Acoustic Radiation Force Impulse for evaluation of liver fibrosis in HIV-HCV co-infected patients

• Published in: BMC infectious diseases 2014-07, Vol.14
• Main Authors: Frulio, Nora, Trillaud, Hervñ, Perez, Paul, Asselineau, Julien, Vandenhende, Marianne, Hessamfar, Mojgan, Bonnet, Fabrice, Maire, Florent, Delaune, Jean, De Ledinghen, Victor, Morlat, Philippe
• Format: Article
• Language: English
• Subjects: Acoustic properties; Care and treatment; Complications and side effects; Diagnosis; Fibrosis; Risk factors
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/1471-2334-14-405

Transient elastography (TE) is widely used for non-invasive assessment of liver fibrosis in HIV-HCV co-infected patients. TE, however, cannot determine liver morphology. Acoustic radiation force impulse (ARFI) imaging is a novel procedure enabling assessment of liver fibrosis during a conventional ultrasonographic examination. This study evaluated the correlation between liver fibrosis measurements by TE and ARFI. Each of 46 HIV-HCV patients underwent both ARFI and TE within 6 months. Patients were evaluated by the "equivalent METAVIR" scoring system, using previously established cut-off values. Agreements between the ARFI and TE scores were estimated by Kappa coefficients, with Kappa values [greater than or equai to]0.40, [greater than or equai to]0.60, and [greater than or equai to]0.80 defined as moderate, good and very good agreement, respectively. ARFI and TE yielded "Equivalent Metavir" fibrosis scores of F1 in 26 and 31 patients, respectively; F2 in nine and seven, respectively; F3 in three and two, respectively; and F4 in eight and six, respectively. The two methods showed very good agreement in predicting overall stages [Kappa = 0.82] and for F [greater than or equai to]3 [Kappa = 0.80] and moderate agreement in predicting significant fibrosis F [greater than or equai to]2 [Kappa = 0.50]. Morphologic ultrasound analysis concomitant to ARFI detected two hepatocarcinomas. ARFI showed promising results in the non-invasive assessment of liver fibrosis in HIV-HCV patients, with liver fibrosis staging similar to that of TE. Moreover, ARFI can assess morphology and fibrosis during the same session.