English   español  
Por favor, use este identificador para citar o enlazar a este item: http://hdl.handle.net/10261/143538
Título

Liver stiffness measurement versus liver biopsy to predict survival and decompensations of cirrhosis among HIV/hepatitis C virus-coinfected patients

AutorMacias, Juan; López-Cortés, Luis F. ; Pineda, Juan A.
Fecha de publicación23-oct-2013
EditorLippincott Williams & Wilkins
CitaciónAIDS 27(16): 2541–2549 (2013)
Resumen[Abstract Objective] To compare the prognostic performance of liver biopsy with that of liver stiffness measurement (LSM) to predict survival and liver decompensations among HIV/hepatitis C virus (HCV)-coinfected patients.
[Design] Retrospective cohort study.
[Methods] Cohort of 297 HIV/HCV-coinfected patients, who underwent a liver biopsy and LSM separated by 12 months or less, followed in 10 Spanish tertiary care centers from December 2005 to December 2011 (median follow-up, 5 years; interquartile range, 4.2–5.4 years). Liver biopsies were staged following the Scheuer's score. LSM was obtained by hepatic transient elastometry. A survival analysis was carried out and the integrated discrimination improvement was computed to compare the ability of the survival models to predict outcomes. The incidence of death from any cause and of development of the first decompensation of cirrhosis was calculated.
[Results] Overall mortality rate was 1.63 [95% confidence interval (CI) 1.06–2.49] per 100 person-years. The adjusted hazard ratio [AHR (95% CI)] of baseline fibrosis (per stage of fibrosis) was 1.52 (1.08–2.15, P = 0.017) and of LSM (per 5 kPa increase) 1.28 (1.12–1.46, P < 0.001). LSM including models yielded a performance 3.9% better than the liver biopsy-based models (P = 0.072). For the prediction of liver decompensations, the AHR (95% CI) of baseline fibrosis by liver biopsy (per stage of fibrosis) was 1.67 (1.15–2.43, P = 0.007) and of LSM (per 5 kPa increase) 1.37 (1.21–1.54, P < 0.001). LSM-based models yielded a performance 8.4% better than the liver biopsy-based models (P = 0.045).
[Conclusion] LSM-based prediction achieves a similar yield than liver biopsy-based models to predict overall mortality in HIV/HCV-coinfected patients. Models including LSM could predict better liver decompensations than liver biopsy.
DescripciónMacias, Juan et al.
Versión del editorhttp://doi.org/10.1097/QAD.0b013e32836381f3
URIhttp://hdl.handle.net/10261/143538
DOI10.1097/QAD.0b013e32836381f3
Identificadoresissn: 0269-9370
e-issn: 1473-5571
Aparece en las colecciones: (IBIS) Artículos
Ficheros en este ítem:
Fichero Descripción Tamaño Formato  
accesoRestringido.pdf15,38 kBAdobe PDFVista previa
Visualizar/Abrir
Mostrar el registro completo
 

Artículos relacionados:


NOTA: Los ítems de Digital.CSIC están protegidos por copyright, con todos los derechos reservados, a menos que se indique lo contrario.