Comparative evaluation of liver, spleen, and kidney stiffness in HIV-monoinfected pediatric patients via shear wave elastography
Comparative evaluation of liver, spleen, and kidney stiffness in HIV-monoinfected pediatric patients via shear wave elastography
Background/aim: This study aimed to evaluate the stiffness of the liver, spleen, and kidneys in HIV-monoinfected children via shearwave elastography (SWE).Materials and methods: Twenty-one HIV-monoinfected children and 37 healthy subjects were included in this study. Livers, spleens,and kidneys of the participants were examined via ultrasound and SWE. Patients were divided into two groups according to the presenceof pathologic ultrasonographic findings. Routine laboratory tests were also recorded. Stiffness of these organs was compared betweenpatients and control groups.Results: Liver transaminases, blood urea, and creatinine levels were normal in all subjects. Ultrasonographic examination revealedhepatosplenomegaly (n = 1, 4.7%), grade 1 hepatosteatosis (n = 1, 4.7%), and hepatosteatosis and minimal heterogeneity of the liver (n = 1,4.7%). Ultrasonographic features were normal in 18 patients. Stiffness of the liver, spleen, and kidneys of all HIV-monoinfected childrenwith normal laboratory parameters was significantly higher than in healthy subjects. Eighteen patients with normal ultrasonographicfindings also had higher stiffness values when compared to control subjects.Conclusion: Stiffness of the liver, spleen, and kidneys in HIV-monoinfected children was increased. SWE can be used in the detectionof early parenchymal changes even in patients with normal laboratory parameters and ultrasonographic findings.
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- 1. Kaspar MB, Sterling RK. Mechanisms of liver disease in
patients infected with HIV. BMJ Open Gastroenterology 2017;
4 (1): e000166. doi: 10.1136/bmjgast-2017-000166
- 2. Sharma V, Ramachandran VG, Mogha NS, Bharadwaj M.
Hepatitis B & C virus infection in HIV seropositive individuals
& their association with risk factors: a hospital-based study.
Indian Journal of Medical Research 2018; 147 (6): 588-593. doi:
10.4103/ijmr.IJMR_1151_16
- 3. Colineau L, Rouers A, Yamamoto T, Xu Y, Urrutia A et al. HIVinfected spleens present altered follicular helper T Cell (Tfh)
subsets and skewed B cell maturation. PLoS One 2015; 10 (10):
e0140978. doi: 10.1371/journal.pone.0140978
- 4. Cheynier R, Henrichwark S, Hadida F, Pelletier E,
Oksenhendler E et al. HIV and T cell expansion in splenic
white pulps is accompanied by infiltration of HIV-specific
cytotoxic T lymphocytes. Cell 1994; 78 (3): 373-387.
- 5. Husain NE, Ahmed MH, Almobarak AO, Noor SK, Elmadhoun
WM et al. HIV-associated nephropathy in Africa: pathology,
clinical presentation and strategy for prevention. Journal of
Clinical Medicine Research 2018; 10 (1): 1-8. doi: 10.14740/
jocmr3235w
- 6. Moso MA, Woolnough E, Langham F, Hoy JF, Cheng AC et
al. Increasing prevalence and risk of chronic kidney disease
in human immunodeficiency virus-infected individuals:
changing demographics over a 6-year period. Journal of
Infectious Diseases 2018; 217 (6): 1013-1015. doi: 10.1093/
infdis/jix676
- 7. Zaro R, Dina L, Pojoga C, Vesa S, Badea R. Evaluation of the
pancreatic tumors by transabdominal shear wave elastography:
preliminary results of a pilot study. Medical Ultrasonography
2018; 20 (3): 285-291. doi: 10.11152/mu-1492
- 8. You J, Chen J, Xiang F, Song Y, Khamis S et al. The value of
quantitative shear wave elastography in differentiating the
cervical lymph nodes in patients with thyroid nodules. Journal
of Medical Ultrasonics 2018; 45 (2): 251-259. doi: 10.1007/
s10396-017-0819-0
- 9. Iyama T, Takata T, Koda M, Fukuda S, Hoi S et al. Renal shear
wave elastography for the assessment of nephron hypertrophy:
a cross-sectional study in chronic kidney disease. Journal
of Medical Ultrasonics 2018; 45 (4): 571-576. doi: 10.1007/
s10396-018-0866-1. doi: 10.1007/s10396-018-0866-1
- 10. Shin HJ, Lee YS, Yoon H, Kim MJ, Han SW et al. Testicular
volume and elasticity changes in young children with
undescended testes. Medical Ultrasonography 2017; 19 (4):
380-385. doi: 10.11152/mu-1093
- 11. Balleyguier C, Ciolovan L, Ammari S, Canale S, Sethom S et al.
