Korean J Gastroenterol.  2005 May;45(5):340-347.

Efficacy of AST to Platelet Ratio Index in Predicting Severe Hepatic Fibrosis and Cirrhosis in Chronic Hepatitis B Virus Infection

• Sim SJ
• Cheong JY
• Cho SW
• Kim JS
• Lim TY
• Shin DH
• Lim SG
• Kim YB
• Lee KM
• Yoo BM
• Lee KJ
• Hahm KB
• Kim JH

Abstract

BACKGROUND/AIMS: An ideal noninvasive diagnostic test for hepatic fibrosis should be simple, inexpensive, and accurate. We aimed to find the simple marker for predicting hepatic fibrosis and to compare the accuracy of AST, platelet, AST/ALT ratio and AST to platelet ratio index (APRI) in chronic hepatitis B patients without clinical evidence of cirrhosis. METHODS: A total of one hundred and twenty-six chronic hepatitis B patients who underwent liver biopsy at the Ajou University Hospital from August 1998 to December 2003 were enrolled. Hepatic fibrosis was assessed using the Ludwig classification. Significant fibrosis was defined as fibrosis score of 3 or more. The AST/ALT ratio and APRI were calculated and correlations with hepatic fibrosis were analyzed. RESULTS: APRI showed a significant correlation (r=0.501, p=0.000) with hepatic fibrosis, and was superior to AST, AST/ALT ratio and platelet in predicting fibrosis. Patients with significant fibrosis (fibrosis stage 3, 4) can be identified to have APRI=1 with sensitivity 71.2% and specificity 70.3%. The sensitivity and specificity of an APRI = 1.5 for cirrhosis (stage 4) were 83.3% and 75.0%. CONCLUSIONS: Simple index using AST and platelet value can predict the presence of significant fibrosis and cirrhosis in chronic hepatitis B patients without clinical evidence of cirrhosis.

Keyword

Hepatitis B; Liver fibrosis; AST/ALT ratio; AST to platelet ratio index

MeSH Terms

Adult
Alanine Transaminase/blood
Aspartate Aminotransferases/*blood
Female
Hepatitis B, Chronic/blood/enzymology/*pathology
Humans
Liver/pathology
Liver Cirrhosis/*pathology/virology
Male
*Platelet Count
Sensitivity and Specificity