Abstract
BackgroundLittle is known about the utility of transient elastography (TE) for assessing the prognosis of patients with decompensated cirrhosis (DC).MethodsWe analyzed HIV/HCV-coinfected patients with DC who underwent TE as part of their routine follow-up between 2006 and 2015. We also calculated the liver stiffness spleen diameter-to-platelet score (LSPS), FIB-4 index, albumin, MELD score, and Child-Pugh score. The primary outcome was death.ResultsThe study population comprised 65 patients. After a median follow-up of 32 months after the first TE, 17 patients had received anti-HCV therapy and 31 patients had died. The highest area under the receiver operating characteristic curve (AUROC) value for prediction of death was observed with albumin (0.695), followed by Child-Pugh score (0.648), both with P values < .05. Lower AUROC values were observed with MELD score (0.633), TE (0.618), LSPS score (0.595), and FIB-4 (0.569), all with P values > .05. In the univariate Cox regression analysis, albumin, FIB-4, Child-Pugh score, and MELD score, but not TE, were associated with death. In the multivariate analysis, albumin and Child-Pugh score were the only baseline variables associated with death.ConclusionsOur results suggest that TE is not useful for assessing the prognosis of HIV-infected patients with decompensated HCV-related cirrhosis. Albumin concentration and Child-Pugh scores were the most consistent predictors of death in this population group.
Highlights
Little is known about the utility of transient elastography (TE) for assessing the prognosis of patients with decompensated cirrhosis (DC)
Survival is primarily related to liver function, which is usually assessed with scoring systems such as the ChildPugh score and the Model for End-Stage Liver Disease (MELD) score [5]
Study population and variables We studied all consecutive human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients with decompensated cirrhosis who underwent transient elastography as part of their routine follow-up between 2006 and 2015
Summary
Little is known about the utility of transient elastography (TE) for assessing the prognosis of patients with decompensated cirrhosis (DC). Assessment of prognosis is an essential element of the care of patients with HCV-related cirrhosis, as it provides useful information for clinical management and treatment decisions. Portal pressure, which is usually determined using the hepatic venous pressure gradient (HVPG), is the most accurate predictor of liver-related events in patients with compensated cirrhosis [4]. Survival is primarily related to liver function, which is usually assessed with scoring systems such as the ChildPugh score and the Model for End-Stage Liver Disease (MELD) score [5]
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