Benmassaoud, Amine; Macias, Juan; Delamarre, Adèle; Corma-Gomez, Anaïs; Guaraldi, Giovanni; Milic, Jovana; Rockstroh, Jürgen K; Van Bremen, Kathrin; Tsochatzis, Emmanuel; Mulay, Akhilesh; Price, Jennifer; Garvey, Lucy J; Lemoine, Maud; Kablawi, Dana; Lebouche, Bertrand; Klein, Marina B; Ballesteros, Luz R; Boesecke, Christopher; Schepis, Filippo; Bhagani, Sanjay; ... (2023). Prognostic value of non-invasive scores based on liver stiffness measurement, spleen diameter and platelets in HIV-infected patients. Liver international, 43(7), pp. 1427-1439. Wiley 10.1111/liv.15605
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BACKGROUND AND AIMS
People living with HIV (PLWH) are at high risk for advanced chronic liver disease and related adverse outcomes. We aimed to validate the prognostic value of non-invasive scores based on liver stiffness measurement (LSM) and on markers of portal hypertension (PH), namely platelets and spleen diameter, in PLWH.
METHODS
We combined data from eight international cohorts of PLWH with available non-invasive scores, including LSM and the composite biomarkers liver stiffness-spleen size-to-platelet ratio score (LSPS), LSM-to-Platelet ratio (LPR) and PH risk score. Incidence and predictors of all-cause mortality, any liver-related event and classical hepatic decompensation were determined by survival analysis, controlling for competing risks for the latter two. Non-invasive scores were assessed and compared using area under the receiver operating curve (AUROC).
RESULTS
We included 1695 PLWH (66.8% coinfected with hepatitis C virus). During a median follow-up of 4.7 (interquartile range 2.8-7.7) years, the incidence rates of any liver-related event, all-cause mortality and hepatic decompensation were 13.7 per 1000 persons-year (PY) (95% confidence interval [CI], 11.4-16.3), 13.8 per 1000 PY (95% CI, 11.6-16.4) and 9.9 per 1000 PY (95% CI, 8.1-12.2), respectively. The AUROC of LSM was similar to that of the composite biomarkers, ranging between 0.83 and 0.86 for any liver-related event, 0.79-0.85 for all-cause mortality and 0.87-0.88 for classical hepatic decompensation. All individual non-invasive scores remained independent predictors of clinical outcomes in multivariable analysis.
CONCLUSIONS
Non-invasive scores based on LSM, spleen diameter and platelets predict clinical outcomes in PLWH. Composite biomarkers do not achieve higher prognostic performance compared to LSM alone.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology 04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine |
UniBE Contributor: |
Berzigotti, Annalisa |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1478-3231 |
Publisher: |
Wiley |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
16 May 2023 09:53 |
Last Modified: |
15 Jun 2023 00:15 |
Publisher DOI: |
10.1111/liv.15605 |
PubMed ID: |
37183550 |
Uncontrolled Keywords: |
fibrosis biomarkers liver-related events mortality people living with HIV portal hypertension |
BORIS DOI: |
10.48350/182577 |
URI: |
https://boris.unibe.ch/id/eprint/182577 |
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