A Vavassori

C Torti

D Gotti

E Focà

E Quiros-Roldan

F Castelnuovo

G Angarano

G Carosi

M Mendeni

N Ladisa

Journal of the International AIDS Society

PubMed

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POSTER PRESENTATION Open Access
Liver fibrosis: concordance analysis between
APRI and FIB-4 scores, evolution and predictors
in a cohort of HIV patients without HCV and
HBV infection
M Mendeni1, E Focà1*, D Gotti1, N Ladisa2, E Quiros-Roldan1, A Vavassori1, F Castelnuovo1, G Carosi1, G Angarano2, C Torti1
From Tenth International Congress on Drug Therapy in HIV Infection
Glasgow, UK. 7-11 November 2010
Purpose of the study
Liver fibrosis (LF) progression is fated to become one of
the major long-term complications in HIV patients,
even in those without HCV or HBV co-infections (HIV-
mono-infected). The aim of this study was to assess LF
progression in HIV-mono-infected patients and asso-
ciated risk factors.
Methods
Observational retrospective study. All HIV naive patients
who started HAART from 1996 to 2006 were included.
Concordance between FIB-4 and APRI scores was assessed
using the weighted kappa coefficient. Rates of transition
from lower classes to higher classes were estimated by
Kaplan-Meier analysis. Cox regression models were
applied to assess possible predictors both at baseline and
during the follow-up.
Summary of results
1,112 naive patients were selected. A moderate concor-
dance between FIB-4 and APRI was demonstrated
(K=0.573). For FIB-4, the incidence of transition to higher
classes was 0.064 PYFU (95% CI, 0.056-0.072), while for
APRI the incidence of transition was 0.099 PYFU (95% CI,
0.089-0.110). Viro-immunological control during HIV
infection appeared to reduce the risk of both FIB-4 and
APRI transitions. HIV-RNA <500 copies/ml (for FIB-4:
HR 2.456 p<0.0001; for APRI: HR 2.084 p<0.0001) and
higher CD4 T-cell counts only for FIB-4 (HR 0.881
p=0.0004 for 100 cells higher) during the follow-up were
statistically protective. Among baseline variables, for FIB-4
transition, age ≥ 40 years (HR 1.037 p<0.0001) and higher
FIB-4 values (HR 1.526 p=0.0038) were associated with
increased risk of LF progression, while sexual risk factor
for HIV acquisition resulted to be protective (HR 0.524
p=0.0314). For APRI, male gender (HR 1.390 p=0.017),
higher GGT values (HR 1.015 p=0.014) and higher APRI
values (HR 1.748 p=0.007) were independently associated
with APRI transition. A sensitivity analysis demonstrated
that DDX drugs (stavudine, didanosine, zalcitabine)as
time-dependent covariates were associated with a signifi-
cant risk of transition with FIB-4 (HR 1.662 p=0.0007) or
APRI (HR 1.661 p=0.0001).
Conclusions
Our data suggest that a better viro-immunological con-
trol of HIV infection may slow down fibrosis progres-
sion provided that DDX are avoided. Moreover our
analysis provided a comprehensive feature of the risk
factors that should be controlled in clinical practice.
Author details
1Institute for Infectious and Tropical Diseases, University of Brescia, Piazzale
Spedali Civili, 1, Brescia, Italy. 2Institute of Infectious Diseases, Policlinico di
Bari, Bari, Italy.
Published: 8 November 2010
doi:10.1186/1758-2652-13-S4-P92
Cite this article as: Mendeni et al.: Liver fibrosis: concordance analysis
between APRI and FIB-4 scores, evolution and predictors in a cohort
of HIV patients without HCV and HBV infection. Journal of the
International AIDS Society 2010 13(Suppl 4):P92.
1Institute for Infectious and Tropical Diseases, University of Brescia, Piazzale
Spedali Civili, 1, Brescia, Italy
Full list of author information is available at the end of the article
Mendeni et al. Journal of the International AIDS Society 2010, 13(Suppl 4):P92
http://www.jiasociety.org/content/13/S4/P92
© 2010 Focà et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.


Liver fibrosis: concordance analysis between APRI and FIB-4 scores, evolution and predictors in a cohort of HIV patients without HCV and HBV infection

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Liver fibrosis: concordance analysis between APRI and FIB-4 scores, evolution and predictors in a cohort of HIV patients without HCV and HBV infection

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