ArticleHepatology (Baltimore, Md.)2020
Evaluating Noninvasive Markers to Identify Advanced Fibrosis by Liver Biopsy in HBV/HIV Co-infected Adults.
Article in Hepatology (Baltimore, Md.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 43 citations in OpenAlex.
- Managing HBV/HIV coinfection: from diagnostics to long-acting antiretroviral therapy.Clinical and experimental hepatology · 2026Review
- Current and Investigational Biomarkers of Liver Disease in HIV-HBV Co-infection.Current HIV/AIDS reports · 2025Review
- The Role of Liver Biopsy and Fine Needle Aspiration in Novel HBV Therapeutics in HIV and HBV Coinfection.Current HIV/AIDS reports · 2025Review
- Diagnostic accuracy of noninvasive steatosis biomarkers with magnetic resonance imaging proton density fat fraction as gold standard.World journal of radiology · 2025Article
- Nonlinear associations of the hs-CRP/HDL-C index with metabolic dysfunction-associated steatotic liver disease and advanced liver fibrosis in US adults: insights from NHANES 2017-2018.Scientific reports · 2025Article
- Patterns of liver fibrosis evolution in Chinese HIV/HBV co-infected adults following 5-year antiretroviral treatment: A longitudinal study using non-invasive APRI and Fib-4 scores.Virologica Sinica · 2025Article
- Prevalence of hepatitis B virus infection in a cohort of HIV-positive women in Uganda: a cross-sectional survey at the "Zia Angelina" Medical Centre.The Pan African medical journal · 2025Article
- Inflammatory and metabolic markers mediate the association between urinary metals and non-alcoholic fatty liver disease in U.S. adults: a cross-sectional study.Frontiers in public health · 2025Article
- Liver Fibrosis Scores as Predictors of Blood-Culture-Positive and Sepsis in Patients withInfection and drug resistance · 2024Article
- The predictive role of the platelet-to-lymphocyte ratio for the risk of non-alcoholic fatty liver disease and cirrhosis: a nationwide cross-sectional study.Frontiers in endocrinology · 2024Article
- Article
- DAPS score - a novel score for prediction of significant fibrosis in incidentally detected asymptomatic hepatitis B subjects.Clinical and experimental hepatology · 2023Article
- Hepatitis delta coinfection in persons with HIV: misdiagnosis and disease burden in Italy.Pathogens and global health · 2023Article
- Integrated hepatitis B virus DNA maintains surface antigen production during antiviral treatment.The Journal of clinical investigation · 2022Article
- Evaluation of Magnetic Resonance Elastography and Transient Elastography for Liver Fibrosis and Steatosis Assessments in the Liver Transplant Setting.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2022Article
- Liver fibrosis progression in a cohort of young HIV and HIV/ HBV co-infected patients: A longitudinal study using non-invasive APRI and Fib-4 scores.Frontiers in medicine · 2022Article
- Risk of HCC With Hepatitis B Viremia Among HIV/HBV-Coinfected Persons in North America.Hepatology (Baltimore, Md.) · 2021Article
- A Prospective Study Evaluating Changes in Histology, Clinical and Virologic Outcomes in HBV-HIV Co-infected Adults in North America.Hepatology (Baltimore, Md.) · 2021Observational
- Accuracy of Transient Elastography in Assessing Fibrosis at Diagnosis in Naïve Patients With Primary Biliary Cholangitis: A Dual Cut-Off Approach.Hepatology (Baltimore, Md.) · 2021Article
- Hepatitis B Virus (HBV) Genotype Mixtures, Viral Load, and Liver Damage in HBV Patients Co-infected With Human Immunodeficiency Virus.Frontiers in microbiology · 2021Article
Corrections and comments
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- Commented on byReply.2019
Authors and funding
12 authors at 9 institutions in 2 countries.
Funding
Abstract
Noninvasive biomarkers are used increasingly to assess fibrosis in patients with chronic liver disease. We determined the utility of dual cutoffs for noninvasive biomarkers to exclude and confirm advanced fibrosis in hepatitis B virus (HBV)-human immunodeficiency virus (HIV) co-infected patients receiving combined antiretroviral therapy. Participants were anti-HIV/hepatitis B surface antigen-positive adults from eight clinical sites in the United States and Canada of the Hepatitis B Research Network. Fibrosis was staged by a central pathology committee using the Ishak fibrosis score (F). Clinical, laboratory, and vibration-controlled transient elastography (VCTE) data were collected at each site. Dual cutoffs for three noninvasive biomarkers (aspartate aminotransferase-to-platelet ratio index, Fibrosis-4 index [FIB-4], and liver stiffness by VCTE) with the best accuracy to exclude or confirm advanced fibrosis (F ≥ 3) were determined using established methodology. Of the 139 enrolled participants, 108 with a liver biopsy and having at least one noninvasive biomarker were included: 22% had advanced fibrosis and 54% had normal alanine aminotransferase. The median (interquartile range) of APRI (n = 106), FIB-4 (n = 106), and VCTE (n = 63) were 0.34 (0.26-0.56), 1.35 (0.99-1.89), and 4.9 (3.8-6.8) kPa, respectively. The area under the curve for advanced fibrosis was 0.69 for APRI, 0.66 for FIB-4, and 0.87 for VCTE. VCTE cutoffs of 5.0 kPa or less (to exclude) and 8.8 kPa or greater (to confirm) advanced fibrosis had a sensitivity of 92.3% and specificity of 96.0%, respectively, and accounted for 65.1% of participants. Among the 34.9% with values between the cutoffs, 26.1% had advanced fibrosis. Considering APRI or FIB-4 jointly with VCTE did not improve the discriminatory capacity. Conclusion: VCTE is a better biomarker of advanced fibrosis compared with APRI or FIB-4 in HBV/HIV co-infected adults on combined antiretroviral therapy. Using VCTE dual cutoffs, approximately two-thirds of patients could avoid biopsy to determine advanced fibrosis.
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