Noninvasive diagnosis of hepatic fibrosis in HIV/HCV-Coinfected patients

被引:29
作者
Larrousse, Maria
Laguno, Montserrat
Segarra, Marta
De lazzari, Elisa
Martinez, Esteban
Blanco, Dose Luis
Leon, Agathe
Deulofeu, Ramn
Miquel, Rosa
Milinkovic, Ana
Lonca, Montserrat
Miro, Jose Maria
Biglia, Alejandra
Murillas, Javier
Gatell, Jose Maria
Mallolas, Josep
机构
[1] Univ Barcelona, Hosp Clin Barcelona, Infect Dis Unit, IDIBAPS, E-08036 Barcelona, Spain
[2] Univ Barcelona, IDIBAPS, Hosp Clin Barcelona, Serv Biochem, Barcelona, Spain
[3] Univ Barcelona, IDIBAPS, Hosp Clin Barcelona, Pathol Serv, Barcelona, Spain
关键词
noninvasive diagnosis of hepatic fibrosis; HIV/HCVcoinfected; patients; tissue inhibitors of matrix metalloprotemases; (TIMP-1); hyaluronic acid (HA);
D O I
10.1097/QAI.0b013e3181520502
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Several serum markers reflecting extracellular matrix status have been correlated with liver fibrosis in non-HIV-infected patients with chronic hepatitis C infection. These indexes have been less examined in HIV/HCV-coinfected individuals. alternative to liver biopsy when the degree of liver fibrosis needs to be estimated. Objective: We aimed to evaluate the predictive value of serum markers for liver fibrosis in non-HIV-infected patients with chronic hepatitis C virus (HVC). Methods: Serum levels of metalloproteinases I and 2 (MMP-1 and -2), tissue inhibitors of matrix metalloprotemases (TIMP-1), procollagen type III N-terminal peptide (PIIINP), and hyaluronic acid (HA) were measured in non-HIV-infected patients with chronic hepatitis C at the time of obtaining a liver biopsy and before the consideration of anti-hepatitis C therapy. Results: One hundred and nineteen consecutive HIV-HVC coinfected patients were included. TIMP-1 (r = 0.6; P < 0.001), TIMP-1/MMP-1 ratio (r = 0.5; P < 0.001), TIMP-1/MMP-2 ratio (r = 0.3; P < 0.001), MMP-2 (r = 0.2; P = 0.044), PIIINP (r = 0.4; P < 0.00 1), and HA (r = 0.5; P < 0.001) were positively and significantly correlated with the fibrosis stage. In the multivariate analysis, TIMP-1 (odds ratio [OR] = 1.004, 95% confidence interval [Cl]: 1.002 to 1.006, P = 0.00 1) and HA >95 mu g/dL (OR = 6.041, 95% Cl: 1.184 to 30.816, P = 0.03 1) were independently associated with liver fibrosis. The area under the curve of score to discriminate mild (FO-FI) from significant (F2-F4) fibrosis in the received-operating analysis using the variables TIMP-1 and HA was 0.84, with a sensitivity of 72.9% and a specificity of 83.1 %. Conclusion: TIMP-I and HA were quite sensitive and specific for predicting the degree of liver fibrosis in non-HIV-infected patients with chronic hepatitis C. These parameters may become a noninvasive alternative to liver biopsy when the degree of liver fibrosis needs to be estimated.
引用
收藏
页码:304 / 311
页数:8
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