title: Validity of aspartate aminotransferase to platelet ratio index as predictor of early viral response in patients with hepatitis C treated by interferon-based therapy.
abstract: OBJECTIVE
  To observe any change in value of aspartate aminotransferase to platelet ratio index from the baseline and to compare it with the Hepatitis C virus ribonucleic acid at 12 weeks after the start of interferon-based treatment in patients with Hepatitis C.
  
  
  METHODS
  The prospective study, conducted at the Department of Medicine, Liaquat University of Medical and Health Sciences Hospital, Jamshoro, Pakistan, from September 2009 to March 2010, included 158 consecutive, chronic patients of Hepatitis C with grade > or = 2 fibrosis on liver biopsy, or having aspartate aminotransferase/Platelet ratio index of > 1. The aspartate aminotransferase to platelet ratio index was determined as aspartate aminotransferase level (upper normal limit)/platelets counts (10(9)/L) x 100. Eligible patients were assigned to receive thrice weekly subcutaneous injection of 3MIU standard interferon > or = -2b and weight-base dosage of ribavirin. The early virological response was defined as undetectable Hepatitis C virus ribonucleic acid test at week 12 of the study. APRI < 1 was considered to be the response to therapy. Paired sample t-test was applied to observe pre-and post-treatment mean +/- SD of continuous variables, while Chi-square test was applied for comparing categorical variables. A p-value of 0.05 was considered statistically significant.
  
  
  RESULTS
  Out of 158 patients enrolled, 90 fulfilled the inclusion criteria. The aspartate aminotransferase to platelet ratio index before treatment was 1.61 +/- 1.00 and after treatment 1.10 +/- 1.08. Hepatitis C virus ribonucleic acid after 12 weeks of treatment was non-detectable (early viral response achieved) in 72 (80%) patients. A strong relation was found between aspartate aminotransferase to platelet ratio index and Negative polymerase chain reaction with early virological response as only 2 (4.5%) patients with negative polymerase chain reaction at 12 weeks had aspartate aminotransferase to platelet ratio index > 1 (p = 0.001).
  
  
  CONCLUSIONS
  APRI can act as a predictor of early viral response in patients with Hepatits C.
authors.affiliation: Department of Medicine, Liaquat University of Medical & Health Sciences, Jamshoro, Hyderabad. shaikhsamiullah@yahoo.com
authors.forename: Shaikh
authors.initials: S
authors.lastname: Samiullah
authors.forename: Devrajai
authors.initials: D
authors.lastname: Bikharam
authors.forename: Kalhoro
authors.initials: K
authors.lastname: Musarat
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000097:blood*; D016009:Chi-Square Distribution; D005260:Female; D006526:Hepatitis C / Q000097:blood* / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008297:Male; D010154:Pakistan; D010976:Platelet Count; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D012254:Ribavirin / Q000627:therapeutic use; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D012254:Ribavirin; D007372:Interferons; D001219:Aspartate Aminotransferases