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. 2021 Dec 22;12(1):14.
doi: 10.3390/diagnostics12010014.

Discordant Liver Fibrosis Predictors in Virologically Suppressed People Living with HIV without Hepatitis Virus Infection

Barbara Rossetti  1 , Valentina Borgo  1   2 , Arianna Emiliozzi  2 , Marta Colaneri  3 , Giacomo Zanelli  1   2 , Miriana d'Alessandro  4 , Davide Motta  5 , Laura Maiocchi  3 , Francesca Montagnani  1   2 , Maria Cristina Moioli  5 , Chiara Baiguera  5 , Margherita Sambo  3 , Teresa Chiara Pieri  3 , Pietro Valsecchi  3 , Raffaele Bruno  3 , Massimo Puoti  5 , Massimiliano Fabbiani  1
Affiliations

Discordant Liver Fibrosis Predictors in Virologically Suppressed People Living with HIV without Hepatitis Virus Infection

Barbara Rossetti et al. Diagnostics (Basel). .

Abstract

Severe liver fibrosis (LF) is associated with poor long-term liver-related outcomes in people living with HIV (PLWH). The study aimed to explore the prevalence and predictors of LF and the concordance between different non-invasive methods for the estimation of LF in HIV-infected individuals without hepatitis virus infection. We enrolled PLWH with HIV-1-RNA <50 copies/mL for >12 months, excluding individuals with viral hepatitis. LF was assessed by transient elastography (TE) (significant >6.65 kPa), fibrosis-4 (FIB-4) (significant >2.67), and AST-to-platelet ratio index (APRI) (significant >1.5). We included 234 individuals (67% males, median age 49 years, median time from HIV diagnosis 11 years, 38% treated with integrase strand transfer inhibitors). In terms of the TE, 13% had ≥F2 stage; FIB-4 score was >1.5 in 7%; and APRI > 0.5 in 4%. Higher body mass index, diabetes mellitus, detectable baseline HIV-1 RNA and longer atazanavir exposure were associated with higher liver stiffness as per TE. Predictors of higher APRI score were CDC C stage and longer exposure to tenofovir alafenamide, while HBcAb positivity and longer exposure to tenofovir alafenamide were associated to higher FIB-4 scores. Qualitative agreement was poor between FIB-4/TE and between APRI/TE by non-parametric Spearman correlation and kappa statistic. In our study, in the group of PLWH without viral hepatitis, different non-invasive methods were discordant in predicting liver fibrosis.

Keywords: ART; HIV; liver fibrosis.

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Conflict of interest statement

B.R. received speakers’ honoraria and support for travel to meetings from Gilead Sciences, Janssen-Cilag, Merck Sharp and Dohme (MSD), ViiV Healthcare, and Menarini, as well as fees for attending advisory boards from ViiV Healthcare, Janssen-Cilag, Merck Sharp and Dohme (MSD), Gilead Sciences, and Bristol Myers Squibb (BMS). F.M. received support for travel to meetings from Angelini; she is principal investigator in a sponsor study by TLS (Toscana Life Science) and by GSK Vaccine SRL, and she is the contact person for a service contract between GSK Vaccine SRL and Department of Medical Biotechnologies, University of Siena, without receiving any personal remuneration. M.F. received speakers’ honoraria, support for travel to meetings, and/or fees for attending advisory boards from Bristol Myers Squibb (BMS), Gilead, Janssen-Cilag, Merck Sharp and Dohme (MSD), and ViiV Healthcare.

Figures

Figure 1
Figure 1
(a) Correlation between liver stiffness assessed by TE and APRI score. Rho Spearman 0.006; p = 0.93. (b) Correlation between livers stiffness assessed by TE and FIB-4 score. Rho Spearman 0.05; p = 0.41.
Figure 1
Figure 1
(a) Correlation between liver stiffness assessed by TE and APRI score. Rho Spearman 0.006; p = 0.93. (b) Correlation between livers stiffness assessed by TE and FIB-4 score. Rho Spearman 0.05; p = 0.41.
See this image and copyright information in PMC

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