[Evaluation of APRI score in liver disease following the introduction of antiretroviral therapy in HIV and HCV coinfected versus HIV monoinfected patients]

Rev Soc Bras Med Trop. 2010 Nov-Dec;43(6):678-81. doi: 10.1590/s0037-86822010000600015.
[Article in Portuguese]

Abstract

Introduction: The impact of highly active antiretroviral therapy (HAART) on hepatic fibrosis progression in HIV and hepatitis C virus coinfected patients is not completely understood. Noninvasive hepatic fibrosis markers show great promise in determining liver fibrosis staging and monitoring disease progression.

Methods: Twenty-four patients divided equally into two groups: 12 HIV-monoinfected and 12 with HIV/HCV coinfected patients, were followed from July 2008 to August 2009, after initiating HAART, with clinical, epidemiological and laboratorial assessments every 3 months and calculation of the aspartate aminotransferase to platelet ratio index (APRI). This study aimed to compare the progression of APRI, a noninvasive hepatic fibrosis marker, among populations with HIV and HIV/HCV coinfection.

Results: No differences were observed between the groups regarding age, sex, measurement of CD4 and HIV viral load in all consultations, type of HAART and APRI before initiating HAART. Coinfected patients showed a significantly higher APRI than the monoinfected group in month 3 (0.57 ± 0.31 x 0.27 ± 0.105, p = 0.02) and 6 (0.93 ± 0.79 x 0.28 ± 0.11, p = 0.04).

Conclusions: In the present study, HAART was associated with APRI increases over six months follow-up in HIV/HCV coinfected patients, suggesting that these may be experiencing cumulative hepatotoxicity and immune reconstitution inflammatory syndrome after initiating antiretroviral drugs.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Antiretroviral Therapy, Highly Active*
  • Aspartate Aminotransferases / blood
  • CD4 Lymphocyte Count
  • Disease Progression
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • Hepatitis C / complications*
  • Hepatitis C / pathology
  • Humans
  • Liver Cirrhosis / etiology*
  • Liver Cirrhosis / pathology
  • Male
  • Prospective Studies
  • Time Factors

Substances

  • Aspartate Aminotransferases
  • Alanine Transaminase