Assessment of liver fibrosis progression in patients with chronic hepatitis C and normal alanine aminotransferase values: the role of AST to the platelet ratio index.
OBJECTIVE
To verify the value of indirect serum markers in the non-invasive assessment of liver fibrosis in patients with persistently normal or near normal alanine aminotransferases levels (NALT).


METHODS
Forty HCV RNA positive, untreated patients with NALT (30 non-drinkers) underwent two liver biopsies, with a median interval of 78.5 months. The AST/ALT ratio, age-platelet index, AST to platelet ratio index (APRI), Forns fibrosis index and Bonacini's discriminant score were simultaneously determined.


RESULTS
In 19 patients, worsening of fibrosis was observed at the second biopsy in comparison to the index biopsy. Among non-drinkers, an APRI >0.4 had a 100% sensitivity in identifying subjects with significant liver fibrosis (Ishak staging score >2) and an APRI < or =0.4 had a 100% negative predictive value in excluding significant liver fibrosis.


CONCLUSIONS
APRI performs better, in comparison to all other markers, in correctly classifying patients with NALT with no progression to significant liver fibrosis.
DPMSC Medical Liver Transplantation Unit, University of Udine, Italy.
Carlo
C
Fabris
Carlo
C
Smirne
Pierluigi
P
Toniutto
Cosimo
C
Colletta
Rachele
R
Rapetti
Rosalba
R
Minisini
Edmondo
E
Falleti
Mario
M
Pirisi
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D000428:Alcohol Drinking; D001219:Aspartate Aminotransferases / Q000097:blood*; D001706:Biopsy; D001792:Blood Platelets / Q000201:enzymology*; D018450:Disease Progression; D005260:Female; D019698:Hepatitis C, Chronic / Q000201:enzymology / Q000473:pathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000201:enzymology / Q000473:pathology*; D008297:Male; D008875:Middle Aged
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase