TY  - JOUR
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
Y1  - 2023/06//
TI  - Longitudinal Assessment of the Enhanced Liver Fibrosis Score in the Era of Contemporary HIV and Hepatitis C Virus Treatment
IS  - 11
N2  - BACKGROUND: The trajectory of liver fibrosis is not well understood in the contemporary era of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) therapy. METHODS: We assessed the Enhanced Liver Fibrosis (ELF) score, aspartate transaminase-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) in 116 women with HIV/HCV coinfection over a 4-year period. Random-effects linear regression models examined the rate of fibrosis change 1-2 years before starting HCV treatment, within 1 year before starting (peri-HCV treatment), within 1 year after and 1-2 years post-HCV treatment in unadjusted and adjusted models including age, race, and changes from pretreatment of factors that might affect fibrosis (eg, alcohol, integrase strand inhibitor [INSTI] use, waist circumference, CD4 count). RESULTS: INSTI use nearly doubled from pre- to peri-HCV treatment. In unadjusted analysis, there was a 3.3% rate of rise in ELF pre-HCV treatment, 2.2% and 3.6% rate of decline during the peri- and 1-year post-HCV treatment period, respectively, followed by a 0.3% rise. Similar findings were observed for APRI and FIB-4. There was little effect on the estimated fibrosis trajectories after adjustment. CONCLUSIONS: The apparent lack of decline in biomarkers of liver fibrosis beyond 1 year after HCV cure suggests that continued monitoring of liver fibrosis and interventions to mitigate progression in people with HIV after HCV cure remains essential.
VL  - 227
SN  - 0022-1899
EP  - 1281
SP  - 1274
ID  - discovery10157002
PB  - Oxford University Press (OUP)
JF  - Journal of Infectious Diseases
KW  - APRI
KW  -  ELF
KW  -  FIB-4
KW  -  HIV
KW  -  direct-acting antiviral therapy
KW  -  enhanced liver fibrosis score
KW  -  hepatitis C
UR  - https://doi.org/10.1093/infdis/jiac315
A1  - Gardner, Annelys Roque
A1  - Ma, Yifei
A1  - Bacchetti, Peter
A1  - Price, Jennifer C
A1  - Kuniholm, Mark H
A1  - French, Audrey L
A1  - Gange, Stephen
A1  - Adimora, Adaora A
A1  - Minkoff, Howard
A1  - Kassaye, Seble
A1  - Ofotokun, Igho
A1  - Rosenberg, William
A1  - Kovacs, Andrea AZ
A1  - Tien, Phyllis C
AV  - public
ER  -