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ABSTRACT
Background: In HCV mono-infected patients FibroScan (FS), FibroTest (FT) and APRI
are widely used for the assessment of cirrhosis. Recently, FS and FT have also been
recommended for first-line assessment of cirrhosis in HIV-HCV co-infected patients.
The aim of this study was to assess the prevalence and factors associated with discordance
for the diagnosis of cirrhosis among non-invasive tests in HIV-HCV patients.
Methods: This study included patients from the ANRS CO13 HEPAVIH cohort, for whom FT,
FS and APRI index results were available, and who were not treated for HCV infection.
Thresholds used for the diagnosis of cirrhosis were: FS>12.5KPa, FT≥0.75, and APRI>2.
Tests were compared two by two. A discordance was considered when only one test
classified a patient as cirrhotic.
Results: 378 HIV-HCV patients were included. A discordance between FT/FS, FT/APRI or
FS/APRI was found in 22, 21 and 13% of patients, respectively. In multivariate analyses,
male gender, older age, body mass index >28, presence of lipodystrophy, increase of ALT,
GGT, bilirubin or of α2-macroglobulin, as well as a low apolipoprotein A1, were
independently associated with discordances. These discordances were more often
attributable to FT than to FS or APRI.
Conclusion: FT, FS and APRI provide discordant results for the diagnosis of cirrhosis in 13
to 22% of HIV-HCV patients. In clinical practice, a careful examination for the presence of
potential factors leading to discordance is required before using these scores.
KEY WORDS: HIV-HCV co-infection, non-invasive scores, cirrhosis
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