caa a22 4500 445795549 CHVBK 20180317145123.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s10620-011-1710-2 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1710-2 Comparison of FIB-4 and APRI in HIV-HCV Coinfected Patients with Normal and Elevated ALT [Elektronische Daten] [Amy Shah, Paula Smith, Richard Sterling] Background and Aims: Liver biopsy is standard for assessment of disease severity in patients with chronic HCV. However, associated risks have led to the development of simple non-invasive models. However, their utility in those with normal ALT is unknown. Methods: FIB-4 and APRI were calculated for patients with HIV-HCV coinfection undergoing biopsy. The performance of each model and AUROC for predicting significant fibrosis (Ishak 4-6) were determined for the entire cohort and stratified by elevated (≥60U/l in men and ≥40U/l in women) and normal ALT. Results: Two-hundred and ninety-five liver biopsies from 237 patients were included. Elevated ALT was observed in 55, and 15% had significant fibrosis. The AUROC curve for patients with elevated ALT was 0.8 for FIB-4 and 0.76 for APRI, compared with 0.90 for the FIB-4 and 0.85-0.95 for the APRI in those with normal ALT. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FIB-4 were 1.0, 0.91, 0.50, and 1.0 for patients with normal ALT; the values were 0.67, 0.99, 0.67, and 0.99 for APRI. Conclusions: Both FIB-4 and APRI are useful for highly accurate identification of those without advanced fibrosis. However, because they have poor positive predictive value, liver biopsy will continue to be used for assessment of patients with coinfection. Springer Science+Business Media, LLC, 2011 Non-invasive markers nationallicence Liver fibrosis nationallicence HIV-HCV coinfection nationallicence Shah Amy Divisions of Gastroenterology, Hepatology and Nutrition Infectious Diseases, Virginia Commonwealth University Health System, Richmond, VA, USA aut Smith Paula Divisions of Gastroenterology, Hepatology and Nutrition Infectious Diseases, Virginia Commonwealth University Health System, Richmond, VA, USA aut Sterling Richard Divisions of Gastroenterology, Hepatology and Nutrition Infectious Diseases, Virginia Commonwealth University Health System, Richmond, VA, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/10(2011-10-01), 3038-3044 0163-2116 56:10<3038 2011 56 10620 https://doi.org/10.1007/s10620-011-1710-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1710-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shah Amy Divisions of Gastroenterology, Hepatology and Nutrition Infectious Diseases, Virginia Commonwealth University Health System, Richmond, VA, USA aut NATIONALLICENCE 700 1- Smith Paula Divisions of Gastroenterology, Hepatology and Nutrition Infectious Diseases, Virginia Commonwealth University Health System, Richmond, VA, USA aut NATIONALLICENCE 700 1- Sterling Richard Divisions of Gastroenterology, Hepatology and Nutrition Infectious Diseases, Virginia Commonwealth University Health System, Richmond, VA, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/10(2011-10-01), 3038-3044 0163-2116 56:10<3038 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer