Brief Article
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World J Hepatol. Oct 27, 2013; 5(10): 584-588
Published online Oct 27, 2013. doi: 10.4254/wjh.v5.i10.584
Risk factors for liver fibrosis among human immunodeficiency virus monoinfected patients using the FIB4 index in Morocco
Mohamed Tahiri, Mustapha Sodqi, Fatima Ez Zahra Lahdami, Latifa Marih, Hassan Lamdini, Wafaa Hliwa, Ahd Oulad Lahcen, Wafaa Badre, Fouad Haddad, Abdelfetah Chakib, Ahmed Bellabah, Rhimou Alaoui, Kamal Marhoum El Filali
Mohamed Tahiri, Fatima Ez Zahra Lahdami, Wafaa Hliwa, Wafaa Badre, Fouad Haddad, Ahmed Bellabah, Rhimou Alaoui, Department of Hepato-Gastro-Enterology, Ibn Rochd Hospital University Center, Casablanca 20270, Morocco
Mustapha Sodqi, Latifa Marih, Hassan Lamdini, Ahd Oulad Lahcen, Abdelfetah Chakib, Kamal Marhoum El Filali, Department of Infectious Diseases, Ibn Rochd Hospital University Center, Casablanca 20270, Morocco
Author contributions: Tahiri M and Sodqi M contributed equally to this paper, with significant contributions from Lahdami FEZ, Marih L, Lamdini H, Hliwa W, Lahcen AO, Badre W, Haddad F, Chakib A, Bellabah A, Alaoui R and El Filali KM.
Correspondence to: Mohamed Tahiri, PhD, Department of Hepato-Gastro-Enterology, Ibn Rochd Hospital University Center, 187 Lotissement Mandarona Sidi Maarouf, Casablanca 20270, Morocco. docteurtahirimohamed@yahoo.fr
Telephone: +212-67-7561214 Fax: +212-67-65437686
Received: April 13, 2013
Revised: August 31, 2013
Accepted: September 18, 2013
Published online: October 27, 2013
Abstract

AIM: To study the prevalence and risk factors of significant hepatic fibrosis in Moroccan human immunodeficiency virus (HIV) monoinfected patients.

METHODS: We conducted a cross-sectional study among HIV monoinfected patients (negative for hepatitis B surface antigen and hepatitis C antibody). Clinical and laboratory data were collected from the data base of the Infectious Diseases Unit in Ibn Rochd Hospital Center [age, gender, duration of HIV infection, CD4 T lymphocyte count, HIV viral load, glycemia and current or prior use of antiretroviral and antiretroviral therapy (ART) duration]. The primary outcome was a FIB4 score > 1.45. Multivariable logistic regression identified independent risk factors for FIB4 > 1.45.

RESULTS: A FIB4 score > 1.45 was identified in 96 among 619 (15.5%). HIV monoinfected patients followed up between September 1990 and September 2012. Multivariate analysis showed that only a viral load > 75 (OR = 2.23, 95%CI: 1.36-3.67), CD4 > 200 cells/mm3 (OR = 0.39, 95%CI: 0.21-0.72) and age at FIB4 index calculation (OR = 1.10, 95%CI: 1.07-1.13) were independently associated with the occurrence of FIB4 index (> 1.45). Gender, duration of HIV infection, glycemia, use of antiretroviral therapy and ART duration were not associated with significant fibrosis by FIB4.

CONCLUSION: FIB4 score > 1.45 was found in 15.5% of Moroccan HIV monoinfected patients. Age, HIV viremia > 75 copies/mL and CD4 count > 200 cells/mm3 are associated with liver fibrosis. Further studies are needed to explore mechanisms for fibrosis in HIV monoinfected patients.

Keywords: Human immunodeficiency virus, FIB4, Liver, Monoinfected, Risk factors

Core tip: We evaluated, for the first time in Morocco, the prevalence and risk factors of significant hepatic fibrosis in Moroccan human immunodeficiency virus (HIV) monoinfected patients using the FIB4 score which represents a noninvasive, composite index that is a validated measure of hepatic fibrosis. FIB4 score > 1.45 was found in 15.5% of Moroccan HIV monoinfected patients. Age, HIV viremia > 75 copies/mL and CD4 count < 200 cells/mm3 are associated with liver fibrosis. Gender, duration of HIV infection, glycemia, use of antiretroviral therapy and antiretroviral therapy duration were not associated with significant fibrosis.