Gut Liver.  2007 Dec;1(2):145-150.

Simple Tests to Predict Hepatic Fibrosis in Nonalcoholic Chronic Liver Diseases

• Shin WG
• Park SH
• Jun SY
• Jung JO
• Moon JH
• Kim JP
• Kim KO
• Park CH
• Hahn TH
• Yoo KS
• Kim JH
• Park CK

Abstract

BACKGROUND/AIMS: 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 > or =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 > or =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.

Keyword

Aspartate aminotransferase; Fibrosis; Hepatitis B

MeSH Terms

Aspartate Aminotransferases
Biopsy
Blood Platelets
Diagnosis
Fatty Liver
Fibrosis*
Hepatitis B
Hepatitis B, Chronic
Hepatitis C, Chronic
Humans
Liver Diseases*
Liver*
ROC Curve
Biomarkers
Aspartate Aminotransferases