Can Transient Elastography Replace Liver Biopsy in Assessment of Liver Fibrosis in Patients with HCV

Twenty-Seventh Congress of Internal Medicine Iranian society -14 to 17 May 1395

Can Transient Elastography Replace Liver Biopsy in Assessment of Liver Fibrosis in Patients with HCV/HIV Co- infection

Parisa poursamimi1. Mehri Nikbin1 , Heidar Sharafi2, Seyed Moayed Alavian2, Maryam Hoseini- Rad1, Bita Behnava2 , Maryam Keshvari3

1 Iran Hepatitis Network , Tehran, Iran

2 Middle East Liver Disease Center ,Tehran, Iran

3 Blood Transfusion Research Center , High Institute for Research and Education in Transfusion Medicine, Tehran, Iran

Background:

Liver disease is increasing as a cause of morbidity and mortality among patients with co- infection of human immune deficiency virus (HIV) and hepatitis C virus (HCV).An accurate assessment of liver fibrosis is fundamental for monitoring the disease progression and for the therapeutic decisions to be made in HCV/HIV confection .Liver biopsy is the gold standard for fibrosis staging .However , this method is invasive and entailing side effects or complications in a minority of cases. In the past few years, transient elastography (FibroScan) has gained an important role in the detection of liver fibrosis .The aim of this retrospective study was to compare transient elastography with histologic methods among HCV/HIV – coinfected particpants.

Material/Methods:

A total of 46 patients with HCV/HIV co-infection were studied .Liver fibrosis was evaluated using FibroScan and liver biopsy and the time period between the two assessments were less than 6 months .Liver fibrosis scoring system uses .the METAVIR score performance of each technique for distinguishing F0 to F4 was compared.

Results:

The mean -SD age of patients was 44.2 -7.92 .The majority of patients showed mild liver disease by both methods. The results by FibroScan and liver biopsy was significantly concordant (p<0.001)(Table1).

Conclusions:

This study showed that fibrosis stage predicted by Fibro scan is similar to that predicted by examination of a biopsy specimen in patients with HCV/HIV co- infection .Elastography – based measurement of liver stiffness holds promise to expand liver disease screening and monitoring instead of liver biopsy .

Table 1. Comparison of liver fibrosis obtained by fibro Scan and liver biopsy