title: Comparison of non-invasive liver fibrosis biomarkers in HIV/HCV co-infected patients: the fibrovic study--ANRS HC02.
abstract: OBJECTIVE
  To compare non-invasive biological liver fibrosis scores, as alternatives to liver biopsy, in HIV/HCV co-infected patients.
  
  
  METHODS
  Two hundred and seventy-two HIV/HCV patients, nai ve for HCV treatment, underwent liver biopsy [197 (72%) men, 39.9 years, fibrosis stage (Metavir) F1 (25%), F2 (40%), F3 (25%), F4 (10%), median CD4 486/mm(3) and median HIV viral load 3.5log. Fibrotest (FT), Hepascore (HS), Fibrometer (FM), SHASTA, APRI, Forns index, and Fib-4 were tested in order to differentiate patients with mild to moderate fibrosis (F2) and those with advanced fibrosis (F3). The AUROC and the rate of well-classified patients were compared to liver biopsy.
  
  
  RESULTS
  FT, HS, and FM were able to stage liver fibrosis in all patients with AUROCs of 0.78, 0.84 and 0.89 for the diagnosis of F2, respectively. The correlation coefficient indexes were 0.37, 0.46 and 0.48, respectively. The rates of well-classified patients were 62%, 68% and 71%, respectively. Fib-4, APRI and the Forn's index were only able to stage 37-61% of patients and showed lower accuracies. Using a combination of FT, HS and FM did not significantly increase the performance of each test.
  
  
  CONCLUSIONS
  In HIV/HCV co-infected patients, Fibrometer, Hepascore and Fibrotest outperformed other non-invasive liver fibrosis biomarkers for the prediction of significant liver fibrosis.
authors.affiliation: Université Pierre et Marie Curie-Paris 6, CNRS, UMR 7087, Paris, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
authors.forename: Fabrice
authors.initials: F
authors.lastname: Carrat
authors.forename: Pierre
authors.initials: P
authors.lastname: Bédossa
authors.forename: Jérôme
authors.initials: J
authors.lastname: Lambert
authors.forename: Guillaume
authors.initials: G
authors.lastname: Pénaranda
authors.forename: Christian
authors.initials: C
authors.lastname: Perronne
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
authors.forename: Philippe
authors.initials: P
authors.lastname: Halfon
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D006526:Hepatitis C / Q000150:complications* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers