OBJECTIVE: Aspartate aminotransferase (AST) to platelet ratio index (APRI) has been proposed as an easily determined and accurate noninvasive marker of liver fibrosis in chronic hepatitis C. To validate APRI in hepatitis C and to determine its usefulness in other liver diseases, we evaluated APRI in patients with liver fibrosis due to excessive alcohol consumption with or without viral hepatitis C. METHODS: A total of 1,308 subjects from two VA cooperative studies of alcoholic liver disease were evaluated. Liver biopsy was available from 781 noncirrhotic patients while a history of decompensation was present in 527. Alcohol intake was determined by self-report. Hepatitis C was confirmed by PCR. RESULTS: Ninety-eight percent were men with a mean age of 51.5 yr. Alcohol intake averaged 19 drinks/day for 20.6 yr. One hundred thirty-three (10.2%) were hepatitis C positive. In the HCV-positive subgroup, APRI had a sensitivity of 35.6% and a specificity of 29.7% for significant fibrosis. Of 64 patients classified as significant fibrosis, 21 (32.8%) were incorrectly classified. In the 507 HCV negative patients with biopsy confirmed fibrosis, the sensitivity of APRI for significant fibrosis was 13.2% and the specificity was 77.6%. Twenty percent were classified incorrectly. CONCLUSION: APRI has low sensitivity and specificity for the diagnosis of significant fibrosis in patients with alcoholic liver disease, including patients who have hepatitis C. Given the frequent history of alcohol use in patients with hepatitis C, APRI may be of limited usefulness in the diagnosis of fibrosis in many patients.
OBJECTIVE: Aspartate aminotransferase (AST) to platelet ratio index (APRI) has been proposed as an easily determined and accurate noninvasive marker of liver fibrosis in chronic hepatitis C. To validate APRI in hepatitis C and to determine its usefulness in other liver diseases, we evaluated APRI in patients with liver fibrosis due to excessive alcohol consumption with or without viral hepatitis C. METHODS: A total of 1,308 subjects from two VA cooperative studies of alcoholic liver disease were evaluated. Liver biopsy was available from 781 noncirrhotic patients while a history of decompensation was present in 527. Alcohol intake was determined by self-report. Hepatitis C was confirmed by PCR. RESULTS: Ninety-eight percent were men with a mean age of 51.5 yr. Alcohol intake averaged 19 drinks/day for 20.6 yr. One hundred thirty-three (10.2%) were hepatitis C positive. In the HCV-positive subgroup, APRI had a sensitivity of 35.6% and a specificity of 29.7% for significant fibrosis. Of 64 patients classified as significant fibrosis, 21 (32.8%) were incorrectly classified. In the 507 HCV negative patients with biopsy confirmed fibrosis, the sensitivity of APRI for significant fibrosis was 13.2% and the specificity was 77.6%. Twenty percent were classified incorrectly. CONCLUSION: APRI has low sensitivity and specificity for the diagnosis of significant fibrosis in patients with alcoholic liver disease, including patients who have hepatitis C. Given the frequent history of alcohol use in patients with hepatitis C, APRI may be of limited usefulness in the diagnosis of fibrosis in many patients.
Authors: Woon Geon Shin; Sang Hoon Park; Sun-Young Jun; Jae One Jung; Joon Ho Moon; Jong Pyo Kim; Kyoung Oh Kim; Cheol Hee Park; Tai Ho Hahn; Kyo-Sang Yoo; Jong Hyeok Kim; Choong Kee Park Journal: Gut Liver Date: 2007-12-31 Impact factor: 4.519
Authors: Saurabh Sethi; Douglas A Simonetto; Soha S Abdelmoneim; Michael B Campion; Irakli Kaloiani; Amy C Clayton; Walter K Kremers; Kevin C Halling; Patrick S Kamath; Jayant Talwalkar; Vijay H Shah Journal: J Clin Exp Hepatol Date: 2012-04-12
Authors: John B Whitfield; Steven Masson; Suthat Liangpunsakul; Jessica Hyman; Sebastian Mueller; Guruprasad Aithal; Florian Eyer; Dermot Gleeson; Andrew Thompson; Felix Stickel; Michael Soyka; Ann K Daly; Heather J Cordell; Tiebing Liang; Tatiana Foroud; Lawrence Lumeng; Munir Pirmohamed; Bertrand Nalpas; Camille Bence; Jean-Marc Jacquet; Alexandre Louvet; Romain Moirand; Pierre Nahon; Sylvie Naveau; Pascal Perney; Philippe Podevin; Paul S Haber; Helmut K Seitz; Christopher P Day; Philippe Mathurin; Timothy M Morgan; Devanshi Seth Journal: Alcohol Date: 2017-09-23 Impact factor: 2.405
Authors: Matthew D Sadler; Pam Crotty; Linda Fatovich; Stephanie Wilson; Harvey R Rabin; Robert P Myers Journal: Can J Gastroenterol Hepatol Date: 2015-04