Use of fibroscan as non-invasive alternative to liver biopsy in HCV/HIV coinfection
Simon Collins, HIV i-Base
Rodger and colleagues from the Royal Free presented results from the use of FirboScan in 30 HIV-positive patients with chronic liver disease related to HBV, HCV, alcohol and steotosis.
Liver fibrosis was evaluated using the METAVIR scoring system. Fibroscan measures of <7.9 Kpa were used as the cut off for no or minimal fibrosis (F0/1) and >11.9Kpa as the cut off for severe fibrosis (F4).
Twelve patients had liver biopsy scores of F0/1 and 16 had scores of F3/4.
Stiffness was significantly correlated to stage of fibrosis (r = 0.68, P < 0.0001). Median values for F0/F1 were 5.6 Kpa (range 3.610.2) and for F4, 14.3 Kpa (range 7.867.9). Patients with cirrhosis (F4) were detected with a positive predictive value (PPV) of 75% and a negative predictive value (NPV) of 91%. For moderate or severe fibrosis (>F2) a cut off of >7.9 Kpa gave a PPV of 92% and a NPV of 76%. Minimal fibrosis (F0/F1) was detected with a PPV of 61% and a NPV of 92%.
The authors concluded that FibroScan is a reliable method for the diagnosis of significant fibrosis (>F2) and cirrhosis (F4) in HIV-positive patients with chronic liver disease, although further research is needed to inform its use in monitoring over time.
Rodger A et al. Assessment of staging of liver fibrosis by transient elastography in HIV-positive patients with chronic liver disease using liver biopsy as the gold standard. Poster 72.