The role of Aspartate Aminotransferase-to-Platelet ratio (APRI) in the Prediction of Liver Fibrosis in Chronic HCV Patients

Abstract

Introduction/Objective Chronic hepatitis C virus (HCV) infection is typically characterized by slowly progressive hepatic fibrosis, with progression from stage 0 (no fibrosis) to stage 4 (cirrhosis). Aspartate aminotransferase-to- platelet ratio (APRI) may be a simple and convenient noninvasive diagnostic test because it is based on the regular laboratory tests and demographic data. However, its overall test performance in various settings remains questionable. Methods/Case Report Objectives: This study aimed to evaluate the diagnostic accuracy of APRI in the prediction of hepatic fibrosis. Subjects and Methods: Serum samples were collected from patients recruited from Internal Medicine Dept., Mansoura University Hospitals, Egypt. The study included 118 liver fibrosis patients associated with chronic HCV infection (60 males and 58 females) and 50 age-matched healthy volunteers (27 males and 23 females). The HCV infection was diagnosed based on biochemical, serologic, and histological criteria. All samples of fibrotic liver patients showed a positive result for anti-HCV Abs using ELISA as a confirmatory test. AST, ALT, albumin, and total bilirubin were measured using standard methodologies. Routine blood pictures, including platelets counting were determined. The AST-ALT ratio was calculated as [AST/ ALT]. The APRI was calculated as [AST/ (upper limits of normal)/ platelets count 109/L]×100. Results (if a Case Study enter NA) There was no statistically significant difference between sex distribution in liver fibrosis patients and healthy volunteers. The mean±SD was (46.1±10.44 and 33.3±11.13) respectively. The medians of the selected laboratory markers in the healthy group and liver fibrotic patients were (41,39), (272.5,167), (36,54), (35.5,51), (0.9,0.98), (0.71,2.5), and (0.34, 0.86) for Albumin, Platelet count, AST, ALT, AST/ALT ratio, Total Bilirubin, APRI respectively. There was a statistically significant difference between the two groups in all laboratory parameters (p<0.001) and for APRI (p<0.0001). Conclusion The evaluation of APRI is uncomplicated, inexpensive, and has a reasonable degree of diagnostic accuracy in determining whether or not patients with chronic HCV have liver fibrosis.