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Change in Fibrosis Score as a Predictor of Mortality Among HIV-Infected Patients with Viral Hepatitis.
- Source :
-
AIDS Patient Care & STDs . Feb2012, Vol. 26 Issue 2, p73-80. 8p. 3 Charts, 2 Graphs. - Publication Year :
- 2012
-
Abstract
- Noninvasive markers of liver fibrosis, measured at baseline, have been shown to predict liver-related mortality. It remains unknown if a change in the value of the scores over time predicts mortality in patients with HIV and viral hepatitis. In this retrospective study, survival in HIV/hepatitis B virus (HBV; n=67), HIV/hepatitis C virus (HCV; n=43), and HIV/HBV/HCV ( n=41) patients was examined using Kaplan-Meier life table analysis. Aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and FIB-4 scores, two noninvasive markers of liver fibrosis, were calculated at baseline and at last available clinical follow-up to determine the change in fibrosis score. Factors associated with mortality were assessed by Cox proportional hazards, including the change in the noninvasive marker score between the two time points. All-cause mortality was determined by Social Security Death Index and chart review. Sixty-seven were coinfected with HIV/HBV, 43 with HIV/HCV, and 41 were triply infected (HIV/HBV/HCV). Kaplan-Meier analysis showed similar survival for the three groups at 7 years of follow-up ( p=0.10). However, median length of follow-up was lower in HIV/HCV (60.5; range 0-102) compared to HIV/HBV (75.7; 12.3-126.5) and HIV/HBV/HCV (80.0; 2.7-123) months, respectively, p=0.02. Baseline fibrosis score ( p=0.002), an increase in the value for noninvasive measurements for fibrosis ( p<0.001), and the presence of HIV/HCV coinfection ( p=0.041) were each associated with higher risk for mortality. Baseline fibrosis score ( p=0.03) and an increase in FIB-4 score ( p=0.05) were independent predictors of all-cause mortality, but liver-related mortality was not evaluated. In this study, baseline fibrosis score was predictive of 7-year all-cause mortality. Further studies are needed in a prospective cohort to evaluate the predictive value of monitoring changes in fibrosis scores over time to predict mortality in patients with viral hepatitis. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ASPARTATE aminotransferase
*BIOMARKERS
*BLOOD cell count
*STATISTICAL correlation
*HEPATITIS D
*HEPATITIS B
*HEPATITIS C
*HIV infections
*CIRRHOSIS of the liver
*STATISTICS
*SURVIVAL analysis (Biometry)
*T cells
*FIBROSIS
*DRUG abusers
*ALANINE aminotransferase
*PREDICTIVE tests
*PROPORTIONAL hazards models
*RETROSPECTIVE studies
*DATA analysis software
*DESCRIPTIVE statistics
*PROGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 10872914
- Volume :
- 26
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- AIDS Patient Care & STDs
- Publication Type :
- Academic Journal
- Accession number :
- 70857751
- Full Text :
- https://doi.org/10.1089/apc.2011.0191