Zhang Qingrong, Sun Lijun, Liang Yuxuan, Zou Wenlu, Huang Jingtao, Zhang Yuan, Jin Yi, Zhou Na, Ye Jiangzhu, Zou Huachun, Wu Hao, Zhang Tong, Su Bin, Jiang Taiyi, Chen Haitao
School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, 510080, China; School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China.
Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
Virol Sin. 2025 Feb;40(1):118-124. doi: 10.1016/j.virs.2024.12.009. Epub 2024 Dec 31.
The long-term effects of combined antiretroviral therapy (ART) on liver fibrosis patterns in adults living with human immunodeficiency virus (HIV) and chronic hepatitis B virus (HBV) are not well understood. Therefore, this study aimed to investigate the trajectories of liver fibrosis and identify the associations of baseline variables with different patterns of liver fibrosis evolution. A total of 333 individuals with HIV/HBV co-infection and undergoing long-term ART were enrolled in this study. Demographic, clinical, and biochemical data were collected at baseline and during annual visits. Group-based trajectory models (GBTMs) were used to detect the patterns of liver fibrosis evolution based on longitudinal data of fibrosis-4 (Fib-4) and aspartate aminotransferase to platelet ratio index (APRI) scores. Logistic regression analysis was performed to identify baseline predictors of liver fibrosis evolution. The median age of all participants was 33 years. Among them, 89.5% initially received TDF-containing ART. GBTMs identified two distinct patterns of liver fibrosis evolution using either APRI or Fib-4 scores. The majority of individuals (78.5% for APRI and 75.3% for Fib-4; pattern A) showed stable or low fibrosis with no progression, while the remaining participants showed regression from high fibrosis levels (21.5% for APRI and 24.7% for Fib-4; pattern B). Pattern A participants were younger and had higher CD4 cell counts, higher lymphocyte cell counts, higher white blood cell counts, and lower platelet counts at baseline compared to pattern B participants. For HIV/HBV co-infected patients with varying degrees of initial liver fibrosis, long-term ART has shown distinct patterns of alleviating liver fibrosis.
联合抗逆转录病毒疗法（ART）对感染人类免疫缺陷病毒（HIV）和慢性乙型肝炎病毒（HBV）的成年人肝纤维化模式的长期影响尚不清楚。因此，本研究旨在调查肝纤维化的发展轨迹，并确定基线变量与不同肝纤维化演变模式之间的关联。本研究共纳入了333例HIV/HBV合并感染且正在接受长期ART治疗的个体。在基线和年度随访期间收集了人口统计学、临床和生化数据。基于群体的轨迹模型（GBTMs）用于根据纤维化4（Fib-4）和天冬氨酸转氨酶与血小板比值指数（APRI）评分的纵向数据检测肝纤维化演变模式。进行逻辑回归分析以确定肝纤维化演变的基线预测因素。所有参与者的中位年龄为33岁。其中，89.5%的人最初接受含替诺福韦二吡呋酯（TDF）的ART治疗。GBTMs使用APRI或Fib-4评分确定了两种不同的肝纤维化演变模式。大多数个体（APRI为78.5%，Fib-4为75.3%；模式A）显示纤维化稳定或较低且无进展，而其余参与者则显示从高纤维化水平消退（APRI为21.5%，Fib-4为24.7%；模式B）。与模式B参与者相比，模式A参与者在基线时更年轻，CD4细胞计数更高、淋巴细胞计数更高、白细胞计数更高且血小板计数更低。对于不同程度初始肝纤维化的HIV/HBV合并感染患者，长期ART已显示出减轻肝纤维化的不同模式。
