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Home >> Publications >> FIB-4 index is associated with hepatocellular carcinoma risk in HIV-infected patients.

Publication

Author(s):

Park LS, Tate JP, Justice AC, Lo Re V 3rd, Lim JK, Brê_u N, Brown ST, Butt AA, Gibert C, Goetz MB, Rimland D, Rodriguez-Barradas MC, Dubrow R.

Pub Title:

FIB-4 index is associated with hepatocellular carcinoma risk in HIV-infected patients.

Pub Date:

Dec 31 2011

Journal Issue:

12

Page Number:
2512-7

Journal:

Title: 
Cancer Epidemiology Biomarkers Prevention
Link: 
http://cebp.aacrjournals.org/content/20/12/2512.long

PubMed: 22028407
Pub PDF: PDF icon 22028407.pdf

Abstract
BACKGROUND
: Chronic inflammation caused by hepatitis B virus infection, hepatitis C virus infection, and/or heavy alcohol use can lead to fibrosis, cirrhosis, and eventually hepatocellular carcinoma (HCC). FIB-4 is an index score calculated from platelet count, alanine transaminase, aspartate transaminase, and age that predicts fibrosis and cirrhosis. We hypothesized that high FIB-4 would be associated with development of HCC in HIV-infected persons, who are at high risk due to high prevalence of viral hepatitis and alcohol consumption, and possibly due to HIV infection itself.

METHODS: Using proportional hazards models, we tested this hypothesis among 22,980 HIV-infected men from the Veterans Aging Cohort Study. We identified incident HCC cases from the Veterans Affairs Central Cancer Registry.

RESULTS: During follow-up, there were 112 incident HCC diagnoses. The age- and race/ethnic group-adjusted HR was 4.2 [95% confidence interval (CI), 2.4-7.4] for intermediate FIB-4 and 13.0 (95% CI, 7.2-23.4) for high FIB-4, compared with low FIB-4. After further adjustment for enrollment year, CD4 count, HIV-1 RNA level, antiretroviral therapy use, hepatitis B and C virus infection, alcohol abuse/dependency, and diabetes, FIB-4 remained a strong, significant, independent risk factor for HCC. The multivariate-adjusted HR was 3.6 (95% CI, 2.1-6.4) for intermediate FIB-4 and 9.6 (95% CI, 5.2-17.4) for high FIB-4.

CONCLUSIONS: Calculated from routine, noninvasive laboratory tests, FIB-4 is a strong, independent HCC risk factor in HIV-infected patients.

IMPACT: FIB-4 might prove valuable as an easily measured index to identify those at highest risk for HCC, even prior to development of clinical cirrhosis.

PMID: 22028407 [PubMed - indexed for MEDLINE]

PMCID: PMC3237927

 

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Citation:

Park LS, Tate JP, Justice AC, Lo Re V 3rd, Lim JK, Bräu N, Brown ST, Butt AA, Gibert C, Goetz MB, Rimland D, Rodriguez-Barradas MC, Dubrow R. FIB-4 index is associated with hepatocellular carcinoma risk in HIV-infected patients. Cancer Epidemiol Biomarkers Prev. 2011 Dec;20(12):2512-7. doi: 10.1158/1055-9965.EPI-11-0582. Epub 2011 Oct 25. PubMed PMID: 22028407; PubMed Central PMCID: PMC3237927.