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Curr HIV/AIDS Rep. 2016 Oct;13(5):279-88. doi: 10.1007/s11904-016-0329-5.

Use of Non-invasive Testing to Stage Liver Fibrosis in Patients with HIV.

Author information

1
Department of Internal Medicine, Duke University Medical Center, Durham, NC, USA.
2
Division of General Internal Medicine, Koo Foundation Sun Yat-Sen Cancer Center, Taipei City, Taiwan.
3
Toronto Centre for Liver Disease, University Health Network Toronto, Toronto, ON, Canada. keyur.patel@uhn.ca.
4
University of Toronto, Toronto Centre for Liver Disease, Toronto General Hospital, Eaton North, 9th floor Room 232, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada. keyur.patel@uhn.ca.

Abstract

Patients with HIV have a proclivity to develop liver fibrosis, especially when associated with other conditions such as HCV, HBV, and NAFLD. Identifying HIV-infected patients with significant fibrosis or cirrhosis plays an important role in clinical and therapeutic decision-making. Liver biopsy is currently considered as the gold standard for fibrosis assessment but carries many shortcomings (cost, invasiveness, complications, false negative rate of 20 %). Multiple non-invasive methods of liver fibrosis assessment have been developed, but not all have been studied in HIV-infected individuals. Non-invasive liver fibrosis tools include both serologic-based testing scores (rely on direct and/or indirect markers) such as APRI, FIB4, FibroTest, FibroSpect II, HepaScore, or imaging-based methods such as vibration controlled liver elastography. There is validated data to support the use of non-invasive modalities of fibrosis assessment in HIV-HCV co-infected individuals for the exclusion of cirrhosis, but may be poorly reliable or not enough data exists for the assessment of other co-morbid disease processes.

KEYWORDS:

Biomarkers; HIV non-alcoholic fatty liver disease; HIV-hepatitis B; HIV-hepatitis C; Liver fibrosis; Transient elastography

PMID:
27485838
DOI:
10.1007/s11904-016-0329-5
[Indexed for MEDLINE]

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