Abstract :
Objectives: Liver biopsy remains the gold standard to assess histologic liver fibrosis for patients with chronic hepatitis C before therapy indication. The aim of this study was to evaluate correlate of APRI score with the degree of histologic liver fibrosis in chronic hepatitis C patients at Phramongkutklao Hospital and Bhumibol Adulyadej Hospital.
Methods: Fifty nine patients who tested positive for hepatitis C antibody (anti HCV) and had been performed liver biopsy from March 2001 to January 2011 were included in the study. Complete blood count, blood urea nitrogen, creatinine, liver function test, coagulogram and HCV genotype were tested for all patients. APRI score was calculated by using the formula [(AST/ULN)/platelet counts (109/L)] × 100 for every patients. Liver
tissues were reviewed by one pathologist for evaluating histologic liver fibrosis by Metavir classification. Patient characteristics and APRI score were compared between those with fibrosis score F ≤2 and those with score F ≥3.
Results: We divided the patients into two groups with non-significant and significant histologic liver fibrosis (F0, F1, F2 vs. F3, F4). When using APRI score = 0.7515 as the cutoff point, it showed 90.48% sensitivity, 63.16% specificity, 72.88% accuracy, 57.58% positive predictive value and 92.31% negative predictive value.
Conclusions: APRI score cannot be used for predicting histologic liver fibrosis in chronic hepatitis C patients at Phramongkutklao Hospital and Bhumibol Adulyadej Hospital because of low accuracy (72.88%). Because
of high sensitivity and negative predictive value, we can use APRI score as a screening test for evaluating histologic liver fibrosis. In chronic hepatitis C patient who has low APRI score (<0.7515) and no sign of chronic
liver disease, we can predict that the |
file/Thai-Journal-of-gastroenterology-vol-13-no-1-4856429.pdf