APRI and FIB-4 performance to assess liver fibrosis against predefined Fibroscan values in chronic hepatitis C virus infection

Abstract

Backgrounds and Aims: Chronic hepatitis C (CHC) infection can leads to chronic liver disease, fibrosis, then cirrhosis, and, finally, hepatocellular carcinoma (HCC); moreover, it is the most common indication for liver transplantation. Liver biopsy is still the gold standard method for the staging of liver fibrosis as it is an invasive procedure with complications. There are some noninvasive methods such as fibroscan that are now the investigation of choice; FIB-4 and aminotransferase to platelet ratio index (APRI) are other noninvasive tools to assess liver fibrosis by using aspartate aminotransferase (AST), alanine aminotransferase (ALT), platelet count, and age. This study aims to evaluate the efficacy and performance of FIB-4 and APRI against fibroscan in patients infected with the hepatitis C virus. Method: It is a cross-sectional study that was conducted in a tertiary health care center in Uttar Pradesh, India, from January 2017 to January 2020. Fibroscan was done for all patients. A blood sample was used to determine AST, ALT, and platelet count. FIB-4 and APRI were calculated from laboratory data. Result: 187 of the 487 patients in the study have F0-F1 fibrosis, 69 have F2, 53 have F3 fibrosis, and 178 have cirrhosis. Based on receiver operating characteristic (ROC) analysis, single optimum cut-offs for diagnosing significant fibrosis and cirrhosis were 1.2 for APRI and 2.25 for FIB-4. Conclusions: Compared with Fibroscan, APRI and FIB-4 showed good performance in detecting the patients without liver fibrosis as well as satisfactory performance in detecting significant fibrosis. These scores should be used in combination with other noninvasive scores for an accurate assessment of liver fibrosis.

Hepatocellular Carcinoma: The Role of Surgery in Liver Cirrhosis

“…It also works to detect smaller changes as the disease progresses and the liver deteriorates [48]. Closely associated with this index are typical fibrosis scores, such as FIB-4 (formula: age [years] * AST [IU/L]/platelet count [10 9 /L] * ALT [IU/L] 1/2 ) as well as the AST to platelet ratio index {APRI; formula: [AST (IU/L)/upper normal limit of AST (IU/L)]/platelet count [10 9 /L]} [49].…”

Role of Anthropometric Indices in Prediction of Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes Mellitus Patients

“…Additionally Rungta et al's (2021) research explored the efficacy of the Aspartate Aminotransferase to Platelet Ratio Index, also known as APRI and the Fibrosis-4 or FIB-4 indices in evaluating liver fibrosis. Findings shed light on non-invasive methods for assessing liver health, particularly in cases of chronic hepatitis C virus infection [22] and in a separate study, Fan et al (2018) conducted a comprehensive dose-response analysis with the aim of elucidating the correlation between BMI and the likelihood of developing fatty liver. Their research provides nuanced perspectives on the complex interplay between obesity and liver well being [23] .…”

Both APRI and FIB‐4 could effectively evaluate liver fibrosis in liver transplantation recipients

“…5 Recent studies have found that compared with TE, the aminotransferase-platelet ratio index (APRI) and fibrosis score 4 (FIB-4) showed satisfactory performance in detecting significant fibrosis in LT recipients and chronic hepatitis C (CHC) virus infection, and could be used as an estimate of significant fibrosis at centers where TE was not available. 6,7 However, few clinical studies are available on the evaluation and diagnosis of post-LT hepatic fibrosis using APRI and FIB-4, compared with TE. This study aimed to evaluate the effectiveness of APRI and FIB-4 in assessing liver fibrosis after LT, compared with TE.…”

“…Several studies have found that novel noninvasive diagnostic techniques, such as TE and acoustic radiation force impulse (ARFI), could accurately detect hepatic steatosis and fibrosis in LT recipients and patients with chronic liver disease. 8-10 Rungta et al 6 found that APRI and FIB-4 showed satisfactory performance in detecting significant fibrosis in patients with CHC infection, compared with TE. 6 According to Nishimura et al, 11 the diagnostic performance of APRI and FIB-4 was inferior to that of ARFI, in the chronic hepatitis B (CHB) and CHC cohorts.…”

“…8-10 Rungta et al 6 found that APRI and FIB-4 showed satisfactory performance in detecting significant fibrosis in patients with CHC infection, compared with TE. 6 According to Nishimura et al, 11 the diagnostic performance of APRI and FIB-4 was inferior to that of ARFI, in the chronic hepatitis B (CHB) and CHC cohorts. Therefore, we conducted this study on LT recipients, and showed that compared with TE, APRI and FIB-4 could accurately diagnose advanced liver fibrosis after LT.…”