Simple tests to predict hepatic fibrosis in nonalcoholic chronic liver diseases.
OBJECTIVE
Several simple tests for hepatic fibrosis employ indirect markers. However, the efficacy of using direct and indirect serum markers to predict significant fibrosis in clinical practice is inconclusive. We analyzed the efficacy of a previously reported indirect marker of hepatic fibrosis - the aspartate aminotransferase to platelet ratio index (APRI) - in patients with nonalcoholic chronic liver diseases (CLDs).


METHODS
A total of 134 patients who underwent a percutaneous liver biopsy with a final diagnosis of chronic hepatitis B (n=93), chronic hepatitis C (n=18), or nonalcoholic fatty liver disease (n=23) were enrolled. A single-blinded pathologist staged fibrosis from F0 to F4 according to the METAVIR system, with significant hepatic fibrosis defined as a METAVIR fibrosis score of >/=2.


RESULTS
The mean area under the receiver operating characteristic curve (AUROC) of APRI for predicting significant fibrosis in nonalcoholic CLDs was 0.84 [95% confidence interval (CI), 0.78-0.91]. APRI yielded the highest mean AUROC in the patients with chronic hepatitis B (0.85; 95% CI, 0.771-0.926). The positive predictive value of APRI >/=1.5 for predicting significant fibrosis was 89%. The negative predictive value of APRI <0.5 for excluding significant fibrosis was 80%.


CONCLUSIONS
APRI might be a simple and noninvasive index for predicting significant fibrosis in nonalcoholic CLDs.
Shin
Woon Geon
WG
Department of Internal Medicine, Hallym Universtiy Sacred Heart Hospital of Hallym Universtiy Medical Center, Anyang, Korea.
Park
Sang Hoon
SH
Jun
Sun-Young
SY
Jung
Jae One
JO
Moon
Joon Ho
JH
Kim
Jong Pyo
JP
Kim
Kyoung Oh
KO
Park
Cheol Hee
CH
Hahn
Tai Ho
TH
Yoo
Kyo-Sang
KS
Kim
Jong Hyeok
JH
Park
Choong Kee
CK