Prediction of hepatic fibrosis in HIV/HCV co-infected patients using serum fibrosis markers: The SHASTA index
Prediction of hepatic fibrosis in HIV/HCV co-infected patients using serum fibrosis markers: The SHASTA index
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DOI：
10.1016/j.jhep.2005.02.025
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发表时间：
2005-07-01
影响因子：
25.7
通讯作者：
Afdhal, NH
中科院分区：
文献类型：
--
作者：
Kelleher, TB;Mehta, SH;Afdhal, NH
背景/目的：探讨血清纤维化生物标志物是否能准确地判断丙型肝炎和HIV混合感染患者的肝病分期。方法：从约翰霍普金斯大学HIV临床队列中随机选择137例HIV/丙型肝炎混合感染者。95人在肝脏活检时收集的血清中进行了完整的纤维化标志物检测。根据Ishak改良的组织学活动指数(F0无纤维化至F6肝硬变)对活检组织进行评分。以丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷草转氨酶(AST)/血小板比值(APRI)、白蛋白、总胆红素、透明质酸(HA)和YKL-40为指标评价肝纤维化程度。结果：69例(73%)门静脉无或轻度纤维化(F0~2)，与其余受试者(F3~6)比较。在HA水平为86 ng/ml的患者中，纤维化评分>；=F3的发生率是后者的27倍，在HA水平为41-86 ng/ml的患者中，纤维化评分的发生率是后者的5.5倍。白蛋白水平为3.5g/dl(OR4.85)和AST>；60in的相关性较弱(OR5.91)。所有35名HA、白蛋白和AST检测结果良好的受试者都有轻微的纤维化(F0-2)。结论：在HIV/丙型肝炎合并感染的患者中，血清HA、白蛋白和AST(Shasta指数)检测能够准确地分期轻度和晚期纤维化。(C)2005年欧洲肝脏研究协会。爱思唯尔出版，版权所有。
Background/Aims: To examine if serum fibrosis biomarkers could accurately identify the stage of liver disease amongst hepatitis C (HCV) and HIV co-infected patients.Methods: One hundred and thirty seven HIV/HCV co-infected persons were randomly selected from the Johns Hopkins HIV Clinic cohort. Ninety five had complete testing for fibrosis markers in sera collected at the time of liver biopsy. Biopsies were scored according to Ishak modified histological activity index (F0 no fibrosis to F6 cirrhosis). Fibrosis was evaluated against alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST to platelet ratio (APRI), albumin, total bilirubin, hyaluronic acid (HA) and YKL-40.Results: Sixty nine (73%) had no or minimal portal fibrosis (F0-2) and were compared with remaining subjects (F3-6). Fibrosis scores >= F3 were found 27 times more often in persons with HA levels > 86 ng/ml and 5.5 times more often in persons with HA levels 41-86 ng/ml. Less substantial associations were detected with levels of albumin < 3.5 g/dl (OR 4.85) and AST > 60 in (OR 5.91). All 35 subjects who had favorable results of HA, albumin, and AST had minimal fibrosis (F0-2).Conclusions: Amongst HIV/HCV co-infected patients, serum testing for HA, albumin, and AST (SHASTA Index) was able to accurately stage mild and advanced fibrosis. (c) 2005 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.