title: HIV monoinfection is associated with increased aspartate aminotransferase-to-platelet ratio index, a surrogate marker for hepatic fibrosis.
abstract: BACKGROUND
  Although liver disease commonly causes morbidity and mortality among human immunodeficiency virus (HIV)-infected individuals, data are limited on its prevalence in HIV monoinfection. We used the aspartate aminotransferase-to-platelet ratio index (APRI) as a surrogate marker of hepatic fibrosis to characterize liver disease in the Multicenter AIDS Cohort Study.
  
  
  METHODS
  Men were categorized based on their HIV and viral hepatitis status: uninfected (n = 1170), HIV monoinfected (n = 509), viral hepatitis monoinfected (n = 74), and HIV-viral hepatitis coinfected (n = 66).
  
  
  RESULTS
  The median APRI in the HIV-monoinfected group was similar to that in the hepatitis-monoinfected group (0.42 vs 0.43; P > .05), higher than in the uninfected group (0.42 vs 0.27; P < .001) but lower than in the coinfected group (0.42 vs 1.0; P < .001). On multivariable analysis, HIV infection (1.39-fold increase [FI]; P < .001), viral hepatitis infection (1.52-FI; P < .001), and the interaction between HIV and viral hepatitis infections were independently associated with a higher APRI (1.57-FI; P < .001). Among the HIV-infected men, viral hepatitis coinfection (2.34-FI; P < .001), HIV RNA ≥100 000 copies/mL (1.26-FI; P = .007), and CD4 count ≤200 cells/mL (1.23-FI; P = .022) were independently associated with a higher APRI.
  
  
  CONCLUSIONS
  HIV and viral hepatitis are independently associated with an increased APRI. Further studies are needed to understand the biological basis for the association between HIV and liver disease.
authors.affiliation: Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA. jcohen@jhmi.edu
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Price
authors.forename: Eric C
authors.initials: EC
authors.lastname: Seaberg
authors.forename: Sheila
authors.initials: S
authors.lastname: Badri
authors.forename: Mallory D
authors.initials: MD
authors.lastname: Witt
authors.forename: Kristin
authors.initials: K
authors.lastname: D'Acunto
authors.forename: Chloe L
authors.initials: CL
authors.lastname: Thio
mesh_terms: D000328:Adult; D001219:Aspartate Aminotransferases / Q000032:analysis*; D015415:Biomarkers / Q000032:analysis; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000472:pathogenicity*; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D006505:Hepatitis / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007407:Interviews as Topic; D016014:Linear Models; D008103:Liver Cirrhosis / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases