scholarly journals Liver Fibrosis and Steatosis in Virally Suppressed HIV-Infected Patients with Cytomegalovirus Seropositivity

2022 ◽  
Vol 22 (3) ◽  
pp. 180-187
Author(s):  
Chyntia Olivia Maurine Jasirwan ◽  
Adik Wibowo ◽  
Amal C Sjaaf ◽  
Gita Aprilicia ◽  
Dyah Purnamasari ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Clinical Presentation ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Human Herpesvirus ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Coefficient Corrélation ◽  
One Year

Background: Cytomegalovirus (CMV) is a human herpesvirus common in people with human immunodeficiency virus (HIV). In a patient with immunocompetence, long periodic asymptomatic CMV might affect to develop the abnormal liver function and contribute to non-AIDS defining morbidity, including chronic liver disease. This study aims to know the prevalence of liver fibrosis and steatosis in virally suppressed HIV infected patients with CMV reactive and summarize the correlation of clinical presentation with liver fibrosis and steatosis in these subjects.Method: A cross-sectional study in HIV Integrated Care Unit, Cipto Mangunkusumo Hospital, was conducted from April 2019 until June 2020. Subjects enrolled in this study were suppressed HIV patients aged between 30-40 years with positive IgG CMV and already using stable ART for at least one year. Transient elastography measured the liver stiffness. Patients with liver stiffness above 7 kPa were defined as having significant liver fibrosis. In addition, Spearman correlation was conducted to evaluate the correlation of clinical presentation of subjects related to liver fibrosis and steatosis. Results: A total of subjects was included in this study. Dominantly male (62.5%) with average age 38 ± 4.68 years. The median amount of CMV DNA was 466 (17-21284) copy/ml. Significant Fibrosis was found in 17/80 (21%) subjects. In this study, clinical parameters correlated with liver fibrosis were insulin, glucose fasting, Homa IR, triglyceride, HDL, and platelet. A medium positive correlation was found in insulin, and Homa IR, with coefficient correlation for insulin, was r = 0.475, p 0.001; and coefficient correlation for Homa IR was r = 0 .487, p 0.001.Conclusion: The prevalence of liver fibrosis was 12% in these subjects. In addition, insulin and Homa IR had a positive correlation with increasing liver fibrosis.

scholarly journals Risk of Liver Fibrosis in Hepatitis B Virus and HIV Coinfected Youths Receiving Tenofovir-Containing Antiretroviral Regimen

2019 ◽  
Vol 18 ◽  
pp. 232595821882325 ◽  
Author(s):  
Linda Aurpibul ◽  
Suparat Kanjanavanit ◽  
Apinya Leerapun ◽  
Thanyawee Puthanakit
Keyword(s):  
Hepatitis B Virus ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Therapy Regimen ◽  
B Virus ◽  
Risk Of Progression

Background: Hepatitis B virus (HBV) and HIV coinfection is associated with risk of progression to chronic liver disease. We assessed liver stiffness in HBV-HIV coinfected youths. Methods: A cross-sectional study in HBV-HIV coinfected youths aged 18 to 25 years who received a tenofovir (TDF)-containing antiretroviral therapy regimen for >96 weeks. Measurements included HBV DNA level, HBV serology profiles, and transient elastography (TE). The cutoff for TE results included ≥5.9 kPa for F2-moderate fibrosis, ≥7.4 kPa for F3-severe fibrosis, and ≥9.6 kPa for F4-cirrhosis. Results: From March to December 2016, 15 HBV-HIV coinfected youths with a median duration on TDF-containing regimens of 3.3 years were enrolled. Five (33%) youths had significant liver fibrosis, 3 with F2-moderate, 1 with F3-advanced fibrosis, and 1 with F4-cirrhosis. Other 5 without liver fibrosis had hepatitis B surface e antigen (HBsAg) and hepatitis B surface e antigen (HBeAg) loss. Higher mean alanine transaminase (ALT) was observed among the group with F2-F4 when compared to those with F0. Conclusion: Liver fibrosis was evidenced in HBV-HIV coinfected youths in Thailand. Transient elastography might be considered for those who do not achieve HBsAg loss or have persistent ALT elevation while on treatment.

scholarly journals Usefulness of fibro scan in assessing liver fibrosis in adult patients with psoriasis

2019 ◽  
Vol 5 (2) ◽  
pp. 376
Author(s):  
Parimalam Kumar ◽  
Suchithra Ganapathi ◽  
Athilakshmi Sivasubramanian
Keyword(s):  
Liver Fibrosis ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Cross Sectional Study ◽  
Adult Patients ◽  
Correct Treatment ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Psoriatic Arthropathy ◽  
Gender Influence

<p class="abstract"><strong>Background:</strong> Patients with psoriasis are at higher risk of developing “systemic” co-morbidities. Non alcoholic fatty liver disease (NAFLD) is found to be more prevalent among psoriasis patients, where it is closely associated with obesity, metabolic syndrome, and psoriatic arthropathy. Elderly participants with psoriasis are 70% more likely to have NAFLD than those without psoriasis independent of common NAFLD risk factors.Methotrexate is a commonly used drug in the management of psoriasis owing to its cost effectiveness and easy administration. In the presence of NAFLD the choice of potentially hepatotoxic drug therapy, such as methotrexate, should be considered with caution. By assessing the liver stiffness measurement (LSM), such drugs can be prescribed with caution in individual with significant liver fibrosis. We have conducted a study to assess the LSM in patients with psoriasis. Aim was to detect the proportion of liver fibrosis (LSM) in adult patients with psoriasis, which will help in choosing the correct treatment.</p><p class="abstract"><strong>Methods:</strong> Hospital based cross sectional study was conducted in 102 adults with psoriasis who were not treated with methotrexate. Transient elastography (TE) was performed in all and LSM was noted.<strong></strong></p><p class="abstract"><strong>Results:</strong> There was no statistically significant gender influence on LSM in patients with psoriasis. There was significant increase in liver fibrosis in psoriatic patients as age advances.</p><p class="abstract"><strong>Conclusions:</strong> Elderly patients with psoriasis are more likely to have liver fibrosis. Hepatotoxic drugs like methotrexate should be prescribed with caution in such patients, preferably after performing LSM.</p>

The impact of direct-acting antivirals on liver fibrosis in Egyptian hepatitis C virus patients: a single center experience

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nadia Abdelaaty Abdelkader ◽  
Amira Mahmoud AlBalakosy ◽  
Ahmed Fouad Helmy Sherief ◽  
Mohamed Soliman Gado
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Treatment Unit ◽  
Non Invasive ◽  
One Year ◽  
The Impact

Abstract Background Hepatitis C virus (HCV) infection affects approximately 170 million people worldwide, causing liver cirrhosis and hepatocellular carcinoma (HCC) and leading to liver transplantation and ultimately death. Accurate evaluation of liver fibrosis in patients with chronic liver diseases is crucial, as liver fibrosis is important in order to make therapeutic decisions, determine prognosis of liver disease and to follow-up disease progression. Multiple non-invasive methods have been used successfully in the prediction of fibrosis; however, early changes in noninvasive biomarkers of hepatic fibrosis under effective antiviral therapy are widely unknown. The aim of this study is to evaluate changes of transient elastography values as well as FIB-4 and AST to platelet ratio index (APRI) in patients treated with DAAs. Objectives The aim beyond this study is to evaluate the changes in liver stiffness in hepatitis C Egyptian patients before and at least one year after treatment with DAAs using transient elastography and non-invasive liver fibrosis indices as FIB-4 and APRI scores. Patients and methods The present study was conducted on 100 patients with chronic hepatitis C patients attended to Ain Shams University Hospitals, Viral hepatitis treatment unit between October 2017 and December 2018, who were followed-up during treatment and after treatment for at least one year (retrospective and prospective study). Total number of cases during the study period was 117 patients. 17 patients were excluded from the study due to missed follow-up. Eventually, 100 patients were enrolled in the study fulfilling the inclusion criteria. Results The mean age of our patients is 47.9 years with Male predominance (52 males and 48 females). There was a significant improvement of, platelets counts, ALT and AST levels, which in turn cause significant improvement in FIB-4 and APRI scores. There was a significant improvement of liver stiffness after end of treatment, regardless of the DAA regimen used, as evidenced by Fibroscan. Conclusion Fibrosis regression –assessed by non-invasive markers of fibrosis is achievable upon removal of the causative agent.

scholarly journals Indoor concentrations of particulate matter 2.5 in a pediatric emergency service

2022 ◽  
Vol 40 ◽  
Author(s):  
Catiane Zanin Cabral ◽  
Alan da Silveira Fleck ◽  
Fernanda Chaves Amantéa ◽  
Claudia Ramos Rhoden ◽  
Sérgio Luis Amantéa
Keyword(s):  
Particulate Matter ◽  
Emergency Service ◽  
Pediatric Emergency ◽  
Cross Sectional Study ◽  
Waiting Room ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Pollutant Concentrations ◽  
Four Seasons ◽  
One Year

Abstract Objective: To evaluate air quality in the waiting room of a pediatric emergency service considering the serial concentrations of particulate matter (PM2.5), and to determine if the number of people present in the room can have an influence on the pollutant concentrations. Methods: Cross-sectional study, carried out in the waiting room of a reference pediatric hospital in the city of Porto Alegre, conducted in a one-year period, in a continuous-time sample including all of the four seasons of the year. The monitoring of PM2.5 was performed using a real-time aerosol monitor (DustTrak II). The number of people in the room was determined every hour and the climatic characteristics per daily mean. The concentration of PM2.5 and the number of people were expressed by mean and standard deviation. The means were compared by Analysis of Variance and Pearson's correlation coefficient. Results: There was a significant increase in the concentration of PM2.5 in the autumn, when compared to other seasons (p<0.001). The pollutant increase, in this season, was accompanied by the higher number of people in the emergency room (p=0.026). The association between PM2.5 and the number of people is confirmed by the positive correlation between these two variables (r=0.738; p<0.001). Conclusions: The pediatric emergency waiting room showed elevated PM2.5 in all seasons. The number of people in the room had a positive correlation with the concentration of the pollutant in the environment.

scholarly journals Hepatic fibrosis and factors associated with liver stiffness in HIV mono-infected individuals

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e2867
Author(s):  
Mihály Sulyok ◽  
Tamás Ferenci ◽  
Mihály Makara ◽  
Gábor Horváth ◽  
János Szlávik ◽  
...  
Keyword(s):  
Hepatic Fibrosis ◽  
Bayesian Model Averaging ◽  
Hepatitis Virus ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Model Averaging ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Cross Sectional

BackgroundLiver disease has become an important cause of morbidity and mortality even in those HIV-infected individuals who are devoid of hepatitis virus co-infection. The aim of this study was to evaluate the degree of hepatic fibrosis and the role of associated factors using liver stiffness measurement in HIV mono-infected patients without significant alcohol intake.MethodsWe performed a cross-sectional study of 101 HIV mono-infected patients recruited prospectively from March 1, 2014 to October 30, 2014 at the Center for HIV, St István and St László Hospital, Budapest, Hungary. To determine hepatic fibrosis, liver stiffness was measured with transient elastography. Demographic, immunologic and other clinical parameters were collected to establish a multivariate model. Bayesian Model Averaging (BMA) was performed to identify predictors of liver stiffness.ResultsLiver stiffness ranged from 3.0–34.3 kPa, with a median value of 5.1 kPa (IQR 1.7). BMA provided a very high support for age (Posterior Effect Probability-PEP: 84.5%), moderate for BMI (PEP: 49.3%), CD4/8 ratio (PEP: 44.2%) and lipodystrophy (PEP: 44.0%). For all remaining variables, the model rather provides evidence against their effect. These results overall suggest that age and BMI have a positive association with LS, while CD4/8 ratio and lipodystrophy are negatively associated.DiscussionOur findings shed light on the possible importance of ageing, overweight and HIV-induced immune dysregulation in the development of liver fibrosis in the HIV-infected population. Nonetheless, further controlled studies are warranted to clarify causal relations.

scholarly journals Use of transient elastography in detection of liver fibrosis in psoriasis patients – A cross- sectional study

2020 ◽  
Vol 11 (3) ◽  
pp. 387
Author(s):  
D Banerjee ◽  
Shekhar Neema ◽  
S Radhakrishnan ◽  
Biju Vasudevan ◽  
Preema Sinha ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Transient Elastography ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Liver stiffness by transient elastography accompanies illness severity in COVID-19

2020 ◽  
Vol 7 (1) ◽  
pp. e000445
Author(s):  
Maria Effenberger ◽  
Christoph Grander ◽  
Gernot Fritsche ◽  
Rosa Bellmann-Weiler ◽  
Frank Hartig ◽  
...  
Keyword(s):  
Liver Damage ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Gastrointestinal Symptoms ◽  
Severity Of Illness ◽  
Cross Sectional Study ◽  
Illness Severity ◽  
University Hospital ◽  
Cross Sectional ◽  
Severe Liver Damage

ObjectiveSevere liver damage is associated with worse outcome in COVID-19. Our aim was to explore the degree of liver damage, liver stiffness (LS) and severity of illness in patients with COVID-19.DesignWe investigated 32 patients with COVID-19 admitted to the University Hospital of Innsbruck in a prospective cross-sectional study. We performed laboratory testing, liver and spleen sonography and elastography to measure organ stiffness.Results12 patients (38%) showed elevated aminotransferases and gamma-glutamyltransferase levels. LS was positively correlated with elevated aminotransferase levels in patients with COVID-19 compared with those without elevated enzymes. Even mild liver damage raised LS significantly in COVID-19 as it was in patients with gastrointestinal symptoms. Furthermore, higher LS measurements were significantly associated with illness severity like pneumonia, need for mechanical ventilation, and even death.ConclusionTransient elastography is a useful and non-invasive tool to assess onset and severity of acute liver injury in patients with COVID-19 patients. Increased LS seems to be predictive for a more severe and complicated course of disease.

Increased prevalence of liver fibrosis in people living with HIV without viral hepatitis compared to population controls

2020 ◽  
Author(s):  
Ditte Marie Kirkegaard-Klitbo ◽  
Flemming Bendtsen ◽  
Jens Lundgren ◽  
Robert J de Knegt ◽  
Klaus Fuglsang Kofoed ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
People Living With Hiv ◽  
Previous Exposure ◽  
Hiv Status ◽  
Cross Sectional ◽  
Increased Risk ◽  
Living With Hiv ◽  
Population Controls

Abstract Background Liver fibrosis is associated with poor liver related outcomes and mortality. People living with HIV (PWH) may be at increased risk. We aimed to estimate the prevalence and factors associated with liver fibrosis in PWH compared to population controls. Methods Cross-sectional cohort study. We compared 342 PWH with 2,190 population controls aged 50-70 years. Transient elastography was performed and elevated liver stiffness measurement (LSM) defined as 7.6kPa as a proxy for significant liver fibrosis. Adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) were computed by logistic regression. Results The prevalence of elevated LSM was higher in PWH than in uninfected controls (12% vs 7%), p&lt;0.01). HIV infection was independently associated with elevated LSM. In multivariate analysis, elevated LSM was associated with HIV (aOR:1.84 (1.17;2.88), p&lt;0.01); higher age (per decade, aOR:3.34 (1.81;6.18), p&lt;0.01); ALT (per 10 IU/L, aOR:1.25 (1.05;1.49), p&lt;0.01); BMI (per 1 kg/m 2, aOR:1.17 (1.05;1.29), p&lt;0.01) and previous exposure to didanosine (per year aOR:2.26 (1,01;5.06), p=0.05). Conclusions The prevalence of elevated LSM was higher in PWH compared to population controls. Higher age, BMI, ALT, previous exposure to didanosine and a positive HIV status was independently associated with higher odds of elevated LSM.

scholarly journals Dysregulation of the Immune System in HIV/HCV-Coinfected Patients According to Liver Stiffness Status

Cells ◽  
2018 ◽  
Vol 7 (11) ◽  
pp. 196 ◽  
Author(s):  
Pilar Garcia-Broncano ◽  
Luz Medrano ◽  
Juan Berenguer ◽  
Juan González-García ◽  
Mª Jiménez-Sousa ◽  
...  
Keyword(s):  
Transient Elastography ◽  
Liver Stiffness ◽  
Cross Sectional Study ◽  
T Cell Subsets ◽  
Cross Sectional ◽  
Plasma Cytokine ◽  
Advanced Cirrhosis ◽  
Healthy Donors ◽  
Tnf Α ◽  
Cytokine Levels

Background: Advanced cirrhosis is related to alterations in immunity. We aimed to evaluate the levels of peripheral CD4+ T cells (Tregs) and plasma cytokine in patients coinfected with human immunodeficiency virus and hepatitis C virus (HIV/HCV) according to liver fibrosis stages [evaluated as liver stiffness measure (LSM)] and their linear relationship. Methods: We performed a cross-sectional study on 238 HIV/HCV-coinfected patients (119 had <12.5 kPa, 73 had 12.5–25 kPa, and 46 had >25 kPa). Peripheral T-cell subsets were phenotyped by flow cytometry, plasma biomarkers were assessed by multiplex immunoassays, and LSM was assessed by transient elastography. Results: We found HIV/HCV-coinfected patients had higher values of CD4+ Tregs (p < 0.001), memory Tregs (p ≤ 0.001), and plasma cytokine levels [IFN-γ (p ≤ 0.05) and IL-10 (p ≤ 0.01)] compared with healthy donors and HIV-monoinfected patients. In the multivariate analysis, higher LSM values were associated with reduced levels of IL-10 (adjusted arithmetic mean ratio (aAMR) = 0.83; p = 0.019), IL-2 (aAMR = 0.78; p = 0.017), TNF-α (aAMR = 0.67; p < 0.001), and IL-17A (aAMR = 0.75; p = 0.006). When we focus on HIV/HCV-coinfected patients analyzed by LSM strata, patients with ≥25 kPa had lower values of IL-2 (aAMR = 0.66; p = 0.021), TNF-α (aAMR = 0.565; p = 0.003), and IL-17A (aAMR = 0.58; p = 0.003) than patients with <12.5 kPa. Conclusion: HIV/HCV-coinfected patients showed an immunosuppressive profile compared to healthy controls and HIV-monoinfected patients. Additionally, HIV/HCV-coinfected patients with advanced cirrhosis (LSM ≥ 25 kPa) had the lowest plasma values of cytokines related to Th1 (IL-2 and TNF-α) and Th17 (IL-17A) response.

Sign in / Sign up

Export Citation Format

Share Document