RT Journal Article
SR Electronic
T1 EVALUATION OF HEPATOTOXICITY IN HIV-INFECTED CHILDREN WITH NON-INVASIVE PROCEDURES: A CROSS-SECTIONAL PROSPECTIVE STUDY
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP ps148
OP ps148
VO 93
IS Suppl 2
A1 Rubio, A
A1 Monpoux, F
A1 Truchi, R
A1 Boutte, P
YR 2008
UL http://adc.bmj.com/content/93/Suppl_2/ps148.abstract
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.