title: Aspartate transaminase to platelet ratio index in hepatitis C virus and Schistosomiasis coinfection.
abstract: OBJECTIVE
  To assess the diagnostic accuracy, of aminotransferase-to-platelet ratio index (APRI) alone and with antischistosomal antibody (Ab) in patients with hepatitis C virus (HCV) and schistosomiasis coinfection.
  
  
  METHODS
  This retrospective study included medical records of three hundred and eighty three Egyptian men patients who had undergone percutaneous liver biopsy between January 2006 to April 2014 in tertiary care hospital in Qatar for diagnosis or monitoring purpose were selected. Data of patients > 18 years of age were included in the study. The values of HCV RNA titer and antischistosomal antibody titer were also taken into consideration. Patients were excluded from the study if they had any other concomitant chronic liver disease, including; history of previous antiviral or interferon therapy, immunosuppressive, therapy, chronic hepatitis B infection, human immunodeficiency virus co-infection, autoimmune hepatitis, decompensated liver disease, hepatocellular carcinoma, prior liver transplantation, and if no data about the liver biopsy present.
  
  
  RESULTS
  Median age of patients was 46 years. About 7.1% had no fibrosis, whereas 30.4%, 37.5%, 20.4%, and 4.6% had fibrosis of stage I, II, III, and IV respectively. In bivariate analysis, APRI score, levels of AST, platelet count and age of patient showed statistically significant association with liver fibrosis (P < 0.0001); whereas antischistosomal antibody titer (P = 0.52) and HCV RNA titer (P = 0.79) failed to show a significant association. The respective AUC values for no fibrosis, significant fibrosis, severe fibrosis and cirrhosis of APRI score were 63%, 73.2%, 81.1% and 88.9% respectively. This showed good sensitivity and specificity of APRI alone for grading of liver fibrosis. But the inclusion of anti-Schistosoma antibody did not improve the prediction of fibrosis stage.
  
  
  CONCLUSIONS
  The study results suggest that noninvasive biochemical markers like APRI are sensitive and specific in diagnosing the degree of fibrosis and cirrhosis in patients with coinfection of HCV and schistosomiasis as compared to biopsy. The addition of antischistosomal Ab to APRI did not improve sensitivity for predicting the degree of cirrhosis.
authors.affiliation: Moutaz Derbala, Mohammed Elshiekh Elbadri, Saad AlKaabi, Khaleel Hassan Sultan, Yasser Medhat Kamel, Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha 00974, Qatar.
authors.forename: Moutaz
authors.initials: M
authors.lastname: Derbala
authors.affiliation: Moutaz Derbala, Mohammed Elshiekh Elbadri, Saad AlKaabi, Khaleel Hassan Sultan, Yasser Medhat Kamel, Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha 00974, Qatar.
authors.forename: Mohammed Elshiekh
authors.initials: ME
authors.lastname: Elbadri
authors.affiliation: Moutaz Derbala, Mohammed Elshiekh Elbadri, Saad AlKaabi, Khaleel Hassan Sultan, Yasser Medhat Kamel, Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha 00974, Qatar.
authors.forename: Aliaa Mohamed
authors.initials: AM
authors.lastname: Amer
authors.affiliation: Moutaz Derbala, Mohammed Elshiekh Elbadri, Saad AlKaabi, Khaleel Hassan Sultan, Yasser Medhat Kamel, Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha 00974, Qatar.
authors.forename: Saad
authors.initials: S
authors.lastname: AlKaabi
authors.affiliation: Moutaz Derbala, Mohammed Elshiekh Elbadri, Saad AlKaabi, Khaleel Hassan Sultan, Yasser Medhat Kamel, Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha 00974, Qatar.
authors.forename: Khaleel Hassan
authors.initials: KH
authors.lastname: Sultan
authors.affiliation: Moutaz Derbala, Mohammed Elshiekh Elbadri, Saad AlKaabi, Khaleel Hassan Sultan, Yasser Medhat Kamel, Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha 00974, Qatar.
authors.forename: Yasser Medhat
authors.initials: YM
authors.lastname: Kamel
authors.affiliation: Moutaz Derbala, Mohammed Elshiekh Elbadri, Saad AlKaabi, Khaleel Hassan Sultan, Yasser Medhat Kamel, Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha 00974, Qatar.
authors.forename: Eman Hassan Satti
authors.initials: EH
authors.lastname: Elsayed
authors.affiliation: Moutaz Derbala, Mohammed Elshiekh Elbadri, Saad AlKaabi, Khaleel Hassan Sultan, Yasser Medhat Kamel, Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha 00974, Qatar.
authors.forename: Tony Yervant
authors.initials: TY
authors.lastname: Avades
authors.affiliation: Moutaz Derbala, Mohammed Elshiekh Elbadri, Saad AlKaabi, Khaleel Hassan Sultan, Yasser Medhat Kamel, Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha 00974, Qatar.
authors.forename: Prem
authors.initials: P
authors.lastname: Chandra
authors.affiliation: Moutaz Derbala, Mohammed Elshiekh Elbadri, Saad AlKaabi, Khaleel Hassan Sultan, Yasser Medhat Kamel, Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha 00974, Qatar.
authors.forename: Fatma M
authors.initials: FM
authors.lastname: Shebl
mesh_terms: D000913:Antibodies, Protozoan / Q000097:blood; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D001792:Blood Platelets; D004796:Clinical Enzyme Tests; D060085:Coinfection; D004534:Egypt; D006526:Hepatitis C / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000469:parasitology / Q000821:virology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D011780:Qatar; D012367:RNA, Viral / Q000097:blood; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012552:Schistosomiasis / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000469:parasitology; D012698:Serologic Tests; D012720:Severity of Illness Index; D062606:Tertiary Care Centers; D019562:Viral Load
chemical_list: D000913:Antibodies, Protozoan; D015415:Biomarkers; D012367:RNA, Viral; D001219:Aspartate Aminotransferases
keywords: Aspartate transaminase to platelet ratio index; Hepatitis C; Liver biopsy; Liver fibrosis; Schistosomiasis