Researchers at McGill University Health Centre (MUHC) in Montreal have come up with an innovative way to identify liver fibrosis in HIV patients more accurately than the conventional methods.
Liver fibrosis, the accumulation of scar tissue in the liver, is a serious condition that can result in permanent damage and is a major cause of mortality among those with HIV.
In a recent study published in the Hepatology journal, it was revealed that the commonly used FIB-4 blood test, which aims to detect liver tissue scarring, misclassified more than a third of cases as low risk.
Particularly concerning was FIB-4’s poor performance in detecting fibrosis in individuals with steatotic liver disease (SLD), previously referred to as fatty liver disease. SLD affects a significant portion of adults globally and can progress to liver fibrosis.
The study, involving nearly 5,000 participants from five countries between 2015 and 2025, excluded those with active viral hepatitis or harmful alcohol consumption.
Researchers discovered that many participants with significant liver fibrosis erroneously identified as low risk by the FIB-4 test remained in that category upon retesting 12 and 24 months later. This oversight could potentially hinder necessary clinical intervention.
To address this issue, scientists at MUHC crafted an alternative screening approach by examining the characteristics of those whose liver fibrosis was undetected by FIB-4, ultimately enhancing risk assessment accuracy.
The newly introduced method involves calculating a FIB-HIV score utilizing readily available clinical data and traditional risk factors such as obesity, diabetes, and hypertension, alongside HIV-specific factors like exposure to certain older antiretroviral drugs, HIV infection duration, previous immune suppression severity, and viral load.
Felice Cinque, the study’s author and former postdoctoral fellow at MUHC, emphasized that numerous factors can contribute to liver damage in individuals with HIV without significantly affecting the blood markers used in the FIB-4 score calculation.
Dr. Giada Sebastiani, an associate professor at McGill University and MUHC scientist, expressed optimism that this novel screening technique would advance liver fibrosis detection, particularly as the aging HIV population faces heightened risks.
As the number of individuals over 50 living with HIV continues to rise in high-income nations, liver disease poses an increasingly critical health issue. Sebastiani highlighted the potential of this research to promote a more tailored and efficient liver fibrosis screening method.
Keyphrase: liver fibrosis screening
