Use of Non-invasive Testing to Stage Liver Fibrosis in Patients with HIV
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- 作者：Bassem Matta ; Tzu-Hao Lee ; Keyur Patel
- 关键词：Liver fibrosis ; Biomarkers ; Transient elastography ; HIV ; hepatitis C ; HIV ; hepatitis B ; HIV non ; alcoholic fatty liver disease
- 刊名：Current HIV/AIDS Reports
- 出版年：2016
- 出版时间：October 2016
- 年：2016
- 卷：13
- 期：5
- 页码：279-288
- 全文大小：363 KB
- 刊物主题：Medicine/Public Health, general;
- 出版者：Springer US
- ISSN：1548-3576
- 卷排序：13
文摘
Patients with HIV have a proclivity to develop liver fibrosis, especially when associated with other conditions such as HCV, HBV, and NAFLD. Identifying HIV-infected patients with significant fibrosis or cirrhosis plays an important role in clinical and therapeutic decision-making. Liver biopsy is currently considered as the gold standard for fibrosis assessment but carries many shortcomings (cost, invasiveness, complications, false negative rate of 20 %). Multiple non-invasive methods of liver fibrosis assessment have been developed, but not all have been studied in HIV-infected individuals. Non-invasive liver fibrosis tools include both serologic-based testing scores (rely on direct and/or indirect markers) such as APRI, FIB4, FibroTest, FibroSpect II, HepaScore, or imaging-based methods such as vibration controlled liver elastography. There is validated data to support the use of non-invasive modalities of fibrosis assessment in HIV-HCV co-infected individuals for the exclusion of cirrhosis, but may be poorly reliable or not enough data exists for the assessment of other co-morbid disease processes.