Breast elastography: the technical process and its applications.
Diagnostic and Interventional Imaging 2013; 94 (5): 503-13.
doi: 10.1016/j.diii.2013.02.006
- 12. Bamber J, Cosgrove D, Dietrich CF, Fromageau J, Bojunga J et
al. EFSUMB guidelines and recommendations on the clinical
use of ultrasound elastography. Part 1: Basic principles and
technology. Ultraschall in der Medizin 2013; 34 (2): 169-184.
doi: 10.1055/s-0033-1335205
- 13. Cosgrove D, Piscaglia F, Bamber J, Bojunga J, Correas JM et
al. EFSUMB guidelines and recommendations on the clinical
use of ultrasound elastography. Part 2: Clinical applications.
Ultraschall in der Medizin 2013; 34 (3): 238-253. doi: 10.1055/
s-0033-1335375
- 14. Yada N, Tamaki N, Koizumi Y, Hirooka M, Nakashima O et al.
Diagnosis of fibrosis and activity by a combined use of strain
and shear wave imaging in patients with liver disease. Digestive
Diseases 2017; 35 (6): 515-520. doi: 10.1159/000480140
- 15. Chu C, Pollock LC, Selwyn PA. HIV-associated complications:
a systems-based approach. American Family Physician 2017;
96 (3): 161-169.
- 16. World Health Organization. The Fact Sheet HIV / AIDS.
Geneva, Switzerland: WHO; 2018.
- 17. Hacettepe Üniversitesi HIV / AIDS Tedavi ve Araştırma
Merkezi (HATAM). Türkiye’de HIV/AIDS vakalarinin
dağilimi. Ankara, Turkey: HATAM; 2018 (in Turkish).
- 18. Thornton AC, Jose S, Bhagani S, Chadwick D, Dunn D et al.
Hepatitis B, hepatitis C, and mortality among HIV-positive
individuals. AIDS 2017; 31 (18): 2525-2532. doi: 10.1097/
QAD.0000000000001646
- 19. Pérez-Latorre L, Rivero-Juárez A, Hontañón V, Díez C, Cuenca
F et al. Prognostic value of transient elastography in human
immunodeficiency virus-infected patients with chronic
hepatitis C. Open Forum Infectious Diseases 2016; 3 (4):
ofw212.
- 20. Price JC, Seaberg EC, Badri S, Witt MD, D’Acunto K et al.
HIV monoinfection is associated with increased aspartate
aminotransferase-to-platelet ratio index, a surrogate marker
for hepatic fibrosis. Journal of Infectious Diseases 2012; 205
(6): 1005-1013. doi: 10.1093/infdis/jir885
- 21. Sulyok M, Ferenci T, Makara M, Horváth G, Szlávik J et al.
Hepatic fibrosis and factors associated with liver stiffness in
HIV mono-infected individuals. PeerJ 2017; 5:e2867. doi:
10.7717/peerj.2867
- 22. Giacomet V, Viganò A, Penagini F, Manfredini V, Maconi G et
al. Splenomegaly and variceal bleeding in a ten-year-old HIVinfected girl with noncirrhotic portal hypertension. Pediatric
Infectious Disease Journal 2012; 31 (10): 1059-1060. doi:
10.1097/INF.0b013e3182694126
- 23. Hunter NB, Vogt S, Ambinder RF. Treatment of HIV-associated
lymphomas: the latest approaches for optimizing outcomes.
Oncology (Williston Park) 2017; 31 (12): 872-877, 884.
- 24. Jindal AK, Tiewsoh K, Pilania RK. A review of renal
disease in children with HIV infection. Infectious
Diseases (London, England) 2018; 50 (1): 1-12. doi:
10.1080/23744235.2017.1371852
- 25. Moolasart V, Chottanapund S, Ausavapipit J, Likanonsakul S,
Uttayamakul S et al. The effect of detectable HIV viral load
among hiv-infected children during antiretroviral treatment: a
cross-sectional study. Children (Basel, Switzerland) 2018; 5 (1):
E6. doi: 10.3390/children5010006
- 26. Parisi SG, Basso M, Mengoli C, Scaggiante R, Andreis S et
al. Liver stiffness is not associated with short- and long-term
plasma HIV RNA replication in immunocompetent patients
with HIV infection and with HIV/HCV coinfection. Annals
of Gastroenterology 2017; 30 (5): 534-541. doi: 10.20524/
aog.2017.0175