Evaluation of Red Cell Distribution Width (RDW) to Platelet Ratio as a Novel Non-Invasive Index for Predicting Hepatic Fibrosis in Patients with Chronic Hepatitis C before and after Antiviral Treatment

Abstract

Abstract Background Globally, about 71 million people have chronic HCV infection. A significant number of those who are chronically infected will develop cirrhosis or liver cancer. Approximately 399, 000 person die every year from liver cirrhosis and hepatocellular carcinoma. Liver fibrosis reflects sustained liver injury often from multiple, simultaneous factors. Assessment of the effect of antiviral treatment on liver fibrosis is desirable end point for evaluation of the efficacy of therapy. Aim of the Work To validate and compare the diagnostic performance of RDW to Platelet ratio for prediction of liver fibrosis before and after antiviral treatment in patient with chronic HCV infection. In Comparison with other markers of fibrosis (fib-4, APRI) scores and fibroscan. Patients and Methods This study was conducted on 50 adult patients with chronic hepatitis C virus subdivided into two groups. First group: 25 Non cirrhotic patients having chronic HCV infection. Second group: 25 Cirrhotic CHILD A patients having chronic HCV infection and followed up in Gastroenterology out patient’s clinic, Al Demerdash Hospital, Ain Shams University. Results The results obtained can be summarized as follows: RDW/PLT can predict liver fibrosis and cirrhosis with agood degree of accuracy before HCV treatment. RDW/PLT can predict liver cirrhosis (F3 & F4) with an excellent degree of accuracy after HCV treatment. RDW/PLT cannot predict early liver fibrosis (F1 & F2) after HCV treatment as results assuming apoor degree of accuracy. According to above results RDW/PLT can be used instead of liver biopsy to detect degree of liver fibrosis and cirrhosis before HCV treatment with agood degree of accuracy. While after HCV treatment we can depend on RDW/PLT to predect degree of advanced liver fibrosis and cirrhosis (F3 & F4) with an excellent degree of accuracy. But we need further studies on RDW/PLT to detect the accuracy of prediction of early liver fibrosis (F1 & F2) after HCV treatment. Conclusion RDW/PLT can predict liver fibrosis and cirrhosis with agood degree of accuracy before HCV treatment. RDW/PLT can predict liver cirrhosis (F3 & F4) with an excellent degree of accuracy after HCV treatment. RDW/PLT cannot predict early liver fibrosis (F1 & F2) after HCV treatment as results assuming apoor degree of accuracy. According to above results RDW/PLT can be used instead of liver biopsy to detect degree of liver fibrosis and cirrhosis before HCV treatment with agood degree of accuracy. While after HCV treatment we can depend on RDW/PLT to predect degree of advanced liver fibrosis and cirrhosis (F3 & F4) with an excellent degree of accuracy. But we need further studies on RDW/PLT to detect the accuracy of prediction of early liver fibrosis (F1 & F2) after HCV treatment.