Korean J Gastroenterol.  2004 Apr;43(4):246-251.

Clinical Efficacy of AST/ALT Ratio and Platelet Counts as Predictors of Degree of Fibrosis in HBV Infected Patients without Clinically Evident Liver Cirrhosis

• Park SY
• Kang KH
• Park JH
• Lee JH
• Cho CM
• Tak WY
• Kweon YO
• Kim SK
• Choi YH

Abstract

BACKGROUND/AIMS: Hepatic fibrosis is an important prognostic factor in chronic hepatitis B. Liver biopsy is a gold standard diagnostic tool but an invasive procedure, so it cannot be done on all patients. We evaluated the clinical efficacy of AST/ALT ratio and platelet counts as predictors of fibrosis in chronic hepatitis B. METHODS: We reviewed retrospectively clinical records of 323 patients, who visited Kyungpook National University Hospital for chronic hepatitis B and underwent liver biopsy from September 1998 to May 2002. Correlation with laboratory parameters with hepatic fibrosis stage was identified. RESULTS: Of 323 patients, there were 278 male patients with mean age 27 (9~59). Platelet counts showed a significant correlation (r=-0.343, p=0.000), and AST/ALT ratio showed a weak but significant correlation (r=0.137, p=0.013) with fibrosis stage. Patients with severe fibrosis or cirrhosis (stage 3 and 4) can be identified to have AST/ALT ratio > 1 and platelet counts < 150,000/mm3, which showed with positive predictive value of 66.7%. Sensitivity, specificity, and negative predictive value were 14.6%, 97.5%, and 77.0%, respectively. CONCLUSIONS: In chronic hepatitis B patients without clinical evidence of cirrhosis, severe hepatic fibrosis might be predicted using laboratory parameters of AST/ALT > 1 in combination with platelet counts. However, its sensitivity is too low to replace liver biopsy.

Keyword

Hepatitis B; chronic; Liver fibrosis; AST/ALT ratio; Blood platelets

MeSH Terms

Adolescent
Adult
Aged
Alanine Transaminase/*blood
Aspartate Aminotransferases/*blood
Biological Markers/blood
Child
English Abstract
Female
Hepatitis B, Chronic/*complications
Humans
Liver/pathology
Liver Cirrhosis/*diagnosis/pathology/virology
Male
Middle Aged
*Platelet Count
Predictive Value of Tests
Sensitivity and Specificity