Document Detail

Evaluation of diagnostic accuracy of APRI for prediction of fibrosis in hepatitis C patients.
MedLine Citation:
PMID:  19999223     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Several non-invasive markers are being used to assess the structural liver damage in patients with chronic hepatitis C (CHC). We evaluated Aspartate aminotransferase (AST) to platelet ratio index (APRI) in comparison with Metavir scoring for assessing the severity of hepatic fibrosis in the CHC patients in district Rawalpindi. METHODS: One hundred twenty CHC patients, naive for HCV treatment, underwent liver biopsy in tertiary care hospitals of district Rawalpindi, participated in the study. Liver biopsies were reviewed by Metavir scoring system. Serum AST was analyzed by IFCC method. Platelets were measured on a haematology Analyzer. Patients with mild fibrosis (F0, F1) were differentiated from significant fibrosis (F2, F3, F4) and those with mild/moderate fibrosis (F0, F1, F2) from advanced fibrosis (F3, F4) based on APRI score as compared to liver biopsy. RESULTS: Liver biopsies examination revealed that out of 120 patients 10 (8.3%) had no fibrosis (F0), 46 (38%) portal fibrosis (F1), 34 (28%) septal fibrosis (F2), 21 (18%) bridging fibrosis (F3) and 9 (8%) cirrhosis (F4). APRI correctly classified 58 (48%) patients of significant fibrosis with AUC = 0.82 (95% CI, 0.73-0.88) at cut-off 0.5 and 1.5 with negative predictive value (NPV), Positive predictive value (PPV), sensitivity and specificity of 78%, 72%, 66%, 83% and 58%, 90%, 41% and 90% respectively. Eighty-seven (66%) CHC patients were correctly classified for advanced fibrosis with AUC = 0.87 (95% CI 0.79-0.94) at cutoffs 0.90 and 1.75 with a 95%NPV at 0.90 and 78% PPV at 1.75. CONCLUSION: APRI could correctly identify significant fibrosis in 48% and advanced fibrosis in 66% cases with acceptable degree of diagnostic accuracy in CHC patients in our clinical practice.
Dilshad Ahmad Khan; Fatima-Tuz-Zuhra; Farooq Ahmad Khan; Azhar Mubarak
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  Journal of Ayub Medical College, Abbottabad : JAMC     Volume:  20     ISSN:  1025-9589     ISO Abbreviation:  J Ayub Med Coll Abbottabad     Publication Date:    2008 Oct-Dec
Date Detail:
Created Date:  2009-12-11     Completed Date:  2010-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8910750     Medline TA:  J Ayub Med Coll Abbottabad     Country:  Pakistan    
Other Details:
Languages:  eng     Pagination:  122-6     Citation Subset:  IM    
Department of Pathology, Army Medical College, National University of Sciences and Technology, Rawalpindi, Pakistan.
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MeSH Terms
Aspartate Aminotransferases / blood
Blood Platelets
Hepatitis C / blood,  complications*,  pathology
Liver / pathology,  virology
Liver Cirrhosis / blood,  diagnosis*,  virology*
Predictive Value of Tests
Reproducibility of Results
Severity of Illness Index
Reg. No./Substance:
EC Aminotransferases

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