TY - JOUR A1 - Vermehren, Johannes A1 - Vermehren, Annika A1 - Mueller, Axel A1 - Carlebach, Amina A1 - Lutz, Thomas A1 - Gute, Peter A1 - Knecht, Gaby A1 - Sarrazin, Christoph A1 - Friedrich-Rust, Mireen A1 - Forestier, Nicole A1 - Poynard, Thierry A1 - Zeuzem, Stefan A1 - Herrmann, Eva A1 - Hofmann, Wolf-Peter T1 - Assessment of liver fibrosis and associated risk factors in HIV-infected individuals using transient elastography and serum biomarkers T2 - BMC gastroenterology N2 - Background: Liver fibrosis in human immunodeficiency virus (HIV)-infected individuals is mostly attributable to co-infection with hepatitis B or C. The impact of other risk factors, including prolonged exposure to combined antiretroviral therapy (cART) is poorly understood. Our aim was to determine the prevalence of liver fibrosis and associated risk factors in HIV-infected individuals based on non-invasive fibrosis assessment using transient elastography (TE) and serum biomarkers (Fibrotest [FT]). Methods: In 202 consecutive HIV-infected individuals (159 men; mean age 47 ± 9 years; 35 with hepatitis-C-virus [HCV] co-infection), TE and FT were performed. Repeat TE examinations were conducted 1 and 2 years after study inclusion. Results: Significant liver fibrosis was present in 16% and 29% of patients, respectively, when assessed by TE (≥ 7.1 kPa) and FT (> 0.48). A combination of TE and FT predicted significant fibrosis in 8% of all patients (31% in HIV/HCV co-infected and 3% in HIV mono-infected individuals). Chronic ALT, AST and γ-GT elevation was present in 29%, 20% and 51% of all cART-exposed patients and in 19%, 8% and 45.5% of HIV mono-infected individuals. Overall, factors independently associated with significant fibrosis as assessed by TE (OR, 95% CI) were co-infection with HCV (7.29, 1.95-27.34), chronic AST (6.58, 1.30-33.25) and γ-GT (5.17, 1.56-17.08) elevation and time on dideoxynucleoside therapy (1.01, 1.00-1.02). In 68 HIV mono-infected individuals who had repeat TE examinations, TE values did not differ significantly during a median follow-up time of 24 months (median intra-patient changes at last TE examination relative to baseline: -0.2 kPa, p = 0.20). Conclusions: Chronic elevation of liver enzymes was observed in up to 45.5% of HIV mono-infected patients on cART. However, only a small subset had significant fibrosis as predicted by TE and FT. There was no evidence for fibrosis progression during follow-up TE examinations. KW - HIV KW - HCV KW - co-infection KW - cART KW - Hepatotoxicity KW - Transient elastography KW - Fibrotest KW - Liver enzymes Y1 - 2012 UR - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/24183 UR - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-241836 SN - 1471-230X N1 - © 2012 Vermehren et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. VL - 12 IS - 27 PB - BioMed Central CY - London ER -