| Author | Merchante, Nicolás | |
| Author | Palumbo, Chiara Saroli | |
| Author | Mazzola, Giovanni | |
| Author | Pineda, Juan A. | |
| Author | Téllez, Francisco | |
| Author | Rivero-Juárez, Antonio | |
| Author | Ríos-Villegas, Maria José | |
| Author | Maurice, James B. | |
| Author | Westbrook, Rachel H. | |
| Author | Judge, Rebekah | |
| Author | Guaraldi, Giovanni | |
| Author | Schepis, Filippo | |
| Author | Perazzo, Hugo | |
| Author | Rockstroh, Juergen | |
| Author | Boesecke, Christoph | |
| Author | Klein, Marina B. | |
| Author | Cervo, Adriana | |
| Author | Ghali, Peter | |
| Author | Wong, Philip | |
| Author | Petta, Salvatore | |
| Author | De Ledinghen, Victor | |
| Author | Macías, Juan | |
| Author | Sebastiani, Giada | |
| Access date | 2021-02-24T20:26:09Z | |
| Available date | 2021-02-24T20:26:09Z | |
| Document date | 2019 | |
| Citation | MERCHANTE, Nicolás et al. Prediction of Esophageal Varices by Liver Stiffness and Platelets in Persons With Human Immunodeficiency Virus Infection and Compensated Advanced Chronic Liver Disease. Clinical Infectious Diseases, v. 71, n. 11, p. 1-31, 2019. | |
| URI | https://www.arca.fiocruz.br/handle/icict/46160 | |
| Language | eng | en_US |
| Publisher | Oxford | |
| Rights | restricted access | |
| Subject in Portuguese | Baveno VI criteria | pt_BR |
| Subject in Portuguese | HCV coinfection | pt_BR |
| Subject in Portuguese | Esophagogastroduodenoscopy | pt_BR |
| Subject in Portuguese | Transient elastography | pt_BR |
| Subject in Portuguese | Variceal bleeding | pt_BR |
| Title | Prediction of Esophageal Varices by Liver Stiffness and Platelets in Persons With Human Immunodeficiency Virus Infection and Compensated Advanced Chronic Liver Disease | en_US |
| Type | Preprint | |
| DOI | 10.1093/cid/ciz1181 | |
| Abstract | Background: People living with human immunodeficiency virus (PLWH) are at increased risk of cirrhosis and esophageal varices. Baveno VI criteria, based on liver stiffness measurement (LSM) and platelet count, have been proposed to avoid unnecessary esophagogastroduodenoscopy (EGD) screening for esophageal varices needing treatment (EVNT). This approach has not been validated in PLWH. Methods: PLWH from 8 prospective cohorts were included if they fulfilled the following criteria: (1) compensated advanced chronic liver disease (LSM >10 kPa); (2) availability of EGD within 6 months of reliable LSM. Baveno VI (LSM <20 kPa and platelets >150 000/μL), expanded Baveno VI (LSM <25 kPa and platelets >110 000/μL), and Estudio de las Hepatitis Víricas (HEPAVIR) criteria (LSM <21 kPa) were applied to identify patients not requiring EGD screening. Criteria optimization was based on the percentage of EGDs spared, while keeping the risk of missing EVNT <5%. Results: Five hundred seven PLWH were divided into a training (n = 318) and a validation set (n = 189). EVNT were found in 7.5%. In the training set, Baveno VI, expanded Baveno VI, and HEPAVIR criteria spared 10.1%, 25.5%, and 28% of EGDs, while missing 0%, 1.2%, and 2.2% of EVNT, respectively. The best thresholds to rule out EVNT were platelets >110 000/μL and LSM <30 kPa (HIV cirrhosis criteria), with 34.6% of EGDs spared and 0% EVNT missed. In the validation set, HEPAVIR and HIV cirrhosis criteria spared 54% and 48.7% of EGDs, while missing 4.9% and 2.2% EVNT, respectively. Conclusions: Baveno VI criteria can be extended to HEPAVIR and HIV cirrhosis criteria while sparing a significant number of EGDs, thus improving resource utilization for PLWH with compensated advanced chronic liver disease. | en_US |
| Affilliation | Hospital Universitario de Valme. Unidad Clínica de Enfermedades Infecciosas y Microbiología. Sevilla, Spain. | |
| Affilliation | McGill University Health Centre. Montreal, Quebec, Canada. | |
| Affilliation | University of Palermo. Department of Health Promotion Sciences and Mother and Child Care Giuseppe D'Alessandro. Palermo, Italy. | |
| Affilliation | Hospital Universitario de Valme. Unidad Clínica de Enfermedades Infecciosas y Microbiología. Sevilla, Spain. | |
| Affilliation | Universidad de Cádiz. Facultad de Medicina. Hospital Universitario de Puerto Real. Unidad de Enfermedades Infecciosas. Cádiz, Spain. | |
| Affilliation | Córdoba Universidad de Córdoba. Hospital Universitario Reina Sofía. Unidad de Enfermedades Infecciosas. Instituto Maiomónides de Investigación Biomédica de Córdoba. Córdoba, Spain. | |
| Affilliation | Hospital Universitario Virgen Macarena. Unidad de Enfermedades Infecciosas. Sevilla, Spain. | |
| Affilliation | Imperial College London. London, United Kingdom / Royal Free Hospital London. London, United Kingdom. | |
| Affilliation | Royal Free Hospital London. London, United Kingdom. | |
| Affilliation | Imperial College London. London, United Kingdom. | |
| Affilliation | University of Modena and Reggio Emilia. Modena, Italy. | |
| Affilliation | University of Modena and Reggio Emilia. Modena, Italy. | |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | University Hospital Bonn. Department of Medicine I. Bonn, Germany / German Center for Infection Research Germany. Partner site Bonn-Cologne. German. | |
| Affilliation | University Hospital Bonn. Department of Medicine I. Bonn, Germany / German Center for Infection Research Germany. Partner site Bonn-Cologne. German. | |
| Affilliation | McGill University Health Centre. Montreal, Quebec, Canada. | |
| Affilliation | University of Palermo. Department of Health Promotion Sciences and Mother and Child Care Giuseppe D'Alessandro. Palermo, Italy. | |
| Affilliation | McGill University Health Centre. Montreal, Quebec, Canada. | |
| Affilliation | McGill University Health Centre. Montreal, Quebec, Canada. | |
| Affilliation | University of Palermo. Dipartimento Biomedico di Medicina Interna e Specialistica. Sezione di Gastroenterologia e Epatologia. Palermo, Italy. | |
| Affilliation | Bordeaux University Hospital. Hôpital Haut-Lévêque. Centre d'Investigation de la Fibrose Hépatique. Pessac, France. | |
| Affilliation | Hospital Universitario de Valme. Unidad Clínica de Enfermedades Infecciosas y Microbiología. Sevilla, Spain. | |
| Affilliation | McGill University Health Centre. Montreal, Quebec, Canada. | |
| Embargo date | 2030-12-31 | |
