Prediction of Liver Complications in Patients With Hepatitis C Virus–Related Cirrhosis With and Without HIV Coinfection: Comparison of Hepatic Venous Pressure Gradient and Transient Elastography

Background. Hepatic venous pressure gradient (HVPG) is the best indicator of prognosis in patients with compensated cirrhosis. We compared HVPG and transient elastography (TE) for the prediction of liver-related events (LREs) in patients with hepatitis C virus (HCV)–related cirrhosis with or without...

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Bibliographic Details
Published in:Clinical infectious diseases 2014-03, Vol.58 (5), p.713-718
Main Authors: Pérez-Latorre, Leire, Sánchez-Conde, Matilde, Rincón, Diego, Miralles, Pilar, Aldámiz-Echevarría, Teresa, Carrero, Ana, Tejerina, Francisco, Díez, Cristina, Bellón, José María, Bañares, Rafael, Berenguer, Juan
Format: Article
Language:English
Subjects:
Adult
Alcoholic liver cirrhosis
Biological and medical sciences
Carcinoma, Hepatocellular - diagnosis
Carcinoma, Hepatocellular - pathology
Coinfection - complications
Coinfection - pathology
Comparative analysis
Elasticity Imaging Techniques - methods
Female
Gastroenterology. Liver. Pancreas. Abdomen
Hepacivirus
Hepatitis
Hepatitis C
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - pathology
Hepatocellular carcinoma
HIV
HIV Infections - complications
HIV/AIDS
Human immunodeficiency virus
Human viral diseases
Humans
Infectious diseases
Liver
Liver cirrhosis
Liver Cirrhosis - complications
Liver Cirrhosis - pathology
Liver diseases
Liver Failure - diagnosis
Liver Failure - pathology
Liver Neoplasms - diagnosis
Liver Neoplasms - pathology
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
Other diseases. Semiology
Patients
Portal Pressure
Prognosis
Retrospective Studies
ROC Curve
Statistical median
Tracheoesophageal fistula
Venous pressure
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Viral hepatitis
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Summary:Background. Hepatic venous pressure gradient (HVPG) is the best indicator of prognosis in patients with compensated cirrhosis. We compared HVPG and transient elastography (TE) for the prediction of liver-related events (LREs) in patients with hepatitis C virus (HCV)–related cirrhosis with or without human immunodeficiency virus (HIV) coinfection. Methods. This was a retrospective review of all consecutive patients with compensated HCV-related cirrhosis who were assessed simultaneously using TE and HVPG between January 2005 and December 2011. We used receiver operating characteristic (ROC) curves to determine the ability of TE and HVPG to predict the first LRE (liver decompensation or hepatocellular carcinoma). Results. The study included 60 patients, 36 of whom were coinfected with HIV. After a median follow-up of 42 months, 6 patients died, 8 experienced liver decompensations, and 7 were diagnosed with hepatocellular carcinoma. The area under the ROC curve (AUROC) of TE and HVPG for prediction of LREs in all patients was 0.85 (95% confidence interval [CI], .73–.97) and 0.76 (95% CI, .63–.89) (P = .13); for HIV-infected patients, the AUROC was 0.85 (95% CI, .67–1.00) and 0.81 (95% CI, .64–.97) (P = .57); and for non-HIV-infected patients, the AUROC was 0.88 (95% CI, .75–1.00) and 0.77 (95% CI, .57–.97) (P = .19). Based on the AUROC values, 2 TE cutoff points were chosen to predict the absence (
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/cit768