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Safely restarting GIendoscopy in the eraof COVID-19 Bu HayeeMo ThoufeeqColin Rees2020 год

Safely restarting GI endoscopy in the era of COVID-19
статья из журнала

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Аннотация:

Background:

The factors that influence liver fibrosis progression in patients co-infected with human immunodeficiency virus/hepatitis C virus (HIV/HCV) are not completely understood. It is not known if insulin resistance (IR), a condition that promotes liver fibrosis in HCV mono-infected individuals, is one of these factors.

Objective:

To evaluate the association between IR and liver stiffness (LS).

Design:

Multicentre cross-sectional study.

Patients:

330 patients co-infected with HIV/HCV.

Methods:

LS was assessed by transient elastography, which has shown a high accuracy to predict significant fibrosis in patients co-infected with HIV/HCV. The outcome variable of the study was LS. Patients with LS⩾9 kPa were considered as having significant fibrosis. IR was calculated using the HOMA method.

Results:

LS was ⩾9 kPa in 150 (45%) patients. HOMA correlated with LS (Spearman’s rho correlation coefficient, 0.37; p<0.0001). The median (Q1–Q3) HOMA in patients with LS⩾9 kPa was 3.30 (2.17–5.16) while it was 2.09 (1.37–3.22) in patients with LS <9 kPa (p<0.0001). Ninety-six (39%) individuals with a HOMA <4 and 54 (63%) with a HOMA ⩾4 showed LS⩾9 kPa (p<0.0001). Analyses after excluding patients with cirrhosis yielded similar results. After multivariate analyses, age ⩾40 years (adjusted odds ratio (AOR), 1.85; 95% confidence interval (CI), 1.03 to 3.29; p = 0.03), CD4 cell count <200 cells/ml (AOR, 3.45; 95% CI, 1.67 to 7.11; p = 0.001), hepatitis B virus co-infection (AOR, 9.25; 95% CI, 2.42 to 35.31; p = 0.001), and HOMA ⩾4 (AOR, 5.33; 95% CI, 2.70 to 10.49; p<0.0001) were the independent predictors of LS⩾9 kPa.

Conclusion:

IR is associated with LS in patients co-infected with HIV/HCV.
Год издания: 2020
Авторы: Bu Hayee, Mo Thoufeeq, Colin Rees, Ian Penman, James E. East
Издательство: BMJ
Источник: Gut
Ключевые слова: COVID-19 Clinical Research Studies, Pancreatitis Pathology and Treatment, Liver Disease Diagnosis and Treatment
Другие ссылки: Gut (HTML)
Spiral (Imperial College London) (PDF)
Spiral (Imperial College London) (HTML)
Oxford University Research Archive (ORA) (University of Oxford) (PDF)
Oxford University Research Archive (ORA) (University of Oxford) (HTML)
PubMed (HTML)