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Estudio de concordancia en el grado de fibrosis hep谩ticaestimada mediante los 铆ndices bioqu铆micos APRI y FORNS, y la elastograf铆a de transici贸n (Fibroscan) en pacientes coinfectados por VIH-VHC
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摘要

Introduction

There are non-invasive diagnostic methods of liver fibrosis that are based on biochemical measurements (such as APRI or Forns) or on transient elastography. This study aims to compare the consistency between them in patients coinfected by the human immunodeficiency virus and the hepatitis C virus.

Patients and methods

An elastography, APRI and Forns were performed for 331 patients to evaluate the consistency between the advanced and low grades of fibrosis. The grades of consistency existing between them were calculated with the kappa coefficient.

Results

The grades of fibrosis calculated by APRI and by Forns provided intermediate results (51.1%and 54.7%, respectively), and these patients were not enrolled in the study. The consistency of the elastography in the advanced grade versus the APRI index was 65%and 75%for the Forns index.

When the elastography obtained low grade calculations of fibrosis, the consistency with APRI was 80%and 82.2%with Forns Global consistency was 85.5%and with at least one biochemistry index of 72.1%.

Conclusion

In the HIV and HCV coinfected patients, the use of the APRI and Forns biochemistry indexes to calculate grade of liver fibrosis does not successfully classify at least half of the patients. However, in the patients classified as having high or low fibrosis, the consistency between the calculations obtained by elastography and those derived from the APRI and Forns indexes is moderate to high.

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