviral use and age, ELF continued to perform better than APRI and FIB-4.

Conclusion: ELF predicted all-cause mortality and was superior to APRI and FIB-4 in HIV/HCV coinfected women.

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e-pub ahead of print date: 13 March 2016
Published date: 13 March 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 396570
URI: http://eprints.soton.ac.uk/id/eprint/396570
PURE UUID: 03fda4e7-4b52-4f9e-a81b-9246b6518783
ORCID for Julie Parkes: ORCID iD orcid.org/0000-0002-6490-395X

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Date deposited: 13 Jun 2016 10:57
Last modified: 18 Feb 2021 16:51

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Contributors

Author: Marion G. Peters
Author: Peter Bacchetti
Author: Ross Boylan
Author: Audrey L. French
Author: Phyllis C. Tien
Author: Michael W. Plankey
Author: Marshall J. Glesby
Author: Michael Augenbraun
Author: Elizabeth T. Golub
Author: Roksana Karim
Author: Julie Parkes ORCID iD
Author: William Rosenberg

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