TY - JOUR
T1 - HIV mono-infection is associated with FIB-4 - A noninvasive index of liver fibrosis - In women
AU - Blackard, Jason T.
AU - Welge, Jeffrey A.
AU - Taylor, Lynn E.
AU - Mayer, Kenneth H.
AU - Klein, Robert S.
AU - Celentano, David D.
AU - Jamieson, Denise J.
AU - Gardner, Lytt
AU - Sherman, Kenneth E.
N1 - Funding Information:
Potential conflicts of interest. K.S. is a board member of Vertex, Bristol-Meyers Squibb, Merck, SciClone, Glaxo SmithKline, Three Rivers, J&J, and Regulus and has received funding through his institution from Roche (Genentech), Schering (Merck), Vertex, Gilead, Bristol-Meyers Squibb, SciClone, Anadys. L.T. has received grant funding through her institution from the National Institute on Drug Abuse [k23DA020383-01] and the National Institutes of Health, Lifespan/Tufts/Brown Center for AIDS Research [P30AI42853]; is a consultant for Vertex; has received payment for lectures/speaker’s bureau from Genetech/Roche; and has received grant funding through her institution grant from Roche and Vertex. All other authors: no conflicts.
PY - 2011/3/1
Y1 - 2011/3/1
N2 - Background: FIB-4 represents a noninvasive, composite index that is a validated measure of hepatic fibrosis, which is an important indicator of liver disease. To date, there are limited data regarding hepatic fibrosis in women. Methods: FIB-4 was evaluated in a cohort of 1227 women, and associations were evaluated in univariate and multivariate regression models among 4 groups of subjects classified by their human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection status. Results: The median FIB-4 scores were 0.60 in HIV-/HCV-women, 0.83 in HIV-/HCV+ women, 0.86 in HIV+/HCV-women, and 1.30 in HIV+/HCV+ women. In the HIV/HCV co-infected group, multivariate analysis showed that CD4+ cell count and albumin level were negatively associated with FIB-4 (P <.0001), whereas antiretroviral therapy (ART) was positively associated with FIB-4 score (P =.0008). For the HIV mono-infected group, multivariate analysis showed that CD4+ cell count (P <.0001) and albumin level (P =.0019) were negatively correlated with FIB-4 score, ART was positively associated with FIB-4 score (P =.0008), and plasma HIV RNA level was marginally associated with FIB-4 score (P =.080). In 72 HIV mono-infected women who were also hepatitis B surface antigen negative, ART naive, and reported no recent alcohol intake, plasma HIV RNA level was associated with increased FIB-4 score (P =.030). Conclusions: HIV RNA level was associated with increased FIB-4 score in the absence of hepatitis B, hepatitis C, ART, or alcohol use, suggesting a potential relationship between HIV infection and hepatic fibrosis in vivo. A better understanding of the various demographic and virologic variables that contribute to hepatic fibrosis may lead to more effective treatment of HIV infection and its co-morbid conditions.
AB - Background: FIB-4 represents a noninvasive, composite index that is a validated measure of hepatic fibrosis, which is an important indicator of liver disease. To date, there are limited data regarding hepatic fibrosis in women. Methods: FIB-4 was evaluated in a cohort of 1227 women, and associations were evaluated in univariate and multivariate regression models among 4 groups of subjects classified by their human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection status. Results: The median FIB-4 scores were 0.60 in HIV-/HCV-women, 0.83 in HIV-/HCV+ women, 0.86 in HIV+/HCV-women, and 1.30 in HIV+/HCV+ women. In the HIV/HCV co-infected group, multivariate analysis showed that CD4+ cell count and albumin level were negatively associated with FIB-4 (P <.0001), whereas antiretroviral therapy (ART) was positively associated with FIB-4 score (P =.0008). For the HIV mono-infected group, multivariate analysis showed that CD4+ cell count (P <.0001) and albumin level (P =.0019) were negatively correlated with FIB-4 score, ART was positively associated with FIB-4 score (P =.0008), and plasma HIV RNA level was marginally associated with FIB-4 score (P =.080). In 72 HIV mono-infected women who were also hepatitis B surface antigen negative, ART naive, and reported no recent alcohol intake, plasma HIV RNA level was associated with increased FIB-4 score (P =.030). Conclusions: HIV RNA level was associated with increased FIB-4 score in the absence of hepatitis B, hepatitis C, ART, or alcohol use, suggesting a potential relationship between HIV infection and hepatic fibrosis in vivo. A better understanding of the various demographic and virologic variables that contribute to hepatic fibrosis may lead to more effective treatment of HIV infection and its co-morbid conditions.
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U2 - 10.1093/cid/ciq199
DO - 10.1093/cid/ciq199
M3 - Article
C2 - 21248367
AN - SCOPUS:79951843023
SN - 1058-4838
VL - 52
SP - 674
EP - 680
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 5
ER -