Published 2019
| Version v1
Journal article
Liver stiffness and fibrosis-4 alone better predict liver events compared with aspartate aminotransferase to platelet ratio index in a cohort of human immunodeficiency virus and hepatitis C virus co-infected patients from ANRS CO13 HEPAVIH cohort
Creators
- Chalouni, Mathieu
- Sogni, Philippe
- Miailhes, Patrick
- Lacombe, Karine
- Poizot-Martin, Isabelle
- Chas, Julie
- Vittecoq, Daniel
- Neau, Didier
- Aumaitre, Hugues
- Alric, Laurent
- Piroth, Lionel
- Bouchaud, Olivier
- Katlama, Christine
- Morlat, Philippe
- Lascoux-Combe, Caroline
- Gervais, Anne
- Naqvi, Alissa
- Rosenthal, Eric
- Garipuy, Daniel
- Barange, Karl
- Esterle, Laure
- Salmon, Dominique
- Wittkop, Linda
Contributors
Others:
- Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED) ; Université Bordeaux Segalen - Bordeaux 2
- Bordeaux population health (BPH) ; Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Service d'hépatologie médicale [CHU Cochin] ; Hôpital Cochin [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
- Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL] ; Hôpital de la Croix-Rousse [CHU - HCL] ; Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)
- Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine] ; CHU Saint-Antoine [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
- Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
- Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD) ; Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Service de Maladies infectieuses et tropicales [CHU Tenon] ; CHU Tenon [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
- Service de Maladies Infectieuses et Tropicales [CHU Bicêtre] ; AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)
- Service des maladies infectieuses et tropicales, hôpital Pellegrin ; CHU Bordeaux [Bordeaux]
- Service des maladies infectieuses [CH Perpignan] ; Centre Hospitalier Saint Jean de Perpignan
- CHU Toulouse [Toulouse]
- Service de Maladies Infectieuses et Tropicales [CHU Dijon] ; Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)
- Service de maladies infectieuses et tropicales [CHU Avicenne] ; Hôpital Avicenne [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
- Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC) ; CHU Pitié-Salpêtrière [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
- Hôpital Saint-André
- Service de maladies infectieuses et tropicales [Saint-Louis] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité)
- Services de Maladies Infectieuses et Tropicales [CHU Bichat] ; AP-HP - Hôpital Bichat - Claude Bernard [Paris] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
- Hôpital l'Archet
- Université Nice Sophia Antipolis - Faculté de Médecine (UNS UFR Médecine) ; Université Nice Sophia Antipolis (1965 - 2019) (UNS) ; COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)
- Hôpital Joseph Ducuing - Varsovie [Toulouse] (HJD)
- Service de Gastro-entérologie - Hépatologie [Purpan] ; CHU Toulouse [Toulouse]
- Service Maladies infectieuses et tropicales [AP-HP Hôpital Cochin] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Description
Objectives HIV/hepatitis C virus (HCV) co-infection leads to major complications, and noninvasive markers developed to stage liver fibrosis could be used as prognostic markers. We aimed to compare the performances of liver stiffness (LS), fibrosis-4 (FIB-4), and aspartate aminotransferase to platelet ratio index (APRI) to predict liver-related events in HIV/HCV co-infected patients.Patients and methods HIV/HCV co-infected patients from the ANRS CO13 HEPAVIH cohort were included if they had LS, FIB-4, and APRI measurements done in a window of 3 months. Primary outcome was the time between inclusion and occurrence of a liver-related event. Univariable and multivariable Fine and Gray models were performed. Predictive performances were compared by the area under the receiver operating characteristic (AUROC) differences after correction of optimistic by bootstrap samples. Best cutoffs to predict liver-related events were estimated by sensitivity and specificity maximization.Results A total of 998 patients were included. Overall, 70.7% were men. Their median age was 46.8 years. According to LS value, 204 (20.4%) patients had cirrhosis. Overall, 39 patients experienced at least one liver-related event. In univariable analysis, LS AUROC curve was significantly superior to FIB-4 and APRI AUROC curves, being 87.9, 78.2, and 75.0%, respectively. After adjustment on age, CD4 levels, and insulin resistance, no differences were observed. The best cutoffs to identify patients at low or high risk of liver-related events were below 8.5, 1.00, and 0.35 and above 16.5, 4.00, and 1.75 for LS, FIB-4, and APRI, respectively.Conclusion To predict HCV-related events, APRI had lower performance than LS and FIB-4. FIB-4 is as good as LS to predict HCV-related events, suggesting that it can be used for the management of HIV/HCV co-infected patients and replace LS.
Abstract
International audienceAdditional details
Identifiers
- URL
- https://hal-amu.archives-ouvertes.fr/hal-02613148
- URN
- urn:oai:HAL:hal-02613148v1
Origin repository
- Origin repository
- UNICA