title: Use of Non-invasive Testing to Stage Liver Fibrosis in Patients with HIV.
abstract: Patients with HIV have a proclivity to develop liver fibrosis, especially when associated with other conditions such as HCV, HBV, and NAFLD. Identifying HIV-infected patients with significant fibrosis or cirrhosis plays an important role in clinical and therapeutic decision-making. Liver biopsy is currently considered as the gold standard for fibrosis assessment but carries many shortcomings (cost, invasiveness, complications, false negative rate of 20 %). Multiple non-invasive methods of liver fibrosis assessment have been developed, but not all have been studied in HIV-infected individuals. Non-invasive liver fibrosis tools include both serologic-based testing scores (rely on direct and/or indirect markers) such as APRI, FIB4, FibroTest, FibroSpect II, HepaScore, or imaging-based methods such as vibration controlled liver elastography. There is validated data to support the use of non-invasive modalities of fibrosis assessment in HIV-HCV co-infected individuals for the exclusion of cirrhosis, but may be poorly reliable or not enough data exists for the assessment of other co-morbid disease processes.
authors.affiliation: Department of Internal Medicine, Duke University Medical Center, Durham, NC, USA.
authors.forename: Bassem
authors.initials: B
authors.lastname: Matta
authors.affiliation: Division of General Internal Medicine, Koo Foundation Sun Yat-Sen Cancer Center, Taipei City, Taiwan.
authors.forename: Tzu-Hao
authors.initials: TH
authors.lastname: Lee
authors.affiliation: Toronto Centre for Liver Disease, University Health Network Toronto, Toronto, ON, Canada. keyur.patel@uhn.ca.|University of Toronto, Toronto Centre for Liver Disease, Toronto General Hospital, Eaton North, 9th floor Room 232, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada. keyur.patel@uhn.ca.
authors.forename: Keyur
authors.initials: K
authors.lastname: Patel
mesh_terms: D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D060085:Coinfection; D054459:Elasticity Imaging Techniques / Q000379:methods*; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000821:virology; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology
chemical_list: D015415:Biomarkers
keywords: Biomarkers; HIV non-alcoholic fatty liver disease; HIV-hepatitis B; HIV-hepatitis C; Liver fibrosis; Transient elastography