Researchers at McGill University Health Centre in Montreal have introduced a more effective method for detecting liver fibrosis in HIV patients, a condition characterized by the accumulation of scar tissue in the liver. Liver fibrosis, a leading cause of mortality among individuals with HIV, can result in permanent liver damage.
A study published in the Hepatology journal revealed that the commonly used FIB-4 blood test, aimed at identifying liver tissue scarring, inaccurately classified more than a third of cases as low risk. Particularly, the test showed poor performance in detecting fibrosis in individuals with steatotic liver disease (SLD), previously known as fatty liver disease, which affects one in three adults globally and can lead to liver fibrosis.
The study, encompassing nearly 5,000 participants from five countries over a decade, excluded individuals with active viral hepatitis or excessive alcohol use. The research emphasized that participants erroneously categorized as low risk by the FIB-4 score continued to remain in that category upon retesting after 12 and 24 months, potentially missing out on crucial clinical follow-up.
To address this issue, researchers at McGill University Health Centre devised an innovative screening approach by formulating a FIB-HIV score. This score incorporates routine clinical data and traditional risk factors such as overweight, obesity, diabetes, and hypertension, along with HIV-specific factors like exposure to specific antiretroviral drugs, duration of HIV infection, previous immune suppression severity, and viral load.
Felice Cinque, the study’s author and former postdoctoral fellow at McGill University Health Centre, highlighted the significance of considering individual metabolic and HIV-related factors to provide a more precise assessment of liver fibrosis risk.
Dr. Giada Sebastiani, an associate professor at McGill University and a scientist at McGill University Health Centre, expressed optimism that this new screening method would enhance liver fibrosis detection, especially as the population of aging individuals living with HIV continues to rise.
In high-income nations, an increasing number of individuals with HIV are aged over 50, making liver disease a growing health concern. The researchers aim for these findings to promote a tailored and efficient approach to liver fibrosis screening.