Abstract
Introduction: For diagnosis of staging of liver fibrosis, the liver biopsy is the only recognized gold standard technique. The aspartate transaminase to platelet ratio index (APRI) has been proposed as a noninvasive and readily available tool for the assessment of liver fibrosis.
Method: The present prospective study was carried out in the Department of Medicine, Muzaffarnagar Medical College, Muzaffarnagar.
Result: In this study, we have included 203 patients, out of which 72 % were male and 28% were female. Viral etiology noted in 48.3%, alcoholism in 5.9% and other etiology noted in 45.8%. With APRI cut-off 1 the specificity, sensitivity and positive predictive value to detect advanced fibrosis was 87%, 42%, 75% respectively.
Conclusion: The present showed that the APRI is a specific non-invasive biomarker to detect advanced fibrosis but liver elastography remains the best available non-invasive tool to diagnosis liver low grade and advanced fibrosis due to the poor sensitivity of these markers.
Keywords: APRI, liver fibrosis, Aspartate Transaminase, Platelet count.
References
- Schuppan D, Afdhal NH. Liver Cirrhosis. Lancet 2008;371(9615):838:51.
- Sharma S, Kahlili K, Nguyen GC. No-Invasive Diagnosis of Advanced Fibrosis and Cirrhosis.World J Gastroenterol 2014 7;20(45):16820-30.
- Poynard T, Imbert-Bismut F, Munteanu M, Messous D, Myers RP, Thabut D, et al. Overview of the diagnostic value of biochemical markers of liver fibrosis (Fibro Test, HCV Fibro Sure) and necrosis (Acti Test) in patients with chronic hepatitis C. Comp Hepatol. 2004;23:3–8.
- Forestier J, Dumortier J, Guillaud O, Ecochard M, Roman S, Boillot O, et al. Noninvasive diagnosis and prognosis of liver cirrhosis: a comparison of biological scores, elastometry, and metabolic liver function tests. Eur J Gastroenterol Hepatol. 2010;22:532–40.
- Lesmana CRA, Salim S, Hasan I, Sulaiman AS, Gani RA, Pakasi LS, et al. Diagnostic accuracy of transient elastography (FibroScan) versus the aspartate transaminase to platelet ratio index in assessing liver fibrosis in chronic hepatitis B: the role in primary care setting. J Clin Pathol. 2011;64:916–20.
- Fallatah HI. Noninvasive biomarkers of liver fibrosis: An Overview. Advances in Hepatology. 2014;2014:1–15.
- Papastergiou V, Tsochatzis E, Burroughs AK. No-Invasive Assessment of Liver Fibrosis. Ann Gastroenterol 2012;25(3): 218:31.
- Fabris C, Smirne C, Toniutto P, Colletta C, Rapetti R, Minisiniet R et al. Usefulness of six non-proprietary indirect markers of liver fibrosis in patients with chronic hepatitis C. Clin Chem Lab Med. 2008;46:253–59.
- Paggi S, Colli A, Fraquelli M, Vigano M, Poggio PD, Facciotto C, et al. A non-invasive algorithm accurately predicts advanced fibrosis in hepatitis C: a comparison using histology with internal-external validation. J Hepatol. 2008;49: 564–71.
- AttaullahS , KhanS, AliHepatitis C virus genotypes in Pakistan: a systemic review. Virol J 2011;8.doi:10.1186/1743-422X-8-433.
- AhmadW , IjazB, JavedFT, Gull S, Kausar H, Sarwar MT, et al. A comparison of four fibrosis indexes in chronic HCV: development of new fibrosis-cirrhosis index (FCI). BMC Gastroenterol 2011; 11:44.doi:10.1186/1471-230X-11-44.
- SchmidP, BregenzerA, HuberM, Rauch A, Jochum W, Mullhaupt B, et al. Progression of liver fibrosis in HIV/HCV co-infection: assessment methods and liver biopsy. PLoS One 2015;10:
- Petersen JR, Stevenson HL, Krishna SK, Naniwadekar A, Parkes J, Cross R, et al. Evaluation of the APRI (AST, platelet ratio index) and ELF™ (Enhanced Liver Fibrosis) tests to detect significant fibrosis due to chronic hepatitis C.
- Jain P, Tripathi BK, Gupta B, Bhandari B, Jalan Evaluation of Aspartate Aminotransferase-to-Platelet Ratio Index as a Non-Invasive Marker for Liver Cirrhosis. J Clin Diagn Res 2015; Nov 9(11):22-4.
Corresponding Author
Dr Subodh Katariya
Professor, Department of Medicine, Muzaffarnagar Medical College, Muzaffarnagar (U.P.)
DOI: https://dx.doi.org/10.18535/jmscr/v8i9.26
