Progression of liver fibrosis in HIV/HCV co-infection: A comparison between non-invasive assessment methods and liver biopsy. PLoS ONE
Schmid et al. aimed to compare the diagnostic accuracy of liver fibrosis staging by transient elastography (TE) and six serum biochemical markers in HIV/HCV co-infected patients and to assess changes in liver fibrosis over time. They found that TE was the non-invasive test with the highest diagnostic accuracy in detecting both significant liver fibrosis (METAVIR > = F2) and liver cirrhosis (METAVIR F4) compared to liver biopsy. Three indirect serum markers (APRI-Score, FIB-4 Index, Fibrotest) and one direct serum marker (ELF-Test) were secondary alternatives, whereas performance of the other two direct serum markers (hyaluronic acid and Hepascore) was worse. Non-invasive tests did not change significantly during the 3-year follow-up, suggesting slow liver disease progression in a majority of HIV/HCV co-infected patients on ART.
The study-results support the new recommendations by EASL to use non-invasive tests as first line tests to stage liver fibrosis.