PT  - JOURNAL ARTICLE
AU  - Rubio, A
AU  - Monpoux, F
AU  - Truchi, R
AU  - Boutte, P
TI  - EVALUATION OF HEPATOTOXICITY IN HIV-INFECTED CHILDREN WITH NON-INVASIVE PROCEDURES: A CROSS-SECTIONAL PROSPECTIVE STUDY
DP  - 2008 Nov 01
TA  - Archives of Disease in Childhood
PG  - ps148--ps148
VI  - 93
IP  - Suppl 2
4099  - http://adc.bmj.com/content/93/Suppl_2/ps148.short
4100  - http://adc.bmj.com/content/93/Suppl_2/ps148.full
SO  - Arch Dis Child2008 Nov 01; 93
AB  - Background Progressive hepatotoxicity is a concern in HIV-infected children exposed to long-term antiretroviral drugs and to the cytopathic effect of the HIV virus. New non-invasive procedures are being developed permitting regular assessment of the liver function.Objective The aims of this study were to evaluate the feasibility of non-invasive hepatic investigations in HIV-1 chronically infected children, to assess the prevalence of signs of hepatotoxicity and to analyze the influence of HIV disease severity and exposure to antiretroviral therapy (ART).Design and methods A cross-sectional prospective study conducted in HIV-1 infected children aged 8 to 18 years old. Liver function was assessed with standard serum biochemical markers, FibroTest®, ActiTest®, SteatoTest®, AshTest, NashTest®, Forns’ index, APRI, echography and transient elastography.Results Over 60% of the 26 assessed children had signs of liver affection on at least one of the test results: 54% had elevated liver enzymes, 63%, 33%, 21% and 21% had abnormal Fibrotest®, Actitest®, Forns’ index and APRI respectively. SteatoTest®, AshTest® and NashTest® were in the normal range for most patients. Four children had liver steatosis (17%). The Fibroscan results were higher than in matched healthy children. HIV stage N and exposure to lamivudine were the main risk factors for hepatotoxicity.Conclusions The liver is affected in a great proportion of HIV-infected children, and needs to be regularly followed with non-invasive procedures. Liver enzymes and Fibrotest® are the most sensitive tests to detect hepatotoxicity. The place of transient elastography in the management of these children needs to be further defined.