Abstract
Background: Red cell distribution width to platelet ratio (RPR) is known to be associated with a degree of liver fibrosis in patients with hepatitis B. This study aims to compare the under curve area, sensitivity, specificity, positive predictive value, and negative predictive value between RPR and aspartate aminotransferase to platelet ratio index (APRI) score with degree of fibrosis.Method: This study is a retrospective study, data taken from medical records of all chronic hepatitis B patients examined by Fibroscan at Sanglah General Hospital Denpasar, Bali from January 2016 to February 2018.Results: Ninety eight patients with chronic hepatitis B, 81 patients were recovered after exclusion of patients with chronic kidney disease, malignancy, and dengue haemorrhagic fever (DHF). In receiver operating characteristic (ROC) analysis, obtained area under the ROC curve (AUC) at RPR of 0.816, and at APRI score 0.797. In RPR with cut off 0.066 the sensitivity was 76.9%, specificity 78.6%, PPV 79.5%, NPV 73.8%. While APRI score with cut off 0.85 got 69.2% sensitivity, specificity 76.2%, PPV 73.0%, and NPV 72.7%. According to Kappa test, we found kappa coefficient 0.653 (p 0.05).Conclusion: In predicting severe liver fibrosis in chronic hepatitis B patients, RPR is not inferior than APRI score, and may be used as a diagnostic marker, with 65.3% conformity.
Highlights
Liver fibrosis is a chronic complication of hepatitis B infection
Latar belakang: Red cell distribution width to platelet ratio (RPR) diketahui terkait dengan tingkat fibrosis hati pada pasien dengan hepatitis B
Apabila RDW to platelet ratio (RPR) dipakai cut off 0,066 sensitivitasnya adalah 76,9%, spesifisitas 78,6%, positive predictive value (PPV) 79,5%, negative predictive value (NPV) 73,8%
Summary
Liver fibrosis is a chronic complication of hepatitis B infection This condition remains silent until the patient falls to decompensated cirrhosis, which is the third leading cause of death after cardiovascular disease and cancer.[1] Early detection is very important in the management of chronic hepatitis B, in order to determine therapy and improves prognosis.[2] Histopathological examination of liver tissue is still a gold standard of the diagnosis of fibrosis and cirrhosis of the liver. This method is an invasive procedure and tends to be abandoned lately. This study aims to compare the under curve area, sensitivity, specificity, positive predictive value, and negative predictive value between RPR and aspartate aminotransferase to platelet ratio index (APRI) score with degree of fibrosis
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