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. 2021 May-Jun;25(3):101589.
doi: 10.1016/j.bjid.2021.101589. Epub 2021 Jun 18.

Assessment of liver disease by non-invasive methods in perinatally infected Brazilian adolescents and young adults living with Human Immunodeficiency Virus (HIV)

Aida de Fátima Thomé Barbosa Gouvêa  1 , Roberto Carvalho Filho  2 , Daisy Maria Machado  3 , Fabiana Bononi do Carmo  3 , Suenia Vasconcelos Beltrão  3 , Laurene Sampaio  3 , Maria Isabel de Moraes-Pinto  3 , Regina Célia de Menezes Succi  3
Affiliations

Assessment of liver disease by non-invasive methods in perinatally infected Brazilian adolescents and young adults living with Human Immunodeficiency Virus (HIV)

Aida de Fátima Thomé Barbosa Gouvêa et al. Braz J Infect Dis. 2021 May-Jun.

Abstract

Introduction: Effective and long-term combined antiretroviral therapy (cART) has decreased morbidity and mortality in HIV-infected individuals. Despite treatment advances, HIV-infected children continue to develop noninfectious conditions, including liver fibrosis.

Methods: Cross-sectional study designed to identify liver fibrosis in HIV-infected adolescents and young adults, in an outpatients clinic of Pediatric Infectious Diseases Division at Escola Paulista de Medicina/Universidade Federal de São Paulo (UNIFESP), diagnosed by noninvasive methods (liver elastography-FibroScan®, APRI and FIB4). Variables examined included demographics, clinical, laboratories, HIV treatment. All participants underwent FibroScan® to measure liver parenchyma elasticity. Values equal to above 7.0 kPa were interpreted as the presence of significant liver fibrosis. Two different biomarkers of liver fibrosis were employed: the AST-to-Platelet Ratio Index (APRI) and the Fibrosis-4 score (FIB-4). APRI values above 1.5 have been considered as levels of clinically significant liver fibrosis and FIB-4 values above 3.25 suggested the presence of advanced fibrosis.

Results: Between August 2014 and March 2017, the study enrolled 97 patients, age 10-27 years old, fourteen of 97 subjects (14.4%) presented liver stiffness (≥7 kPa) detected by the liver elastography. No patient had APRI> 1.5. No patient had FIB4 value > 3.25. The only isolated laboratory parameter that could be significantly associated with high liver stiffness was thrombocytopenia (p = 0.022, Fisher's exact test).

Conclusion: Liver stiffness was identified in 14.4% (14/97) of this cohort by liver elastography. Liver disease in HIV-infected adolescents and young adults manifests itself silently, so should be routinely investigated.

Keywords: AIDS; Adolescents; HIV; Hepatic fibrosis; Liver stiffness; Transient hepatic elastography; Vertical transmission.

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Conflict of interest statement

Conflicts of interest The authors declare no conflicts of interest.

References

    1. Nesheim S.R., Hardnett F., Wheeling J.T., Siberry G.K., Paul M.E., Emmanuel P., Bohannon B., Dominguez K. Incidence of opportunistic illness before and after initiation of highly active antiretroviral therapy in children. Pediatr Infect Dis J. 2013;32(10):1089–1095. LEGACY Consortium. - PMC - PubMed
    1. Prendergast A.J. Complications of long-term antiretroviral therapy in HIV-infected children. ArchDisChild. 2013;98(4):245–246. - PubMed
    1. Crane M., Iser D., Lewin S.R. Human immunodeficiency virus infection and the liver. World J Hepatol. 2012;4:91–98. - PMC - PubMed
    1. Debes J.D., Bohjanen P.R., Boonstra A. Mechanisms of accelerated liver fibrosis progression during HIV infection. J ClinTranslHepatol. 2016;4(4):328–335. - PMC - PubMed
    1. Giacomet V., Viganò A., Penagini F., Manfredini V., MaconiG C.M, Zuccotti G.V. Splenomegaly and variceal bleeding in a ten-year-old HIV-infected girl with noncirrhotic portal hypertension. Pediatr Infect Dis J. 2012;31:1059–1060. - PubMed