Platelet/lymphocyte, neutrophil/lymphocyte, and red-cell distribution width/platelet ratios for assessment of hepatitis-C virus infection severity

Abstract

Introduction Chronic hepatitis C is a global health problem with high cost, morbidity, and mortality. There is increasing need for noninvasive parameters to assess disease severity. Some parameters obtained from routine full-blood count are used as indicators for systemic inflammation. These include platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), and red-cell distribution width-to-platelet ratio (RPR). The aim of the present study was to investigate the utility of these parameters in assessment of hepatitis-C virus disease severity. Patients and methods The study population included 180 participants who were divided into four groups. Group I included 90 healthy participants as control. Group II included 30 patients in sustained virus response after 6 months of treatment with direct-acting antiviral agents. Group III included 30 untreated noncirrhotic patients with chronic hepatitis C. Group IV included 30 untreated cirrhotic patients. All underwent thorough clinical evaluation and investigations, including PLR, NLR, RPR, aspartate aminotransferase to platelet-ratio index, and fibrosis index based on the 4 factors. Results NLR did not express significant difference among the studied groups (P=0.998). When moving from the first to the fourth group, PLR showed a gradual decrease being significantly lower in group IV (P<0.001), while RPR showed a gradual increase being significantly higher in group IV (P<0.001). Conclusion PLR and RPR were closely related to disease severity in patients with hepatitis-C virus-related liver disease. NLR was not correlated to disease severity in the same cohort.