Chronic hepatitis C in HIV-infected patients is an increasing cause of death dependent on the development of liver fibrosis, which is currently assessed by liver biopsy despite its limitations. Liver stiffness measurement, a new noninvasive method, allows the evaluation of liver fibrosis. The aim of this prospective study was to assess the accuracy of liver stiffness measurement for the detection of fibrosis and cirrhosis in HIV/hepatitis C virus (HCV)-coinfected patients and to compare its accuracy with other noninvasive methods.
We studied 72 consecutive HIV patients with chronic hepatitis C who had a simultaneous liver biopsy and liver stiffness measurement by transient elastography (FibroScan; Echosens, Paris, France) for the assessment of liver fibrosis.
Liver stiffness values ranged from 3.0 to 46.4 kilopascal. Liver stiffness was significantly correlated to fibrosis stage (Kendall τ-b = 0.48; P < 0.0001). The area under the receiver operating characteristic (AUROC) curve of liver stiffness measurement was 0.72 for F ≥ 2 and 0.97 for F = 4. For the diagnosis of cirrhosis, AUROC curves of liver stiffness measurement were significantly higher than those for platelet count (P = 0.02), aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (P = 0.0001), Aspartate aminotransferase-to-Platelet Ratio Index (APRI) (P = 0.01), and FIB-4 (P = 0.004).
Liver stiffness measurement is a promising noninvasive method for the assessment of fibrosis in HIV-infected patients with chronic HCV infection. Its use for the follow-up of these patients should be further evaluated.
From the *Service d'Hépato-Gastroentérologie, Hôpital Haut Lévêque, Bordeaux, France; †INSERM E362 IFR 66, Université Victor Segalen, Bordeaux, France; ‡Service d'Hépato-Gastroentérologie, Hôpital Henri-Mondor, Créteil, France; §Service de Médecine Interne, Hôpital Saint-Antoine, Paris, France; ∥Laboratoire d'Anatomie-Pathologique, Hôpital Jean Verdier, Bondy, France; ¶Service d'Hépato-Gastroentérologie, Hôpital Jean Verdier, Bondy, France; and #Service d'Hépato-Gastroentérologie, Hôpital Beaujon, Clichy, France.
Received for publication September 6, 2005; accepted October 21, 2005.
Reprints: Victor de Lédinghen, Service d'Hépato-Gastroentérologie, Hôpital Haut Lévêque, Avenue Magellan 33604, Pessac Cedex, France (e-mail: email@example.com).