Chronic permanent hypoxemia predisposes to mild elevation of liver stiffness

AIM:To evaluate the impact of long term permanent hypoxemia noticed in patients with non operated congenital cyanogenic cyanotic cardiopathy on liver stiffness.METHODS:We included ten adult patients with non operated inoperate cyanotic cardiopathy and ten matched patients for age and gender admitted to the gastroenterology department for proctologic diseases;Clinical and laboratory data were collected[age,gender,body mass index,oxygen saturation,glutamate oxaloacetate transaminase(GOT),glutamate pyruvate transaminase(GPT),glycemia and cholesterol].Measurement of hepatic stiffness by transient elastography was carried out in all patients using the Fibroscan device.All patients underwent an echocardiography to eliminate congestive heart failure.RESULTS:Among the patients with cyanotic cardiopathy,median liver stiffness 5.9±1.3 kPa was greater than control group(4.7±0.4 kPa)(P=0.008).Median levels of GOT,GPT,gamma-glutamyltransferase,glycemia and cholesterol were comparable in cardiopathy and control group.In regression analysis including age,gender,body mass index,oxygen saturation,GOT,GPT,glycemia,cholesterol showed that only oxygen saturation was related to liver stiffness(r=-0.63 P=0.002).CONCLUSION:Chronic permanent hypoxemia can induce mild increase of liver stiffness,but further studies are needed to explore the histological aspects of liver injury induced by chronic permanent hypoxemia.

Risk factors for liver fibrosis among human immunodeficiency virus monoinfected patients using the FIB4 index in Morocco

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 FIB4score > 1.45. Multivariable logistic regression identifiedindependent risk factors for FIB4 > 1.45.RESULTS: A FIB4 score > 1.45 was identified in 96among 619(15.5%). HIV monoinfected patients followed up between September 1990 and September2012. Multivariate analysis showed that only a viral load > 75(OR = 2.23, 95%CI: 1.36-3.67), CD4 > 200cells/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/mm3are associated with liver fibrosis. Further studies are needed to explore mechanisms for fibrosis in HIV monoinfected patients.