Stability of liver fibrosis among HCV-infected injection drug users

2012 Antiviral Therapy 17;5 (813-821)

BACKGROUND: There are few published data characterizing patterns of liver stiffness measurements (LSMs) among HCV-infected persons and their potential impact on clinical decisions (for example, deferring treatment and hepatocellular carcinoma surveillance). METHODS: A total of 591 HCV-infected injection drug users in a community-based cohort had four LSMs. We used semi-parametric latent class growth modelling to identify patterns, which then became a gold standard against which we characterized validity of information from the initial measurements. RESULTS: Median age was 49, 68% were male, 92% African-American and 33% HIV-coinfected. The median LSM at visit 1 was 6.7 kPa (IQR 5.3-8.8). Over a median 1.75 years, LSM measures were stable; median change between visits was 0 kPa (IQR -1.4-1.7). Only 3% had evidence of fibrosis progression. Other groups included stable patterns of no fibrosis (59%), moderate fibrosis (21%), severe fibrosis (7%) and cirrhosis (9%). Individuals with fibrosis progression were more likely to be HIV-infected than those with stable low fibrosis (P/=12.3 kPa) was high (positive predictive value =97%). Although no single low LSM had high negative predictive value for significant fibrosis (metavir

Pubmed : 22418880