BACKGROUND: A non-invasive method to assess liver fibrosis by measuring liver stiffness with transient elastography (TE) has been recently introduced. The role of TE among chronic hepatitis B (CHB) patients in starting antiviral therapy in the primary care setting is still controversial because of its high cost. The AST to platelet ratio index (APRI) could be a much cheaper alternative. OBJECTIVES: This study compares the diagnostic accuracy of TE and APRI in assessing liver fibrosis in CHB patients. PATIENTS AND METHODS: A cross-sectional study in CHB patients intending to start antiviral treatment. Liver fibrosis was staged according to the METAVIR scoring system. Liver stiffness was measured by TE performed on the same day with liver biopsy, while APRI was calculated as follows: APRI=(AST/upper limit of normal)×100/platelet count (10(9)/l). Cutoff levels of liver stiffness and APRI were calculated by using the receiver operating characteristic curve to detect significant liver fibrosis, defined as fibrosis stage F2 or more. RESULTS: 117 patients were enrolled in the study; their mean age was 40.6±10.97 years. The median liver stiffness was 5.9 kPa (2.5-48 kPa) and the median APRI was 0.239 (0.09-2.73). The cutoff level of liver stiffness was 5.85 kPa for ≥F2 with an AUC of 0.614, 60.3% sensitivity, 63.6% specificity, 73.3% PPV, 49.1% NPV and a LR+ of 1.66. The APRI cutoff level was 0.235 for F≥2 with an AUC of 0.693, 64.4% sensitivity, 70.5% specificity, 78.3% PPV, 54.4% NPV and a LR+ of 2.18. Both methods gave comparable diagnostic accuracy. CONCLUSION: APRI is a useful marker to screen liver fibrosis in the primary care setting when TE is not available.
BACKGROUND: A non-invasive method to assess liver fibrosis by measuring liver stiffness with transient elastography (TE) has been recently introduced. The role of TE among chronic hepatitis B (CHB) patients in starting antiviral therapy in the primary care setting is still controversial because of its high cost. The AST to platelet ratio index (APRI) could be a much cheaper alternative. OBJECTIVES: This study compares the diagnostic accuracy of TE and APRI in assessing liver fibrosis in CHB patients. PATIENTS AND METHODS: A cross-sectional study in CHB patients intending to start antiviral treatment. Liver fibrosis was staged according to the METAVIR scoring system. Liver stiffness was measured by TE performed on the same day with liver biopsy, while APRI was calculated as follows: APRI=(AST/upper limit of normal)×100/platelet count (10(9)/l). Cutoff levels of liver stiffness and APRI were calculated by using the receiver operating characteristic curve to detect significant liver fibrosis, defined as fibrosis stage F2 or more. RESULTS: 117 patients were enrolled in the study; their mean age was 40.6±10.97 years. The median liver stiffness was 5.9 kPa (2.5-48 kPa) and the median APRI was 0.239 (0.09-2.73). The cutoff level of liver stiffness was 5.85 kPa for ≥F2 with an AUC of 0.614, 60.3% sensitivity, 63.6% specificity, 73.3% PPV, 49.1% NPV and a LR+ of 1.66. The APRI cutoff level was 0.235 for F≥2 with an AUC of 0.693, 64.4% sensitivity, 70.5% specificity, 78.3% PPV, 54.4% NPV and a LR+ of 2.18. Both methods gave comparable diagnostic accuracy. CONCLUSION: APRI is a useful marker to screen liver fibrosis in the primary care setting when TE is not available.
Authors: P M Trembling; P Lampertico; J Parkes; S Tanwar; M Viganò; F Facchetti; M Colombo; W M Rosenberg Journal: J Viral Hepat Date: 2013-08-15 Impact factor: 3.728
Authors: Xiaolong Qi; Min An; Tongwei Wu; Deke Jiang; Mengyun Peng; Weidong Wang; Jing Wang; Chunqing Zhang; On Behalf Of The Chess Study Group Journal: Can J Gastroenterol Hepatol Date: 2018-05-24
Authors: Young Eun Chon; Eun Hee Choi; Ki Jun Song; Jun Yong Park; Do Young Kim; Kwang-Hyub Han; Chae Yoon Chon; Sang Hoon Ahn; Seung Up Kim Journal: PLoS One Date: 2012-09-25 Impact factor: 3.240
Authors: Yu Zhijian; Li Hui; Yao Weiming; Lin Zhanzhou; Chen Zhong; Zheng Jinxin; Wang Hongyan; Deng Xiangbin; Yang Weizhi; Li Duoyun; Liu Xiaojun; Deng Qiwen Journal: Gastroenterol Res Pract Date: 2015-07-05 Impact factor: 2.260