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In late 2011, Vogel and colleagues published a study showing that HIV-infected men with primary hepatitis C virus (HCV) infection had a higher rate of liver fibrosis progression than would be expected in early HCV infection — but that it declined upon resolution of primary HCV infection.1 Now, Fierer and colleagues have written a letter to the editor, questioning the use of transient elastography to measure fibrosis progression in that study.2
Fierer and colleagues argue that although transient elastography provides an accurate assessment of liver stiffness — and thus fibrosis — in the setting of chronic HCV infection, it might not do so during primary HCV infection, when acute inflammation is present. Inflammation can falsely elevate the li…