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在摩洛哥使用FIB4指数的人类免疫缺陷病毒单一感染患者中肝纤维化的危险因素

Risk factors for liver fibrosis among human immunodeficiency virus monoinfected patients using the FIB4 index in Morocco.

作者信息

Tahiri Mohamed, Sodqi Mustapha, Lahdami Fatima Ez Zahra, Marih Latifa, Lamdini Hassan, Hliwa Wafaa, Lahcen Ahd Oulad, Badre Wafaa, Haddad Fouad, Chakib Abdelfetah, Bellabah Ahmed, Alaoui Rhimou, Filali Kamal Marhoum El

机构信息

Mohamed Tahiri, Fatima Ez Zahra Lahdami, Wafaa Hliwa, Wafaa Badre, Fouad Haddad, Ahmed Bellabah, Rhimou Alaoui, Department of Hepato-Gastro-Enterology, Ibn Rochd Hospital University Center, Casablanca 20270, Morocco.

出版信息

World J Hepatol. 2013 Oct 27;5(10):584-8. doi: 10.4254/wjh.v5.i10.584.

Abstract

AIM

To study the prevalence and risk factors of significant hepatic fibrosis in Moroccan human immunodeficiency virus (HIV) monoinfected patients.

METHODS

We conducted a cross-sectional study among HIV monoinfected patients (negative for hepatitis B surface antigen and hepatitis C antibody). Clinical and laboratory data were collected from the data base of the Infectious Diseases Unit in Ibn Rochd Hospital Center [age, gender, duration of HIV infection, CD4 T lymphocyte count, HIV viral load, glycemia and current or prior use of antiretroviral and antiretroviral therapy (ART) duration]. The primary outcome was a FIB4 score > 1.45. Multivariable logistic regression identified independent risk factors for FIB4 > 1.45.

RESULTS

A FIB4 score > 1.45 was identified in 96 among 619 (15.5%). HIV monoinfected patients followed up between September 1990 and September 2012. Multivariate analysis showed that only a viral load > 75 (OR = 2.23, 95%CI: 1.36-3.67), CD4 > 200 cells/mm(3) (OR = 0.39, 95%CI: 0.21-0.72) and age at FIB4 index calculation (OR = 1.10, 95%CI: 1.07-1.13) were independently associated with the occurrence of FIB4 index (> 1.45). Gender, duration of HIV infection, glycemia, use of antiretroviral therapy and ART duration were not associated with significant fibrosis by FIB4.

CONCLUSION

FIB4 score > 1.45 was found in 15.5% of Moroccan HIV monoinfected patients. Age, HIV viremia > 75 copies/mL and CD4 count > 200 cells/mm(3) are associated with liver fibrosis. Further studies are needed to explore mechanisms for fibrosis in HIV monoinfected patients.

摘要

目的

研究摩洛哥人类免疫缺陷病毒(HIV)单感染患者显著肝纤维化的患病率及危险因素。

方法

我们对HIV单感染患者(乙肝表面抗原和丙肝抗体均为阴性)进行了一项横断面研究。从伊本·罗奇德医院中心传染病科数据库收集临床和实验室数据[年龄、性别、HIV感染持续时间、CD4 T淋巴细胞计数、HIV病毒载量、血糖以及当前或既往抗逆转录病毒治疗的使用情况和抗逆转录病毒治疗(ART)持续时间]。主要结局是FIB4评分>1.45。多变量逻辑回归确定了FIB4>1.45的独立危险因素。

结果

在1990年9月至2012年9月期间接受随访的619例HIV单感染患者中,有96例(15.5%)FIB4评分>1.45。多变量分析显示,只有病毒载量>75(比值比=2.23,95%置信区间:1.36 - 3.67)、CD4>200个细胞/mm³(比值比=0.39,95%置信区间:0.21 - 0.72)以及计算FIB4指数时的年龄(比值比=1.10,95%置信区间:1.07 - 1.13)与FIB4指数(>1.45)的发生独立相关。性别、HIV感染持续时间、血糖、抗逆转录病毒治疗的使用情况和ART持续时间与FIB4定义的显著纤维化无关。

结论

在15.5%的摩洛哥HIV单感染患者中发现FIB4评分>1.45。年龄、HIV病毒血症>75拷贝/mL和CD4计数>200个细胞/mm³与肝纤维化相关。需要进一步研究来探索HIV单感染患者纤维化的机制。

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