467. Asymptomatic Liver Damage by Liver Stiffness Measurement in Chronic HIV-infected Patients Receiving Combined Antiretroviral Treatment without Hepatitis Virus Co-infections; Prevalence and Associated Factors
Session: Poster Abstract Session: HIV Primary Care
Friday, October 21, 2011
Room: Poster Hall B1
Background: 

The non-AIDS complications including chronic liver disease (CLD) are considering as the important causes of morbidity and mortality in the combined antiretroviral therapy (cART) era. It is important that asymptomatic liver damage in early stage detect to prevent the progression to irreversible CLD. Non-invasive liver stiffness measurement (LSM) using transient elastography (Fibroscan®) is useful to evaluate liver fibrosis. The aim of this study is to evaluate the prevalence of and associated clinical factors for asymptomatic liver damage using LSM in HIV-infected patients receiving cART without HBV/HCV co-infection.

Methods: 

We prospectively enrolled 93 HIV-infected patients who have continuously received the cART more than 12 months at Severance Hospital in Seoul, South Korea, from June to Dec. 2010. We excluded these patients with HBV/HCV co-infection, active opportunistic infections or AIDS-defining illnesses while undergoing treatment, past history of CLD, abnormal liver ultrasonographic findings and chronic alcoholics. We defined cut-off point of abnormal LSM value as 5.3 kilopascal (kPa) according to normal range of healthy Korean in the published reference.

Results: 

Total mean duration of cART was 50.4 months. The median of LS was 4.9 kPa and 39 (41.9%) had the abnormal LSM values. The only cumulative exposed duration of unboosted protease inhibitors (PIs) had the significant positive correlation with kPa in univariate and multivariate linear regression analysis (r=0.372, p<0.001 and β=0.361, p<0.001). The cumulative exposed duration of boosted PI in the abnormal group was the significantly shorter than those in the normal group (14.0 ± 20.9 vs. 26.5 ± 30.3 months, p=0.021). In the forward stepwise multivariate logistic regression analysis to identify the associated clinical factors with abnormal LSM values, the cumulative exposed duration of boosted-PIs and γ-GT levels had the significant association with abnormal LSM values (OR, 0.941; 95% CI, 0.889-0.997; p=0.039 and OR, 1.032; 95% CI, 1.004-1.060; p=0.023).

Conclusion: The high percentage of patients receiving cART without HBV/HCV co-infection had the higher LSM value than healthy people. Boosted-PIs might take the protective role for asymptomatic liver damage.


Subject Category: H. HIV/AIDS and other retroviruses

Sang Hoon Han, MD1, Seung Up Kim2, Young Goo Song, MD1, Chang Oh Kim1, Su Jin Jeong, MD1, Jun Yong Park2, Jun Yong Choi, MD3, Sang Hoon Ahn2, Do Young Kim2, Chae Yoon Chon2, Kwang-Hyub Han2 and June Myung Kim, MD1, (1)Severance Hosp. and AIDS Res. Inst., Yonsei Univ. Coll. of Med., Seoul, South Korea, (2)Severance Hosp. and Liver Cirrhosis Clinical Res. Ctr., Yonsei Univ. Coll. of Med., Seoul, South Korea, (3)Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea

Disclosures:

S. H. Han, None

S. U. Kim, None

Y. G. Song, None

C. O. Kim, None

S. J. Jeong, None

J. Y. Park, None

J. Y. Choi, None

S. H. Ahn, None

D. Y. Kim, None

C. Y. Chon, None

K. H. Han, None

J. M. Kim, None

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