Sajid Nisar, Fehmida Farrukh Khan, Faisal Masud.
Use of serum aspartate aminotransferase levels and platelet count to predict hepatic fibrosis in chronic hepatitis C.
Esculapio J Services Inst Med Sci Jan ;3(3):15-9.

Background: Chronic hepatitis C (CHC) induces inflammation resulting in fibrosis. Liver biopsy is the gold standard for assessing histology. Progressive fibrosis results in portal hypertension, splenomegaly, thrombocytopenia and decreased clearance with rise of the enzyme serum aspartate aminotransferase (AST) levels. To amplify this difference in AST and platelet count in fibrosis, AST-platelet-ratio-index (APRI) was devised using noninvasive serum markers, suggesting that its application may decrease the need for liver biopsy. Patients and Methods: Cross sectional descriptive study done insixty HCV positive patients fulfilling the criteria. AST levels (IU/L) expressed as a ratio of upper limit of normal (ULN) taken as 9 40, were divided by platelet count (x10 /L) and multiplied by 100 to calculate APRI = {(AST/40)/Platelet Count} x 100. Liver biopsies were then staged by histopathologist for fibrosis according to Ishaq /revised Knodell criteria. Results: APRI of less than 1.5 was associated with absent or minimal fibrosis (F0-F2), whereas values greater than these showed marked fibrosis/ cirrhosis (F3-F6) (p=0.0001). Conclusion: Study showed that APRI has significant association with fibrosis and identifies CHC patients with minimal as well as marked fibrosis and its application may decrease the need for performing liver biopsies for staging.

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