354 LIVER FIBROSIS PROGRESSION IN HIV+ PATIENTS UNDER DISTINCT ANTIRETROVIRAL DRUGS

Objective: The diagnosis of chronic hepatitis is important in predicting progression of the disease and determining efficacy of antiviral treatment.Virtual Touch Tissue Quantification (VTTQ) is an implementation of Acoustic Radiation Force Impulse Imaging (ARFI) technology that provides numerical measurements using sheer wave velocity (Vs) value for a noninvasive quantitative assessment of tissue stiffness.VTTQ also anable us to assess the stiffness of liver tumors.Thus.we evaluated the diagnostic usefulness of VTTQ in assessing liver fibrosis in patients with chronic hepatitis and in differetial diagnosis of liver tumors.Methods: 396 chronic hepatitis and cirrhosis patients proven by liver biopsies were studied (183 male and 213 female;average age 56.9±13.5;71 hepatitis B, 232 hepatitis C, 10 hepatitis B+C, 83 hepatitis non-B non-C).The degree of hepatitis was evaluated using the criteria of Desmet; staging of fibrosis were F0 (n = 23), F1 (n = 152), F2 (n = 68), F3 (n = 69), F4 (n = 84).Vs values of liver tumors were also evaluated using VTTQ (HCC 28 cases, hemangioma 20 cases, metastatic liver tumor 14 cases). Results:1. Diagnosis of the liver fibrosis: The Vs value compared with F0 to F4 stage of the fibrosis stage were 1.17±0.20,1.21±0.29,1.34±0.36,1.57±0.49and 2.09±0.63,respectively, and significant correlation were observed between F3 and F4 (P < 0.001).The area under the receiver operating characteristic curve (AUROC) for distinguishing cirrhosis was 0.876.Cutoff value in predicting cirrhosis was 1.64 (sensitivity 79%, specificity 89).A correlation between the Vs value and biochemical analysis was found in hyaluronic acid (0.455) and slight correlations in aspartate aminotransferase, platelet count, total bilirubin, albumin and prothrombin time.2. Diagnosis of the liver tumors: Vs values of metastatic liver tumors (Vs: 2.85±1.05)were higher than those of HCCs (Vs: 1.49±0.43)and hemangiomas (Vs: 1.50±0.60).Conclusion: Liver stiffness measurement is a good method for the diagnosis of not only fibrosis, but also liver tumors.