[Efficacy of AST to platelet ratio index in predicting severe hepatic fibrosis and cirrhosis in chronic hepatitis B virus infection].
OBJECTIVE
An ideal noninvasive diagnostic test for hepatic fibrosis should be simple, inexpensive, and accurate. We aimed to find the simple marker for predicting hepatic fibrosis and to compare the accuracy of AST, platelet, AST/ALT ratio and AST to platelet ratio index (APRI) in chronic hepatitis B patients without clinical evidence of cirrhosis.


METHODS
A total of one hundred and twenty-six chronic hepatitis B patients who underwent liver biopsy at the Ajou University Hospital from August 1998 to December 2003 were enrolled. Hepatic fibrosis was assessed using the Ludwig classification. Significant fibrosis was defined as fibrosis score of 3 or more. The AST/ALT ratio and APRI were calculated and correlations with hepatic fibrosis were analyzed.


RESULTS
APRI showed a significant correlation (r=0.501, p=0.000) with hepatic fibrosis, and was superior to AST, AST/ALT ratio and platelet in predicting fibrosis. Patients with significant fibrosis (fibrosis stage 3, 4) can be identified to have APRI = 1 with sensitivity 71.2% and specificity 70.3%. The sensitivity and specificity of an APRI = 1.5 for cirrhosis (stage 4) were 83.3% and 75.0%.


CONCLUSIONS
Simple index using AST and platelet value can predict the presence of significant fibrosis and cirrhosis in chronic hepatitis B patients without clinical evidence of cirrhosis.
Sim
Sung Jun
SJ
Department of Gastroenterology, Ajou University College of Medicine, Suwon, Korea.
Cheong
Jae Youn
JY
Cho
Sung Won
SW
Kim
Jong Su
JS
Lim
Tae Young
TY
Shin
Do Hyun
DH
Lim
Sun Gyo
SG
Kim
Young Bae
YB
Lee
Kee Myung
KM
Yoo
Byung Moo
BM
Lee
Kwang Jae
KJ
Hahm
Ki Baik
KB
Kim
Jin Hong
JH
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood*; D005260:Female; D019694:Hepatitis B, Chronic / Q000097:blood / Q000201:enzymology / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology* / Q000821:virology; D008297:Male; D010976:Platelet Count; D012680:Sensitivity and Specificity
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase