APRI: An easy and validated predictor of hepatic fibrosis in chronic hepatitis C

Ned Snyder, Leka Gajula, Shu Yuan Xiao, James Grady, Bruce Luxon, Daryl T Y Lau, Roger Soloway, John Petersen

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

GOALS: To evaluate the aspartate aminotransferase/platelet ratio index (APRI) as a predictor of the presence or absence of significant fibrosis on liver biopsy of patients with chronic hepatitis C (HCV). BACKGROUND: The decision to treat HCV is often made on the basis of the presence or absence of significant fibrosis on the liver biopsy. Because liver biopsy is expensive and invasive a noninvasive marker to evaluate hepatic fibrosis would be useful. The APRI is an easy to calculate index that is one of several markers that have been proposed. STUDY: We retrospectively reviewed the charts of 339 patients with chronic HCV who had liver biopsies from January 2000 to March 2003. We subsequently evaluated 151 patients receiving pretreatment evaluation liver biopsies who had serum aspartate aminotransferase, platelets, routine liver function tests, and demographic data obtained. All liver biopsies were staged by the Batts Ludwig criteria. RESULTS: The area under the curve of the receiver operator characteristics of the calculated APRI compared with the liver biopsy demonstrated that the fibrosis score was 0.889 in the prospective group and 0.790 in the retrospective group. To achieve predictive values of approximately 90%, useful cutoffs were found at 0.40 and 1.5 in the retrospective study, and 0.42 and 1.2 in the prospective study leaving intermediate zones of 58.9% and 41.1%, respectively. In the prospective group, 34 of 36 patients with a value of <0.42 were accurately predicted as having mild fibrosis, whereas 50 of 54 patients with a value >1.2 were accurately predicted to have significant fibrosis. CONCLUSIONS: The APRI is a good estimator of hepatic fibrosis and was more accurate in a prospective group than a retrospective one. It potentially could be used to decrease the number of liver biopsies.

Original languageEnglish (US)
Pages (from-to)535-542
Number of pages8
JournalJournal of Clinical Gastroenterology
Volume40
Issue number6
DOIs
StatePublished - Jul 2006

Fingerprint

Chronic Hepatitis C
Transaminases
Fibrosis
Blood Platelets
Biopsy
Liver
Aspartate Aminotransferases
Liver Cirrhosis
Liver Function Tests
Area Under Curve
Retrospective Studies
Demography
Prospective Studies
Serum

Keywords

  • Aspartate amino transferase
  • Fibrosis
  • Hepatitis C
  • Platelets

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Snyder, N., Gajula, L., Xiao, S. Y., Grady, J., Luxon, B., Lau, D. T. Y., ... Petersen, J. (2006). APRI: An easy and validated predictor of hepatic fibrosis in chronic hepatitis C. Journal of Clinical Gastroenterology, 40(6), 535-542. https://doi.org/10.1097/00004836-200607000-00013

APRI : An easy and validated predictor of hepatic fibrosis in chronic hepatitis C. / Snyder, Ned; Gajula, Leka; Xiao, Shu Yuan; Grady, James; Luxon, Bruce; Lau, Daryl T Y; Soloway, Roger; Petersen, John.

In: Journal of Clinical Gastroenterology, Vol. 40, No. 6, 07.2006, p. 535-542.

Research output: Contribution to journalArticle

Snyder, N, Gajula, L, Xiao, SY, Grady, J, Luxon, B, Lau, DTY, Soloway, R & Petersen, J 2006, 'APRI: An easy and validated predictor of hepatic fibrosis in chronic hepatitis C', Journal of Clinical Gastroenterology, vol. 40, no. 6, pp. 535-542. https://doi.org/10.1097/00004836-200607000-00013
Snyder, Ned ; Gajula, Leka ; Xiao, Shu Yuan ; Grady, James ; Luxon, Bruce ; Lau, Daryl T Y ; Soloway, Roger ; Petersen, John. / APRI : An easy and validated predictor of hepatic fibrosis in chronic hepatitis C. In: Journal of Clinical Gastroenterology. 2006 ; Vol. 40, No. 6. pp. 535-542.
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abstract = "GOALS: To evaluate the aspartate aminotransferase/platelet ratio index (APRI) as a predictor of the presence or absence of significant fibrosis on liver biopsy of patients with chronic hepatitis C (HCV). BACKGROUND: The decision to treat HCV is often made on the basis of the presence or absence of significant fibrosis on the liver biopsy. Because liver biopsy is expensive and invasive a noninvasive marker to evaluate hepatic fibrosis would be useful. The APRI is an easy to calculate index that is one of several markers that have been proposed. STUDY: We retrospectively reviewed the charts of 339 patients with chronic HCV who had liver biopsies from January 2000 to March 2003. We subsequently evaluated 151 patients receiving pretreatment evaluation liver biopsies who had serum aspartate aminotransferase, platelets, routine liver function tests, and demographic data obtained. All liver biopsies were staged by the Batts Ludwig criteria. RESULTS: The area under the curve of the receiver operator characteristics of the calculated APRI compared with the liver biopsy demonstrated that the fibrosis score was 0.889 in the prospective group and 0.790 in the retrospective group. To achieve predictive values of approximately 90{\%}, useful cutoffs were found at 0.40 and 1.5 in the retrospective study, and 0.42 and 1.2 in the prospective study leaving intermediate zones of 58.9{\%} and 41.1{\%}, respectively. In the prospective group, 34 of 36 patients with a value of <0.42 were accurately predicted as having mild fibrosis, whereas 50 of 54 patients with a value >1.2 were accurately predicted to have significant fibrosis. CONCLUSIONS: The APRI is a good estimator of hepatic fibrosis and was more accurate in a prospective group than a retrospective one. It potentially could be used to decrease the number of liver biopsies.",
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N2 - GOALS: To evaluate the aspartate aminotransferase/platelet ratio index (APRI) as a predictor of the presence or absence of significant fibrosis on liver biopsy of patients with chronic hepatitis C (HCV). BACKGROUND: The decision to treat HCV is often made on the basis of the presence or absence of significant fibrosis on the liver biopsy. Because liver biopsy is expensive and invasive a noninvasive marker to evaluate hepatic fibrosis would be useful. The APRI is an easy to calculate index that is one of several markers that have been proposed. STUDY: We retrospectively reviewed the charts of 339 patients with chronic HCV who had liver biopsies from January 2000 to March 2003. We subsequently evaluated 151 patients receiving pretreatment evaluation liver biopsies who had serum aspartate aminotransferase, platelets, routine liver function tests, and demographic data obtained. All liver biopsies were staged by the Batts Ludwig criteria. RESULTS: The area under the curve of the receiver operator characteristics of the calculated APRI compared with the liver biopsy demonstrated that the fibrosis score was 0.889 in the prospective group and 0.790 in the retrospective group. To achieve predictive values of approximately 90%, useful cutoffs were found at 0.40 and 1.5 in the retrospective study, and 0.42 and 1.2 in the prospective study leaving intermediate zones of 58.9% and 41.1%, respectively. In the prospective group, 34 of 36 patients with a value of <0.42 were accurately predicted as having mild fibrosis, whereas 50 of 54 patients with a value >1.2 were accurately predicted to have significant fibrosis. CONCLUSIONS: The APRI is a good estimator of hepatic fibrosis and was more accurate in a prospective group than a retrospective one. It potentially could be used to decrease the number of liver biopsies.

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