AST-platelet ratio index in the prediction of significant fibrosis and cirrhosis in patients with chronic hepatitis B

Abstract

We aimed to evaluate the diagnostic accuracy of AST-platelet ratio index in the prediction of significant fibrosis and cirrhosis in chronic hepatitis B patients by comparison with liver biopsy. We retrospectively reviewed our computerized data of chronic hepatitis B patients who attended the Gastroenterology Clinic from 2004-2009. Treatment-naive chronic hepatitis B patients who had undergone liver biopsy were included in this study. The degree of fibrosis was scored according to the Ishak staging system. Significant fibrosis was defined as F3-6 and cirrhosis as F5-6. AST-platelet ratio index was calculated based on the original studies. Tests results were compared between the groups F0-2 versus F3-6 and F0-4 versus F5-6. Two hundred and fifty consecutive patients with chronic hepatitis B were included in this study. The area under the ROC curves of AST-platelet ratio index to predict significant fibrosis and cirrhosis were 0.779 and 0.781, respectively. Using cut-off values ≤0.5 and >1.5, significant fibrosis was excluded with a negative predictive value of 91.30% and sensitivity of 87.69% and predicted with a positive predictive value of 59.52% and specificity of 90.81% in 53.60% of patients. Using cut-off values ≤1 and >2, cirrhosis was excluded with a negative predictive value of 92.09% and sensitivity of 64.10% and predicted with a positive predictive value of 33.33% and specificity of 91.47% in 81.60% of patients. AST-platelet ratio index may be a useful noninvasive marker in the exclusion of both significant fibrosis and cirrhosis in patients with chronic hepatitis B. However, it is not accurate in the prediction of either significant fibrosis or cirrhosis.