TY - JOUR T1 - Assessment of liver disease by non-invasive methods in perinatally infected Brazilian adolescents and young adults living with Human Immunodeficiency Virus (HIV) JO - The Brazilian Journal of Infectious Diseases T2 - AU - Gouvêa,Aida de Fátima Thomé Barbosa AU - Filho,Roberto Carvalho AU - Machado,Daisy Maria AU - Bononi do Carmo,Fabiana AU - Beltrão,Suenia Vasconcelos AU - Sampaio,Laurene AU - de Moraes-Pinto,Maria isabel AU - Succi,Regina Célia de Menezes SN - 14138670 M3 - 10.1016/j.bjid.2021.101589 DO - 10.1016/j.bjid.2021.101589 UR - https://www.bjid.org.br/en-assessment-liver-disease-by-non-invasive-articulo-S1413867021000581 AB - IntroductionEffective and long-term combined antiretroviral therapy (cART) has decreased morbidity and mortality in HIV-infected individuals. Despite treatment advances, HIV-infected children continue to develop noninfectious conditions, including liver fibrosis. MethodsCross-sectional study designed to identify liver fibrosis in HIV-infected adolescents and young adults, in an outpatients clinic of Pediatric Infectious Diseases Division at Escola Paulista de Medicina/Universidade Federal de São Paulo (UNIFESP), diagnosed by noninvasive methods (liver elastography–FibroScan®, APRI and FIB4). Variables examined included demographics, clinical, laboratories, HIV treatment. All participants underwent FibroScan® to measure liver parenchyma elasticity. Values equal to above 7.0 kPa were interpreted as the presence of significant liver fibrosis. Two different biomarkers of liver fibrosis were employed: the AST-to-Platelet Ratio Index (APRI) and the Fibrosis-4 score (FIB-4). APRI values above 1.5 have been considered as levels of clinically significant liver fibrosis and FIB-4 values above 3.25 suggested the presence of advanced fibrosis. ResultsBetween August 2014 and March 2017, the study enrolled 97 patients, age 10–27 years old, fourteen of 97 subjects (14.4%) presented liver stiffness (≥7 kPa) detected by the liver elastography. No patient had APRI> 1.5. No patient had FIB4 value > 3.25. The only isolated laboratory parameter that could be significantly associated with high liver stiffness was thrombocytopenia (p = 0.022, Fisher's exact test). ConclusionLiver stiffness was identified in 14.4% (14/97) of this cohort by liver elastography. Liver disease in HIV-infected adolescents and young adults manifests itself silently, so should be routinely investigated. ER -