title: Use of transient elastography (FibroScan®) for the noninvasive assessment of portal hypertension in HIV/HCV-coinfected patients.
abstract: The hepatic venous pressure gradient (HVPG) is the gold standard for assessing portal pressure and correlates with the occurrence of portal hypertension (PH)-related complications. Transient elastography (TE) is a new, highly accurate noninvasive technique, which enables us to evaluate hepatic fibrosis to detect advanced fibrosis and cirrhosis. We performed a hepatic haemodynamic study and TE in 38 HIV/HCV-coinfected patients. The association between HVPG and liver stiffness was assessed by linear regression. The diagnostic value of TE was assessed by receiver operating characteristic (ROC) curves. We considered clinically significant PH as an HVPG ≥ 10 mmHg and severe PH as an HVPG ≥ 12 mmHg. A total of 38 HIV/HCV-coinfected patients were included. Twenty-eight patients (73.7%) had clinically significant PH (HVPG ≥ 10 mmHg), and 23 (60.5%) of these had severe PH (HVPG ≥ 12 mmHg). We found a statistically significant association between liver stiffness (kPa) and HVPG (r(2) = 0.46, P < 0.001, straight line equation HVPG=7.4 + 0.204*TE). The areas under the ROC curves were 0.80 [95% confidence interval (CI), 0.64-0.97] and 0.80 (95% CI, 0.66-0.94) for the prediction of HVPG ≥ 10 and ≥ 12 mmHg, respectively. Our data suggest that TE can predict the presence of clinically significant and severe PH in HIV/HCV-coinfected patients.
authors.affiliation: Infectious Diseases and HIV Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain. msconde@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Sánchez-Conde
authors.forename: P
authors.initials: P
authors.lastname: Miralles
authors.forename: J María
authors.initials: JM
authors.lastname: Bellón
authors.forename: D
authors.initials: D
authors.lastname: Rincón
authors.forename: M
authors.initials: M
authors.lastname: Ramírez
authors.forename: I
authors.initials: I
authors.lastname: Gutiérrez
authors.forename: C
authors.initials: C
authors.lastname: Ripoll
authors.forename: J C
authors.initials: JC
authors.lastname: López
authors.forename: J
authors.initials: J
authors.lastname: Cosín
authors.forename: G
authors.initials: G
authors.lastname: Clemente
authors.forename: O
authors.initials: O
authors.lastname: Lo Iacono
authors.forename: R
authors.initials: R
authors.lastname: Bañares
authors.forename: J
authors.initials: J
authors.lastname: Berenguer
mesh_terms: D000328:Adult; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve