Liver fibrosis in human immunodeficiency virus/hepatitis C virus coinfection: Diagnostic methods and clinical impact

Several non-invasive surrogate methods have recently challenged the main role of liver biopsy in assessing liver fibrosis in hepatitis C virus(HCV)-monoinfected and human immunodeficiency virus(HIV)/HCV-coinfected patients, applied to avoid the well-known side effects of liver puncture. Serological...

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Published inWorld journal of hepatology Vol. 7; no. 24; pp. 2510 - 2521
Main Authors Sagnelli, Caterina, Martini, Salvatore, Pisaturo, Mariantonietta, Pasquale, Giuseppe, Macera, Margherita, Zampino, Rosa, Coppola, Nicola, Sagnelli, Evangelista
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 28.10.2015
Subjects
coi
Human
immunodeficiency
Topic Highlight
virus
virus/hepatitis
Liver biopsy
Liver ultrasonography
Liver fibrosis
Fibroscan
Human immunodeficiency virus/hepatitis C virus coinfection
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Summary:Several non-invasive surrogate methods have recently challenged the main role of liver biopsy in assessing liver fibrosis in hepatitis C virus(HCV)-monoinfected and human immunodeficiency virus(HIV)/HCV-coinfected patients, applied to avoid the well-known side effects of liver puncture. Serological tests involve the determination of biochemical markers of synthesis or degradation of fibrosis, tests not readily available in clinical practice, or combinations of routine tests used in chronic hepatitis and HIV/HCV coinfection. Several radiologic techniques have also been proposed, some of which commonly used in clinical practice. The studies performed to compare the prognostic value of noninvasive surrogate methods with that of the degree of liver fibrosis assessed on liver tissue have not as yet provided conclusive results. Each surrogate technique has shown some limitations, including the risk of over- or under-estimating the extent of liver fibrosis. The current knowledge on liver fibrosis in HIV/HCVcoinfected patients will be summarized in this review article, which is addressed in particular to physicians involved in this setting in their clinical practice.
Bibliography:Several non-invasive surrogate methods have recently challenged the main role of liver biopsy in assessing liver fibrosis in hepatitis C virus(HCV)-monoinfected and human immunodeficiency virus(HIV)/HCV-coinfected patients, applied to avoid the well-known side effects of liver puncture. Serological tests involve the determination of biochemical markers of synthesis or degradation of fibrosis, tests not readily available in clinical practice, or combinations of routine tests used in chronic hepatitis and HIV/HCV coinfection. Several radiologic techniques have also been proposed, some of which commonly used in clinical practice. The studies performed to compare the prognostic value of noninvasive surrogate methods with that of the degree of liver fibrosis assessed on liver tissue have not as yet provided conclusive results. Each surrogate technique has shown some limitations, including the risk of over- or under-estimating the extent of liver fibrosis. The current knowledge on liver fibrosis in HIV/HCVcoinfected patients will be summarized in this review article, which is addressed in particular to physicians involved in this setting in their clinical practice.
Human immunodeficiency virus/hepatitis C virus coi
Caterina Sagnelli;Salvatore Martini;Mariantonietta Pisaturo;Giuseppe Pasquale;Margherita Macera;Rosa Zampino;Nicola Coppola;Evangelista Sagnelli;Department of Clinical and Experimental Medicine and Surgery "F.Magrassi e A.Lanzara,Second University of Naples;Department of Mental Health and Public Medicine,Section of Infectious Diseases,Second University of Naples;Division of Infectious Diseases,AORN Sant’ Anna e San Sebastiano di Caserta;Azienda Ospedaliera Universitaria, Second University of Naples;Department of Medical,Surgical,Neurological,Metabolic and Geriatric Sciences,Second University of Naples
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Correspondence to: Evangelista Sagnelli, Professor, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Via L. Armanni 5, 80131 Naples, Italy. evangelistasagnelli@libero.it
Telephone: +39-81-5666719 Fax: +39-81-5666207
Author contributions: Sagnelli C, Martini S, Pisaturo M, Pasquale G, Macera M, Zampino R, Coppola N and Sagnelli E made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content; and final approval of the version to be published.
ISSN:1948-5182
1948-5182
DOI:10.4254/wjh.v7.i24.2510