Diagnostic Accuracy Of The Coopscore((C)) To Predict Liver Fibrosis In Human Immunodeficiency Virus/Hepatitis B Virus Co-Infection

Background Non-invasive methods for assessing liver fibrosis are increasingly used as an alternative to liver biopsy. Recently, a score-based biochemical blood test (Coopscore((c))) was developed in a cohort of patients chronically infected with hepatitis C virus, showing higher diagnostic performances than Fibrometer (R), Fibrotest (R), Hepascore (R) and Fibroscan. Here, we assess its performance in patients co-infected with the human immunodeficiency virus and hepatitis B virus.Methods Ninety-seven human immunodeficiency virus/hepatitis B virus co-infected patients with liver biopsies were included from a previously described cohort. Histological fibrosis staging using METAVIR criteria was used as the reference. Coopscore((c)), Fibrotest (R), Fibrometer (R), Hepascore (R) and Zeng score were computed and compared with the Coopscore (c) using the Obuchowski index and area under the receiving operator characteristic curves.Results The distribution of liver fibrosis levels was as follows: F0-F1 (n=42), F2 (n=25), F3 (n=15) and F4 (n=15). The Obuchowski index was higher for Coopscore((c)) (0.774) than Fibrometer (R) (0.668), Hepascore (R) (0.690) and Zeng scores (0.704) (P<0.05), reflecting a better ability to discriminate between fibrosis stages. Similarly, when predicting significant fibrosis (F2), the AUROC was significantly greater for the Coopscore((c)) (0.836) than the Hepascore (R) (0.727) and Zeng scores (0.746), but not for the Fibrotest (R) (0.778, P=0.14) or Fibrometer (R) (0.790, P=0.19). The Coopscore((c)) did not show a higher capacity than other scores to predict advanced fibrosis (F3) or cirrhosis (F4).Conclusions This study supports the diagnostic value of the Coospcore((c)) in fibrosis staging among human immunodeficiency virus/hepatitis B virus co-infected patients, especially to predict significant fibrosis.