Muhammad Ansar, Umber Shafique, Farrukh Saeed, Mansoor Nadeem, Muhammad Naeem Khan.
Evaluation of ast/ alt ratio as a marker of liver fibrosis and cirrhosis in patients with chronic hepatitis c.
Pak Armed Forces Med J Jan ;59(4):261-2.

Objective: To assess the relation between serum AST/ALT ratio ( AAR ) and hepatic fibrosis and cirrhosis associated with chronic hepatitis C. Study Design: A cross sectional study. Place and Duration of Study: The study was conducted in the department of medicine Military Hospital Rawalpindi from Sep 2004 to Feb 2005. Materials and Methods: Fifty diagnosed patients of chronic hepatitis C were selected whose liver biopsy was performed as a workup plan for treatment. Serum AST/ ALT ratio ( AAR ) was determined and degree of liver fibrosis noted on histopathology, using Knodell scoring system. ANOVA was applied to study the difference in AAR in different stages of liver fibrosis. Results: The mean AAR was found to be higher with each increasing stage of liver fibrosis. The mean AAR in cirrhotics (1.34) was significantly higher compared to noncirrhotics (0.77), p< 0.001. AAR ≥ 1 had 100% sensitivity and negative predictive value in distinguishing cirrhotic from non-cirrhotic patients with 87% specificity and 45% positive predictive value. Conclusion: There is only a modest relation between AAR and early hepatic fibrosis (stages 1-3) in patients with chronic hepatitis C, while AAR is significantly higher in patients with advanced fibrosis/ cirrhosis.

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