Non-invasive assessment of liver steatosis and fibrosis in HIV/HCV- and HCV- infected patients



Título del documento: Non-invasive assessment of liver steatosis and fibrosis in HIV/HCV- and HCV- infected patients
Revue: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000415640
ISSN: 1665-2681
Autores: 1
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Instituciones: 1Universita di Palermo, Dipartimento Biomedico di Medicina Interna, Palermo, Sicilia. Italia
2Universita di Palermo, Dipartimento di Scienze delle Promozione della Salute, Palermo, Sicilia. Italia
3Policlinico Paolo Giaccone-Palermo, Sezione di Malattie Infettive, Palermo, Sicilia. Italia
4University of Pittsburgh Medical Center, Mediterranean Institute for Transplantation and Advanced Specialized Therapies, Palermo, Sicilia. Italia
Año:
Periodo: Sep-Oct
Volumen: 12
Número: 5
Paginación: 740-748
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés Conflicting data have been reported on the prevalence of liver steatosis, its risk factors and its relationship with fibrosis in patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infection or with HCV mono-infection. Aim. The study aims were to assess steatosis prevalence and its risk factors in both HCV groups. We also evaluated whether steatosis was linked with advanced fibrosis. Sixty-eight HIV/HCV co-infected and 69 HCV mono-infected patients were consecutively enrolled. They underwent liver ultrasonography and transient elastography. Bright liver echo-pattern was used to diagnose steatosis; advanced fibrosis was defined as liver stiffness ≥ 9.5 kPa and FIB-4 values ≥ 3.25. The optimal stiffness cut-off according to FIB-4 ≥ 3.25 was evaluated by ROC analysis. Results. No significant difference was found in steatosis-prevalence between mono- and co-infected patients (46.3 vs. 51.4%). Steatosis was associated with triglycerides and impaired fasting glucose/diabetes in HCV mono-infected, with lipodystrophy, metabolic syndrome, total-cholesterol and triglycerides in co-infected patients. Stiffness ≥ 9.5 was significantly more frequent in co-infection (P < 0.003). Advanced fibrosis wasn’t significantly associated with steatosis. The area under the ROC curve was 0.85 (95% CI 0.79-0.9). On multivariate analysis steatosis was associated with triglycerides in both HCV mono- and co-infected groups (P < 0.02; P < 0.03). Conclusion. Although steatosis was common in both HCV mono- and co-infected patients, it was not linked with advanced fibrosis. Triglycerides were independent predictors of steatosis in either of the HCV-groups. Dietary interventions and lifestyle changes should be proposed to prevent metabolic risk factors
Disciplinas: Medicina
Palabras clave: Diagnóstico,
Gastroenterología,
VIH,
Virus de la hepatitis C,
Fibrosis hepática,
Esteatosis,
Elastografía transitoria
Keyword: Medicine,
Diagnosis,
Gastroenterology,
HIV,
Hepatitis C virus,
Liver fibrosis,
Steatosis,
Transient elastography
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