title: Aspartate aminotransferase to platelet ratio index - a reliable predictor of therapeutic efficacy and improvement of Ishak score in chronic hepatitis B patients treated with nucleoside analogues.
abstract: BACKGROUND
  No studies have investigated the predictive and monitoring efficacy of aspartate aminotransferase to platelet ratio index in chronic hepatitis B patients undergoing antiviral therapy based on paired Ishak biopsies pre- and post-treatment. We evaluated the efficacy of aspartate aminotransferase to platelet ratio index in monitoring fibrosis improvement in chronic hepatitis B patients treated with nucleoside analogue or interferon.
  
  
  METHODS
  Pre- and post-treatment Ishak fibrosis scores of 86 nucleoside-analogue- and 42 interferon-treated patients were retrospectively analyzed. The area under the receiver operating characteristic curve was calculated.
  
  
  RESULTS
  In nucleoside-analogue-treated patients, the area under the receiver operating characteristic curve was 0.80 and 0.91 when aspartate aminotransferase to platelet ratio index was used to diagnose fibrosis and cirrhosis, respectively. When the decreased magnitude of aspartate aminotransferase to platelet ratio index was ≥ 0.35, the sensitivity and specificity of predicting fibrosis improvement were 75.8% and 75.0%, respectively. The area under the receiver operating characteristic curve was 0.53 when aspartate aminotransferase to platelet ratio index was used to diagnose fibrosis in 20 interferon-treated patients, while an insufficient patient number in the cirrhosis group prevented the calculation of the area under the receiver operating characteristic curve. The same is true for the remaining 22 interferon-treated patients.
  
  
  CONCLUSIONS
  Our study is the first to demonstrate the aspartate aminotransferase to platelet ratio index as a reliable marker in diagnosing and monitoring fibrosis improvement in nucleoside-analogue-treated patients based on paired Ishak biopsies pre- and post-treatment, but the test is not applicable in interferon therapy.
authors.affiliation: a Department of Infectious Diseases and Hepatology Unit , Southern Medical University Affiliated Nanfang Hospital , Guangzhou , Guangdong , China.
authors.forename: Jie
authors.initials: J
authors.lastname: Peng
authors.affiliation: a Department of Infectious Diseases and Hepatology Unit , Southern Medical University Affiliated Nanfang Hospital , Guangzhou , Guangdong , China.
authors.forename: Shaohang
authors.initials: S
authors.lastname: Cai
authors.affiliation: a Department of Infectious Diseases and Hepatology Unit , Southern Medical University Affiliated Nanfang Hospital , Guangzhou , Guangdong , China.
authors.forename: Tao
authors.initials: T
authors.lastname: Yu
authors.affiliation: a Department of Infectious Diseases and Hepatology Unit , Southern Medical University Affiliated Nanfang Hospital , Guangzhou , Guangdong , China.
authors.forename: Yongpeng
authors.initials: Y
authors.lastname: Chen
authors.affiliation: a Department of Infectious Diseases and Hepatology Unit , Southern Medical University Affiliated Nanfang Hospital , Guangzhou , Guangdong , China.
authors.forename: Youfu
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: a Department of Infectious Diseases and Hepatology Unit , Southern Medical University Affiliated Nanfang Hospital , Guangzhou , Guangdong , China.
authors.forename: Jian
authors.initials: J
authors.lastname: Sun
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D005260:Female; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000188:drug therapy; D008297:Male; D010976:Platelet Count; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D001219:Aspartate Aminotransferases
keywords: Aspartate aminotransferase; Ishak score; chronic; hepatitis B; interferon therapy; liver biopsy; liver cirrhosis; liver fibrosis; non-invasive tests; nucleoside analogue