Table 4.
Factors associated with discordant classification compared with those associated with concordant classification by elastography in participants without histological evidence of liver fibrosis.
| Variable | LSM |
OR (95% CI) |
||
|---|---|---|---|---|
| <9.3 kPa | ≥9.3 kPa | Univariate analysis | Multivariate analysis | |
| Demographic characteristic | ||||
| Age, per 5-year increment | 48 (44–52) | 49 (43–52) | 1.14 (0.84–1.54) | … |
| Male sex | 57 (62.6) | 22 (73.3) | 1.64 (0.66–4.10) | … |
| Black race | 83 (91.2) | 26 (86.7) | 0.63 (0.17–2.25) | … |
| JHHCC | 48 (52.8) | 16 (53.3) | 1.02 (0.45–2.34) | 0.23 (0.06–0.93) |
| Clinical parameters | ||||
| BMI 128 | 17 (19.8) | 8 (28.6) | 1.62 (0.61–4.31) | … |
| AST level, IU/L | 33 (27–41) | 58 (33–98) | 1.03 (1.01–1.05) | … |
| AST level >2.5 × ULN | 5 (5.9) | 7 (23.3) | 4.87 (1.41–16.8) | … |
| ALT level, IU/L | 33 (24–46) | 42 (30–90) | 1.02 (1.01–1.03) | … |
| ALT level >2.5 × ULN | 3 (3.5) | 6 (20.0) | 6.83 (1.59–29.4) | … |
| Platelet count, × 1000 cells/µL | 225 (192–271) | 175 (149–218) | 0.99 (0.98–0.99) | … |
| Platelet count <200,000 cells/µL | 26 (30.6) | 19 (63.3) | 3.92 (1.64–9.40) | … |
| APRI | 0.35 (0.27–0.48) | 0.87 (0.45–1.30) | 8.06 (2.87–22.1) | … |
| APRI >0.5 | 19 (22.6) | 20 (71.4) | 8.55 (3.25–22.5) | 8.81 (3.02–25.7) |
| Albumin level, g/dL | 4.2 (3.9–4.3) | 4.1 (3.8–4.4) | 0.62 (0.25–1.52) | … |
| HIV status | ||||
| HIV uninfected | 32 (37.2) | 6 (20.0) | 1.00 | 1.00 |
| HIV infected | ||||
| CD4 cell count ≥350 cells/mm3 | 29 (33.7) | 8 (26.7) | 1.47 (0.46–4.75) | 3.69 (0.66–20.46) |
| CD4 cell count <350 cells/mm3 | 25 (29.1) | 13 (48.2) | 2.77 (0.92–8.33) | 5.04 (1.15–22.1) |
| Biopsy factor | ||||
| Time from biopsy to LSM, months | 2.11 (0.79–5.76) | 1.17 (0.33–5.49) | 0.94 (0.82–1.08) | … |
| Biopsy specimen length | 12 (11–14) | 11 (10–14) | 0.90 (0.77–1.06) | … |
| No. of portal tracts | 10 (8–13) | 10 (8–12) | 0.90 (0.76–1.07) | … |
| Total MHAI score 15 | 11 (12.4) | 10 (35.7) | 3.89 (1.43–10.6) | … |
| Any steatosis | 28 (31.8) | 10 (35.7) | 1.19 (0.49–2.91) | … |
| Any hepatic iron | 28 (31.5) | 10 (34.5) | 1.15 (0.47–2.78) | … |
| Elastography factors | ||||
| Operator 1 | 32 (35.2) | 8 (26.7) | 1.00 | … |
| Operator 2 | 20 (22.0) | 6 (20.0) | 1.20 (0.36–3.97) | … |
| Operator 3 | 39 (42.9) | 16 (53.3) | 1.64 (0.62–4.20) | … |
| Period | ||||
| October 2005–March 2006 | 24 (26.4) | 7 (23.3) | 1.00 | … |
| April 2006–August 2006 | 47 (51.7) | 15 (50.0) | 1.09 (0.39–3.04) | … |
| September 2006–January 2007 | 20 (22.0) | 8 (26.7) | 1.37 (0.42–4.44) | … |
| Median LSM:IQR 10.3 | 5 (5.5) | 2 (6.7) | 1.23 (0.23–6.69) | … |
| HIV-infected patients only | ||||
| HIV RNA level, per log10 copies/mL | 2.30 (2.30–3.88) | 2.30 (2.30–4.28) | 0.95 (0.60–1.52) | … |
| CD4 cell count, per 100 cells/mm3 increase | 380 (211–565) | 316 (222–491) | 0.92 (0.73–1.16) | … |
| CD4 cell count <350 cells/mm3 | 25/54 (46.3) | 13/24 (61.9) | 1.89 (0.67–5.28) | … |
NOTE. Data are no. (%) of patients for categorical variables and median value (interquartile range [IQR]) for continuous variables. Numbers and percentages of patients are inclusive of patients with available data. Multivariate models were adjusted for all other variables, with the presented estimated risk. Participants without histological evidence of fibrosis were those with a fibrosis score of F0 or F1. Discordant was classified as a liver stiffness measurement (LSM) ≥9.3 kPa, and concordant was classified as an LSM <9.3 kPa). ALT, alanine aminotransferase; APRI, aspartate aminotransferase–to-platelet ratio; AST, aspartate aminotransferase; BMI, body mass index (calculated as the weight in kilograms divided by the square of the height in meters); JHHCC, Johns Hopkins University HIV Clinical Cohort; MHAI, modified hepatic activity index. ULN, upper limit of normal.