부산대학교 도서관

Objectives The aim of the study was to investigate liver fibrosis outcome and the risk factors associated with liver fibrosis progression in hepatitis C virus ( HCV)/ HIV-coinfected patients. Methods We prospectively obtained liver stiffness measurements by transient elastography in a cohort of 154 HCV/ HIV-coinfected patients, mostly Caucasian men on suppressive antiretroviral treatment, with the aim of determining the risk for liver stiffness measurement ( LSM) increase and to identify the predictive factors for liver fibrosis progression. To evaluate LSM trends over time, a linear mixed regression model with LSM level as the outcome and duration of follow-up in years as the main covariate was fitted. Results After a median follow-up time of 40 months, the median increase in LSM was 1.05 kPa/year [95% confidence interval ( CI) 0.72-1.38 kPa/year]. Fibrosis stage progression was seen in 47% of patients, and 17% progressed to cirrhosis. Aspartate aminotransferase ( AST) levels and liver fibrosis stage at baseline were identified as independent predictors of LSM change. Patients with F3 ( LSM 9.6-14.5 kPa) or AST levels ≥ 64 IU/ L at baseline were at higher risk for accelerated LSM increase (ranging from 1.45 to 2.61 kPa/year), whereas LSM change was very slow among patients with both F0− F1 ( LSM ≤ 7.5 kPa) and AST levels ≤ 64 IU/ L at baseline (0.34 to 0.58 kPa/year). An intermediate risk for LSM increase (from 0.78 to 1.03 kPa/year) was seen in patients with F2 ( LSM 7.6-9.5 kPa) and AST baseline levels ≤ 64 IU/ L. Conclusions AST levels and liver stiffness at baseline allow stratification of the risk for fibrosis progression and might be clinically useful to guide HCV treatment decisions in HIV-infected patients. [ABSTRACT FROM AUTHOR]