Abstract
Background and study aim: The gold standard investigation to stage hepatic cirrhosis is liver biopsy. Being invasive with several major and minor procedure-related complications, liver biopsy is not universally-applied in all the indicated population. In addition to observer-related variations and sampling errors, the need for alternatives to liver biopsy has emerged including several lab-based indices of those; red cell volume distribution width-to-platelet ratio (RPR) have been postulated in some studies. The aim of this article is to study the diagnostic performance of RPR in staging liver cirrhosis in HCV-infected patients. Patients and Methods: 236 patients who had underwent liver biopsy for IFN-based therapy were included in the present study according to pre-defined inclusion and exclusion criteria. They were classified into 4 groups according to the stage of cirrhosis reported by the liver biopsy. Laboratory data, including CBC and biochemical studies, RPR, APRI score and FIB-4 were tabulated for statistical analysis. Results: The AUROCs values for RPR were 0.795, 0.811 and 0.886 for F2, F3 and F4 stage of cirrhosis respectively which were consistently higher than those of APRI (0.680, 0.754 and 0.746 for F2, F3 and F4 stages respectively) and FIB-4 (0.653, 0.765 and 0.810 for F2, F3 and F4 stages respectively). RPR was significantly-correlated with APRI (P<0.002), and FIB-4 (P<0.001) for the prediction of F3 stage of cirrhosis, and F4 stage of cirrhosis (P<0.001 & P=0.03 with APRI & FIB-4 respectively). Conclusion: RPR can be a promising, inexpensive non-invasive tool for the prediction of the stage of hepatic cirrhosis in patients with HCV.
Highlights
Hepatitis C Virus (HCV) was discovered in 1989 and since it has been recognized as a major cause for chronic liver diseases worldwide accounting for more than 50% of infected cases [1].The World Health Organization (WHO) reported that about 71 million people were HCV-infected in 2015, accounting for 1% of the total population
The results indicated that each mean value for Red cell distribution width (RDW), Platelet count, red cell volume distribution width-to-platelet ratio (RPR), APRI and FIB-4 were running progressively in correspondence with the stage of cirrhosis with a high statisticallysignificant difference (p
We searched the published data about RPR and we found many studies about its role in staging hepatic cirrhosis in patients with Hepatitis B Virus (HBV)-related liver diseases, NAFLD and PBC
Summary
HCV was discovered in 1989 and since it has been recognized as a major cause for chronic liver diseases worldwide accounting for more than 50% of infected cases [1].The WHO reported that about 71 million people were HCV-infected in 2015, accounting for 1% of the total population. HCV was discovered in 1989 and since it has been recognized as a major cause for chronic liver diseases worldwide accounting for more than 50% of infected cases [1]. Being invasive with several major and minor procedure-related complications, liver biopsy is not universally-. The gold standard investigation to stage hepatic cirrhosis is liver biopsy. Being invasive with several major and minor procedurerelated complications, liver biopsy is not universally-applied in all the indicated population. In addition to observer-related variations and sampling errors, the need for alternatives to liver biopsy has emerged including several lab-based indices of those; red cell volume distribution width-to-platelet ratio (RPR) have been postulated in some studies. The aim of this article is to study the diagnostic performance of RPR in staging liver cirrhosis in HCV-infected patients
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