title: [Efficacy of AST to platelet ratio index in predicting severe hepatic fibrosis and cirrhosis in chronic hepatitis B virus infection].
abstract: 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.
authors.affiliation: Department of Gastroenterology, Ajou University College of Medicine, Suwon, Korea.
authors.forename: Sung Jun
authors.initials: SJ
authors.lastname: Sim
authors.forename: Jae Youn
authors.initials: JY
authors.lastname: Cheong
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Cho
authors.forename: Jong Su
authors.initials: JS
authors.lastname: Kim
authors.forename: Tae Young
authors.initials: TY
authors.lastname: Lim
authors.forename: Do Hyun
authors.initials: DH
authors.lastname: Shin
authors.forename: Sun Gyo
authors.initials: SG
authors.lastname: Lim
authors.forename: Young Bae
authors.initials: YB
authors.lastname: Kim
authors.forename: Kee Myung
authors.initials: KM
authors.lastname: Lee
authors.forename: Byung Moo
authors.initials: BM
authors.lastname: Yoo
authors.forename: Kwang Jae
authors.initials: KJ
authors.lastname: Lee
authors.forename: Ki Baik
authors.initials: KB
authors.lastname: Hahm
authors.forename: Jin Hong
authors.initials: JH
authors.lastname: Kim
mesh_terms: 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
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase