Marker scores for liver disease progressed in youth with HIV

The mean Fibrosis-4 and aspartate aminotransferase-to-platelet ratio index scores increased during time among youth with HIV compared with those without HIV, according to research presented at the International AIDS Conference in Melbourne, Australia.

Researchers compared Fibrosis-4 (FIB-4) and aspartate aminotransferase-to-platelet ratio index (APRI) scores — noninvasive surrogate markers of liver disease — in two cohorts (REACH, PACTG 219/219c) of adolescents with and without HIV. Measurements were taken and compared for patients (aged 15 to 20 years) with and without HIV who attended a single clinic visit. Researchers also assessed longitudinal trends in adolescents with HIV who went to two or more visits to compare data for those with behavioral vs. perinatal HIV infection. Among 1,780 patients in the study, 1,302 had data available from at least two clinic visits.

Research showed that more patients with HIV had an APRI score greater than 0.5 compared with those without HIV (12% vs. 3%) and slightly more patients with HIV had an APRI greater than 1.5 (2.1% vs. 1%) vs. those without HIV. Researchers suggested this was an indication of possible fibrosis (P=.002). The mean adjusted FIB-4 and APRI scores were 38% and 15% greater in patients with HIV compared with those who were uninfected (P<.001 for both).

Males had 20% and 34% greater FIB-4 and APRI scores, respectively, than females, while the mean APRI and FIB-4 scores did not differ between behavioral and perinatal HIV infection. Researchers found that over time, APRI scores increased 2% annually among youth with perinatal HIV infection, while FIB-4 scores increased at 6% per year among all youth with HIV.

“The mean APRI and FIB-4 scores were higher among HIV-infected youth and remained so after adjustments,” the researchers wrote. “Progression to scores suggesting subclinical fibrosis or worse are common. More research is needed on the clinical utility of noninvasive methods to assess liver disease among HIV-infected adolescents.”

For more information:

Kapogiannis B. #MOAB0102. Presented at: 20th International AIDS Conference; July 20-25, 2014; Melbourne, Australia.

Disclosure: Relevant financial disclosures were not provided by researchers.