AST/ALT ratio is not useful in predicting the degree of fibrosis in chronic viral hepatitis patients

Eminler, Ahmet Tarık; Ayyildiz, Talat; İrak, Kader; Kıyıcı, Murat; Gürel, Selım; Dolar, Enver; Gülten, Macit; Nak, Selim Giray

doi:10.1097/meg.0000000000000468

Cited by 38 publications

(41 citation statements)

References 23 publications

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“…The APRI model, which was first investigated by Wai et al in the staging of fibrosis among CHB patients, showed the most accurate diagnostic value and most powerful predictive value for fibrosis among the models in this study (19). The AUROC of APRI in the prediction of significant fibrosis was 0.688; this finding seems to be consistent with the data reported in the literature (20)(21)(22)(23)(24). The NPV of APRI in the prediction of fibrosis and cirrhosis was > 90% in a study by Guzelbulut et al and 92% in a study by Celikbilek et al (20,22).…”

Section: Discussionsupporting

confidence: 82%

“…Overall, the number of studies indicating a relationship between CDS and fibrosis staging is limited in CHB patients. While CDS was insufficient in the diagnosis of liver fibrosis in some studies, it could be used to diagnose fibrosis in several other studies (21,24,30). In the present study, the cut-off value and NPV of CDS for low and significant fibrosis in cirrhotic and noncirrhotic patients were > 5, 75.57%, and 97.42%, respectively.…”

Section: Discussionmentioning

confidence: 58%

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Noninvasive Models to Predict Liver Fibrosis in Patients with Chronic Hepatitis B: A Study from Turkey

Korkmaz¹,

Demirtürk

Batırel³

et al. 2017

Hepat Mon

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Background: Many noninvasive methods, including amino transaminase (AST)/amino transaminase (ALT) ratio (AAR), AST-to-platelet ratio index (APRI), Bonacini cirrhosis discriminant score (CDS), fibrosis-4 (FIB4) index, and age-platelet index (API), have been described to determine the stage of hepatic fibrosis. However, these methods are developed for patients with chronic hepatitis C (CHC) and produce conflicting results in the prediction of liver fibrosis in patients with chronic hepatitis B (CHB). Objectives: The aim of this study was to evaluate the relationship between 7 noninvasive models, including AAR, APRI, CDS, API, FIB-4, neutrophil-to-lymphocyte ratio (NLR), and red cell distribution width (RDW)-to-platelet ratio (RPR) in patients with CHB. Methods: The study population included all patients with CHB, undergoing liver biopsy to determine HBsAg and HBV DNA positivity in more than 6 months. Results: A total of 2520 treatment-naive CHB patients from 40 different centers were included in the study. In total, 62.6% of the patients were male, and the mean age

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 58%

Noninvasive Models to Predict Liver Fibrosis in Patients with Chronic Hepatitis B: A Study from Turkey

Korkmaz¹,

Demirtürk

Batırel³

et al. 2017

Hepat Mon

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“…The other ones also showed that AUC of API was 0.767 and 0.529 for 3.5 and 5.5 cut off values, respectively (34,37). In this study, the AUC of API (0.861 for 5.0 cut off value) was higher than in other studies.…”

Section: U N C O R R E C T E D P R O O Fcontrasting

confidence: 51%

SHFI: A Novel Noninvasive Predictive Model for Significant Fibrosis in Patients With Chronic Hepatitis B

et al. 2018

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“…In a study published by Williams et al in 1988 (58), among 100 patients with HBV, the mean AST/ALT ratio was 0.59 in those without and 1.02 in those with cirrhosis respectively. However, Eminler and colleagues (59) found that the AAR performed inferiorly to other blood-based non-invasive algorithms in estimating the fibrosis stage in 237 HBV patients. Similarly, the ability of the AAR to diagnose significant fibrosis (F2-F4) was poor in a US cohort of 319 HBV patients (AUROC of 0.56) (60).…”

Section: Ast/alt Ratio (Aar)mentioning

confidence: 99%

Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection

Parikh¹,

Ryan²,

Tsochatzis³

2017

Ann. Transl. Med.

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Chronic hepatitis B virus (HBV) infection is a major cause of liver morbidity and mortality worldwide.While a proportion of the 250 million individuals chronically infected with HBV will not come to significant harm or require therapy, many others risk developing complications of the end-stage liver disease such as decompensated cirrhosis and hepatocellular carcinoma (HCC), without intervention. Due to the complex natural history of HBV infection, patients require an expert assessment to interpret biochemistry, viral serology and appropriately stage the disease, and to initiate monitoring and/or therapy where indicated. The detection and quantification of liver fibrosis is a key factor for disease management and prognostication for an individual with HBV. The reliance on invasive liver biopsy to stage disease is diminishing with the advent of robust non-invasive blood-and imagingbased algorithms which can reliably stage disease in many cases. These tests are now incorporated into International guidelines for HBV management and relied upon daily to inform clinical judgement. Both blood-and imagingbased approaches have advantages over liver biopsy, including minimal risks, lower cost, better patient acceptance and speed of results, while disadvantages include lower diagnostic accuracy in intermediate disease stages and variability with co-existing hepatic inflammation or steatosis. This review outlines the methods of fibrosis assessment in chronic HBV infection and focuses on the most commonly used blood-and imaging-based noninvasive tests, reviewing their diagnostic performance and applicability to patient care.

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AST/ALT ratio is not useful in predicting the degree of fibrosis in chronic viral hepatitis patients

Cited by 38 publications

References 23 publications

Noninvasive Models to Predict Liver Fibrosis in Patients with Chronic Hepatitis B: A Study from Turkey

Noninvasive Models to Predict Liver Fibrosis in Patients with Chronic Hepatitis B: A Study from Turkey

SHFI: A Novel Noninvasive Predictive Model for Significant Fibrosis in Patients With Chronic Hepatitis B

Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection

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