Usefulness of elastometry in evaluating the extents of liver fibrosis in hemophiliacs coinfected with hepatitis C virus and human immunodeficiency virus

The newly developed elastometer, FibroScan®, was utilized to evaluate liver fibrosis in hepatitis C virus (HCV)- and human immunodeficiency virus (HIV)-coinfected 33 hemophiliacs and HIV-uninfected 24 patients with chronic hepatitis C. Chronicity in the liver was categorized into 4 stages by abdominal ultrasound (AUS): 1 (normal or fatty liver); 2 (chronic liver disease, mild); 3 (moderate); and 4 (severe). Stiffness of the liver was significantly increased as AUS stages advanced: 5.4 ± 2.2 (N = 3) versus 7.5 ± 2.7 (N = 9), in stage 1; 4.9 ± 1.7 (N = 2) versus 9.9 ± 6.0 (N = 10), in stage 2, 13.5 ± 4.7 (N = 5) versus 12.9 ± 5.9 (N = 6), in stage 3, and 22.0 ± 9.5 (N = 14) versus 28.1 ± 21.3 (N = 8), in stage 4, in non-HIV group and in HIV group, respectively (P = 0.004 and 0.007). Stiffness was correlated with AUS stages (r = 0.740, P < 0.001), platelet counts (PLT; r = −0.642, P = 0.001) and 7S domain of type IV collagen (IV-coll; r = 0.480, P = 0.024) in non-HIV group, while in HIV group, with IV-coll (r = 0.801, P < 0.001), AUS stages (r = −0.603, P < 0.001), procollagen type III peptides (P-III-P; r = 0.621, P = 0.001), PLT (r = −0.480, P = 0.005), and hyaluronic acid (r = 0.433, P = 0.027). FibroScan® is absolutely noninvasive and can be the alternative to liver biopsy, especially in patients with bleeding tendency.