title: Diagnosis of hepatic fibrosis and cirrhosis by transient elastography in HIV/hepatitis C virus-coinfected patients.
abstract: BACKGROUND
  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.
  
  
  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.
  
  
  RESULTS
  Liver stiffness values ranged from 3.0 to 46.4 kilopascal. Liver stiffness was significantly correlated to fibrosis stage (Kendall tau-b = 0.48; P < 0.0001). The area under the receiver operating characteristic (AUROC) curve of liver stiffness measurement was 0.72 for F > or = 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Service d'Hépato-Gastroentérologie, Hôpital Haut Lévêque, Bordeaux, France. victor.deledinghen@chu.bordeaux.fr
authors.forename: Victor
authors.initials: V
authors.lastname: de Lédinghen
authors.forename: Catherine
authors.initials: C
authors.lastname: Douvin
authors.forename: Adrien
authors.initials: A
authors.lastname: Kettaneh
authors.forename: Marianne
authors.initials: M
authors.lastname: Ziol
authors.forename: Dominique
authors.initials: D
authors.lastname: Roulot
authors.forename: Patrick
authors.initials: P
authors.lastname: Marcellin
authors.forename: Daniel
authors.initials: D
authors.lastname: Dhumeaux
authors.forename: Michel
authors.initials: M
authors.lastname: Beaugrand
mesh_terms: D003938:Diagnostic Techniques, Digestive System; D004548:Elasticity; D015658:HIV Infections / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology; D011446:Prospective Studies