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A Three-Dimensional Digital Model for Early Diagnosis of Hepatic Fibrosis Based on Magnetic Resonance Elastography
Published on: July 21, 2023
Noninvasive diagnosis of hepatic fibrosis in HIV/HCV-coinfected patients
Maria Larrousse1, Montserrat Laguno, Marta Segarra
1Infectious Diseases Unit, Hospital Clínic Universitari de Barcelona-IDIBAPS, University of Barcelona, Spain. mlarrou@clinic.ub.es
Insights
Tissue inhibitor of metalloproteinases-1 (TIMP-1) and hyaluronic acid (HA) show promise for predicting liver fibrosis in patients with HIV and hepatitis C. These serum markers offer a noninvasive alternative to liver biopsy for assessing fibrosis severity.
Area of Science:
- Hepatology
- Virology
- Biochemistry
Background:
- Serum markers of extracellular matrix status correlate with liver fibrosis in non-HIV patients with chronic hepatitis C.
- These markers are less studied in HIV/HCV-coinfected individuals.
Purpose of the Study:
- To evaluate the predictive value of serum markers for liver fibrosis in HIV-infected patients with chronic hepatitis C virus (HCV).
Main Methods:
- Serum levels of metalloproteinases (MMP-1, -2), tissue inhibitor of metalloproteinases-1 (TIMP-1), procollagen type III N-terminal peptide (PIIINP), and hyaluronic acid (HA) were measured.
- Measurements were taken in HIV-HCV coinfected patients before anti-HCV therapy, concurrent with liver biopsy.
Main Results:
- TIMP-1, TIMP-1/MMP ratios, MMP-2, PIIINP, and HA significantly correlated with liver fibrosis stage.
- TIMP-1 and HA levels were independently associated with liver fibrosis in multivariate analysis.
- A model using TIMP-1 and HA demonstrated good discrimination between mild and significant fibrosis (AUC=0.84).
Conclusions:
- TIMP-1 and HA are sensitive and specific predictors of liver fibrosis degree in HIV-HCV coinfected patients.
- These serum markers may serve as a noninvasive alternative to liver biopsy for estimating fibrosis.
Background:
Several serum markers reflecting extracellular matrix status have been correlated with liver fibrosis in non-HIV-infected patients with chronic hepatitis C infection. These indexes have been less examined in HIV/HCV-coinfected individuals.
Objective:
We aimed to evaluate the predictive value of serum markers for liver fibrosis in HIV-infected patients with chronic hepatitis C virus (HVC).
Methods:
Serum levels of metalloproteinases 1 and 2 (MMP-1 and -2), tissue inhibitors of matrix metalloproteinases (TIMP-1), procollagen type III N-terminal peptide (PIIINP), and hyaluronic acid (HA) were measured in HIV-infected patients with chronic hepatitis C at the time of obtaining a liver biopsy and before the consideration of anti-hepatitis C therapy.
Results:
One hundred and nineteen consecutive HIV-HVC coinfected patients were included. TIMP-1 (r = 0.6; P < 0.001), TIMP-1/MMP-1 ratio (r = 0.5; P < 0.001), TIMP-1/MMP-2 ratio (r = 0.3; P < 0.001), MMP-2 (r = 0.2; P = 0.044), PIIINP (r = 0.4; P < 0.001), and HA (r = 0.5; P < 0.001) were positively and significantly correlated with the fibrosis stage. In the multivariate analysis, TIMP-1 (odds ratio [OR] = 1.004, 95% confidence interval [CI]: 1.002 to 1.006, P = 0.001) and HA >95 microg/dL (OR = 6.041, 95% CI: 1.184 to 30.816, P = 0.031) were independently associated with liver fibrosis. The area under the curve of score to discriminate mild (F0-F1) from significant (F2-F4) fibrosis in the received-operating analysis using the variables TIMP-1 and HA was 0.84, with a sensitivity of 72.9% and a specificity of 83.1%.
Conclusion:
TIMP-1 and HA were quite sensitive and specific for predicting the degree of liver fibrosis in HIV-infected patients with chronic hepatitis C. These parameters may become a noninvasive alternative to liver biopsy when the degree of liver fibrosis needs to be estimated.
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