Current and Investigational Biomarkers of Liver Disease in HIV-HBV Co-infection.

IF 4.4 2区 医学 Q2 INFECTIOUS DISEASES
Keyur Patel, Giada Sebastiani
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Abstract

Purpose of review: Coinfection with HIV-HBV results in increased rate of liver disease progression through immune and metabolic dysfunction. Additional metabolic risks in ageing people with HIV (PwHIV) contribute to hepatic necroinflammation and fibrogenesis. There are now several blood-based and imaging non-invasive tests (NIT) that are increasingly available as an alternative to biopsy to estimate hepatic fibrosis.

Recent findings: There are few studies for NITs and fibrosis in PwHIV-HBV. Simple tests such as FIB-4 and APRI have poor diagnostic utility for significant fibrosis or disease monitoring in PwHIV-HBV. Transient elastography (TE) has less variability, and may be useful to exclude advanced fibrosis in patients with low viral load and normal liver enzymes. Combination TE and blood-based NITs with concordant results may be useful, but optimal diagnostic test thresholds have not been established. Interpretation of current NITs in PwHIV-HBV should consider context of use, along with clinical and biochemical variables that limit diagnostic accuracy.

HIV-HBV合并感染中肝脏疾病的当前和研究生物标志物。
综述的目的:HIV-HBV合并感染通过免疫和代谢功能障碍导致肝脏疾病进展率增加。老年艾滋病毒(PwHIV)患者的额外代谢风险有助于肝坏死、炎症和纤维化。现在有几种基于血液和成像的非侵入性检查(NIT)越来越多地作为活检评估肝纤维化的替代方法。最近的研究发现:PwHIV-HBV中NITs和纤维化的研究很少。简单的检测如FIB-4和APRI对PwHIV-HBV的显著纤维化或疾病监测的诊断效用较差。瞬时弹性成像(TE)变异性较小,可能有助于排除病毒载量低、肝酶正常的晚期纤维化患者。联合TE和基于血液的NITs结果一致可能是有用的,但最佳的诊断测试阈值尚未建立。解释PwHIV-HBV目前的NITs应考虑使用背景,以及限制诊断准确性的临床和生化变量。
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来源期刊
Current HIV/AIDS Reports
Current HIV/AIDS Reports INFECTIOUS DISEASES-
CiteScore
8.10
自引率
2.20%
发文量
45
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of HIV/AIDS. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antiretroviral therapies, behavioral aspects of management, and metabolic complications and comorbidity. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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