TY - JOUR
T1 - Prediction of hepatic fibrosis in HIV/HCV co-infected patients using serum fibrosis markers
T2 - The SHASTA index
AU - Kelleher, Thomas B.
AU - Mehta, Shruti H.
AU - Bhaskar, Ramakrishnan
AU - Sulkowski, Mark
AU - Astemborski, Jacquie
AU - Thomas, David L.
AU - Moore, Richard E.
AU - Afdhal, Nezam H.
N1 - Funding Information:
Financial support for this study came from DA-11602, DA-16065 and DA-13806 from the National Institute on Injection Drug Abuse, grant HS 07-809 from the Agency for Health Care Policy and Research and MO1-RR00052.
PY - 2005/7
Y1 - 2005/7
N2 - Background/Aims: To examine if serum fibrosis biomarkers could accurately identify the stage of liver disease amongst hepatitis C (HCV) and HIV co-infected patients. Methods: One hundred and thirty seven HIV/HCV co-infected persons were randomly selected from the Johns Hopkins HIV Clinic cohort. Ninety five had complete testing for fibrosis markers in sera collected at the time of liver biopsy. Biopsies were scored according to Ishak modified histological activity index (F0 no fibrosis to F6 cirrhosis). Fibrosis was evaluated against alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST to platelet ratio (APRI), albumin, total bilirubin, hyaluronic acid (HA) and YKL-40. Results: Sixty nine (73%) had no or minimal portal fibrosis (F0-2) and were compared with remaining subjects (F3-6). Fibrosis scores ≥F3 were found 27 times more often in persons with HA levels >86 ng/ml and 5.5 times more often in persons with HA levels 41-86 ng/ml. Less substantial associations were detected with levels of albumin <3.5 g/dl (OR 4.85) and AST >60 iu (OR 5.91). All 35 subjects who had favorable results of HA, albumin, and AST had minimal fibrosis (F0-2). Conclusions: Amongst HIV/HCV co-infected patients, serum testing for HA, albumin, and AST (SHASTA Index) was able to accurately stage mild and advanced fibrosis.
AB - Background/Aims: To examine if serum fibrosis biomarkers could accurately identify the stage of liver disease amongst hepatitis C (HCV) and HIV co-infected patients. Methods: One hundred and thirty seven HIV/HCV co-infected persons were randomly selected from the Johns Hopkins HIV Clinic cohort. Ninety five had complete testing for fibrosis markers in sera collected at the time of liver biopsy. Biopsies were scored according to Ishak modified histological activity index (F0 no fibrosis to F6 cirrhosis). Fibrosis was evaluated against alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST to platelet ratio (APRI), albumin, total bilirubin, hyaluronic acid (HA) and YKL-40. Results: Sixty nine (73%) had no or minimal portal fibrosis (F0-2) and were compared with remaining subjects (F3-6). Fibrosis scores ≥F3 were found 27 times more often in persons with HA levels >86 ng/ml and 5.5 times more often in persons with HA levels 41-86 ng/ml. Less substantial associations were detected with levels of albumin <3.5 g/dl (OR 4.85) and AST >60 iu (OR 5.91). All 35 subjects who had favorable results of HA, albumin, and AST had minimal fibrosis (F0-2). Conclusions: Amongst HIV/HCV co-infected patients, serum testing for HA, albumin, and AST (SHASTA Index) was able to accurately stage mild and advanced fibrosis.
KW - Co-infection
KW - Fibrosis markers
KW - HIV
KW - Hepatitis C
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U2 - 10.1016/j.jhep.2005.02.025
DO - 10.1016/j.jhep.2005.02.025
M3 - Article
C2 - 15894397
AN - SCOPUS:20444424514
SN - 0168-8278
VL - 43
SP - 78
EP - 84
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 1
ER -