Fibrosis-4 index predicts mortality in HIV/HCV co-infected patients receiving combination antiretroviral therapy in rural China
Fibrosis-4 index predicts mortality in HIV/HCV co-infected patients receiving combination antiretroviral therapy in rural China
复制标题
纤维化-4 指数可预测中国农村地区接受联合抗逆转录病毒治疗的 HIV/HCV 合并感染患者的死亡率
DOI：
10.5582/bst.2018.01299
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发表时间：
2019-02-01
影响因子：
5.5
通讯作者：
He, Na
中科院分区：
文献类型：
--
作者：
Chen, Xiaochen;Liu, Xing;He, Na
终末期肝病（ESLD）是HIV和HCV感染者死亡的主要原因之一。目前尚不清楚肝纤维化评分如何预测联合抗逆转录病毒治疗（cART）下HIV/HCV合并感染人群的死亡率。对2005年至2016年在中国云南接受cART的691例HIV/HCV合并感染患者进行了一项回顾性队列研究，以探讨纤维化-4指数（FIB-4）与全因死亡率之间的关系。使用考克斯比例风险模型估计FIB-4和协变量的风险比（HR）。中位随访时间为4.8年，总随访时间为3，696人-年（PY），发生131例死亡，全因死亡率为3.5/100 PY。基线时FIB-4 3.25组的死亡率为2.9（95% CI：2.3-3.5）/100 PY。FIB-4由轻度转为重度组HR为1.81（95% CI：1.01-3.25），FIB-4持续晚期显示HR为3.11（1.75-5.54），与FIB-4患者相比，两者均保持轻度，而已婚人群的死亡风险较低（HR = 0.63，95%CI：0.41-0.99），与未婚者相比，在最近CD 4（+）T细胞计数在200和350个细胞/μ L（0.50，0.30-0.86）之间和> 350个细胞/μ L（0.25，0.15-0.41）的患者中，与CD 4低于200个细胞/μ L相比。晚期和进行性肝纤维化是中国CART下HIV/HCV合并感染患者全因死亡率的强预测因子。
End-stage liver disease (ESLD) is among leading causes of death for people living with HIV and HCV. Little is known how liver fibrosis score predicts mortality in HIV/HCV co-infected population under combination antiretroviral therapy (cART). A retrospective cohort study of 691 HIV/HCV co-infected patients receiving cART in Yunnan, China from 2005 to 2016 was carried out to explore the association between Fibrosis-4 index (FIB-4) and all-cause mortality. Cox proportional hazard models were used to estimate the hazard ratios (HRs) for FIB-4 and covariates. After a median follow-up of 4.8 years with a total follow-up time of 3,696 person-years (PY), 131 deaths occurred and the all-cause mortality was 3.5 per 100 PY. The mortality was 2.9 (95% CI: 2.3-3.5)/100 PY for the FIB-4 3.25 group at baseline. People with FIB-4 changed from mild to advanced group showed HR of 1.81 (95% CI: 1.01-3.25) for death, and with FIB-4 sustaining advanced showed HR of 3.11 (1.75-5.54), both compared to those with FIB-4 remained mild, while lower risk of death was observed among married people (HR = 0.63, 95% CI: 0.41-0.99) compared to unmarried, among those with most recent CD4(+) T cell counts between 200 and 350 cells/mu L (0.50, 0.30-0.86) and > 350 cells/mu L (0.25, 0.15-0.41) compared to CD4 under 200 cells/pL. Advanced and progressive liver fibrosis is a strong predictor of all-cause mortality in HIV/HCV co-infected patients under CART in China.