Halfon Philippe, Carrat Fabrice, Bédossa Pierre, Lambert Jérôme, Pénaranda Guillaume, Perronne Christian, Pol Stanislas, Cacoub Patrice
Laboratoire Alphabio, Service de Maladies Infectieuses, Hôpital Ambroise Paré, Marseille, France.
Antivir Ther. 2009;14(2):211-9.
Non-invasive liver fibrosis scores have been proposed as alternatives to liver biopsy (LB) in hepatitis C virus (HCV)-infected patients. Here, we aimed to assess the effect of antiviral treatment on non-invasive serological markers of liver fibrosis in HIV-HCV-coinfected patients.
We included 114 HIV-HCV-coinfected patients with LBs performed before and 6 months after the end of treatment (week 72; W72). Fibrotest, the Forn's index, age-platelet ratio index, SHASTA, FIB-4, Hepa-score and Fibrometer scores were assessed. There were 29 (25%) patients who achieved sustained virological response (SVR).
At baseline (BL), all non-invasive fibrosis scores except the Forn's index did not show significantly lower values in SVR patients. At W72, all non-invasive scores, except Hepascore, showed a significant decrease in SVR patients (P<0.01). There was a significant difference in fibrosis stages on LBs between BL and W72 in SVR and non-SVR patients.
In HIV-HCV-coinfected patients, HCV clearance is associated with a significant reduction in non-invasive fibrosis serological markers, which most likely reflect the histological improvement associated with SVR. If confirmed, such results will reinforce the reliability of these markers in the follow-up after HCV treatment.
在丙型肝炎病毒(HCV)感染患者中,已提出无创肝纤维化评分可作为肝活检(LB)的替代方法。在此,我们旨在评估抗病毒治疗对HIV-HCV合并感染患者肝纤维化无创血清学标志物的影响。
我们纳入了114例HIV-HCV合并感染患者,在治疗结束前(第72周;W72)和结束后6个月进行了肝活检。评估了Fibrotest、Forn指数、年龄-血小板比率指数、SHASTA、FIB-4、Hepa评分和Fibrometer评分。有29例(25%)患者实现了持续病毒学应答(SVR)。
在基线(BL)时,除Forn指数外,所有无创纤维化评分在SVR患者中均未显示出显著更低的值。在W72时,除Hepa评分外,所有无创评分在SVR患者中均显著降低(P<0.01)。SVR和非SVR患者在BL和W72时肝活检的纤维化分期存在显著差异。
在HIV-HCV合并感染患者中,HCV清除与无创纤维化血清学标志物的显著降低相关,这很可能反映了与SVR相关的组织学改善。如果得到证实,这些结果将加强这些标志物在HCV治疗后随访中的可靠性。