Simple tests to predict hepatic fibrosis in nonalcoholic chronic liver diseases

• Published in: Gut and liver 2007, 1(2), , pp.145-150
• Main Authors: Shin, Woon Geon, Park, Sang Hoon, Jun, Sun-Young, Jung, Jae One, Moon, Joon Ho, Kim, Jong Pyo, Kim, Kyoung Oh, Park, Cheol Hee, Hahn, Tai Ho, Yoo, Kyo-Sang, Kim, Jong Hyeok, Park, Choong Kee
• Format: Article
• Language: English
• Subjects: aspartate aminotransferase; fibrosis; hepatitis b; Original; 내과학
• ISSN: 1976-2283; 2005-1212
• DOI: 10.5009/gnl.2007.1.2.145

Several simple tests for hepatic fibrosis employ indirect markers. However, the efficacy of using direct and indirect serum markers to predict significant fibrosis in clinical practice is inconclusive. We analyzed the efficacy of a previously reported indirect marker of hepatic fibrosis - the aspartate aminotransferase to platelet ratio index (APRI) - in patients with nonalcoholic chronic liver diseases (CLDs). A total of 134 patients who underwent a percutaneous liver biopsy with a final diagnosis of chronic hepatitis B (n=93), chronic hepatitis C (n=18), or nonalcoholic fatty liver disease (n=23) were enrolled. A single-blinded pathologist staged fibrosis from F0 to F4 according to the METAVIR system, with significant hepatic fibrosis defined as a METAVIR fibrosis score of >/=2. The mean area under the receiver operating characteristic curve (AUROC) of APRI for predicting significant fibrosis in nonalcoholic CLDs was 0.84 [95% confidence interval (CI), 0.78-0.91]. APRI yielded the highest mean AUROC in the patients with chronic hepatitis B (0.85; 95% CI, 0.771-0.926). The positive predictive value of APRI >/=1.5 for predicting significant fibrosis was 89%. The negative predictive value of APRI