Accuracy of AST to platelet ratio for predicting liver fibrosis in patients with chronic HCV infection after viral eradication

Abstract

Determining the stage of fibrosis is an essential element of chronic hepatitis C (HCV) management. This study aims to evaluate aminotransferase to platelet ratio (APRI) score in comparison with Vibration-Controlled Transient Elastography (VCTE) for assessing the severity of liver disease in HCV-infected patients. Material and methods: We retrospectively enrolled 293 HCV-infected patients with different stages of fibrosis who achieved sustained virological response (SVR) after direct-acting antivirals (DAAs) therapy, which have been evaluated by VCTE from 1st September 2020 to 30th July 2021. Results: Two hundred and ninety-three patients (72.7% females, mean age of 61.75 ± 10.87 years, and mean BMI of 27.85 ± 4.63 kg/m2) were evaluated. As estimated by VCTE, 44 (15%) of patients were without liver fibrosis (F0), 80 (27.3%) with F1 (mild), 39 (13.3%) with F2 (significant), 43 (14.7%) with F3 (advanced) liver fibrosis, and 87 (29.7%) with F4 (cirrhosis), with a mean value of liver stiffness measurements (LSM) of 10.17 ± 7.42 kPa. The APRI score has a positive correlation with the LSM score (p=0.047), predicting severe liver disease adequately. The optimal receiver operator curve (ROC) for predicting advanced fibrosis was > 1.15 (area under the curve [AUC] 0.79, 95% CI 0.71-0.83; p < 0.001) with a sensitivity (Ss) of 82.5%, specificity (Sp) 28%, a positive predictive value (PPV) of 72%, and negative predictive value (NPV) of 81%. Conclusions: APRI score can predict well the advanced liver fibrosis and cirrhosis and can be a useful non-invasive biochemical marker for resource-limited management of HCV-infected patients.