Rapid, Inexpensive Test Predicts NASH in HIV Patients

The FibroScan-AST (FAST) score has been shown to be effective for the risk assessment of non-alcoholic hepatic steatosis (NASH) in patients without HIV, but its effectiveness in HIV+ patients is currently unknown.

To assess this further, the researchers examined data from 303 people living with HIV (PWH) who were all undergoing antiretroviral therapy. At visits 1, 2, 3, 4, and 5, FAST scores were available for 187, 236, 222, 192 and 111 participants, respectively. Overall, baseline FAST scores were correlated with baseline FIB4 scores and APRI scores, but were weaker with CAP values. Male sex, history of treatment with an INSTI, baseline BMI of >25kg/m2, and type 2 diabetes mellitus were associated with higher FAST scores.

“This is the first report on FAST Score in HIV+ persons. We found a significant correlation with FIB4, APRI and CAP values. In contrast to an observed steady redistribution towards higher CAP values (reflecting an increase in steatosis) over five years, the FAST score remained nearly unchanged in its distribution until there was a sudden increase towards a so far not well defined "grey area" of progressive NAFLD after four years of observation. Possible risk factors in univariable analyses for higher FAST scores were male sex, overweight, DM2 and certain antiretroviral drugs. Due to the rapid, inexpensive and non-invasive assessment of the FAST score, it should be further investigated in PLWH,” the researchers concluded.

—Michael Potts

Reference:

Bischoff J, Gu W, Boesecke C, et al. Application of the novel fibroscan-ast score in an HIV-monoinfected cohort. Paper presented at Virtual CROI 2021. March 6-10, 2021. https://www.vcroi2021.org/sessions/19764921/subsession/25642366/APPLICATION-OF-THE-NOVEL-FIBROSCAN-AST-SCORE-IN-AN-HIV-MONOINFECTED-COHORT