CHRONIC HEPATITIS C

The major causative factor of hepatic cirrhosis and its complications in chronichepatitis C is due to presence of liver fibrosis. To assess prognosis and management relateddecisions, the exact staging of liver fibrosis is of greatest importance. Now, liver biopsyis the inexact gold standard for this purpose. APRI or AST to platelet ratio Index is the bestnoninvasive marker which can predict presence of fibrosis in majority of chronic hepatitis Cpatients without the need of biopsy. It is also cost effective and only depends on routine testing(Platelet count and serum AST). Objectives: To determine the positive predictive value ofAPRI Score for the prediction of fibrosis and cirrhosis in chronic hepatitis C patients. Studydesign: Cross sectional study. Setting: Medical wards and Out Patient Medicine Departmentof Liaquat University Hospital Hyderabad / Jamshoro. Period: 6 months. Methodology: A totalof 51 patients of either gender, age >14 years presenting to Medical wards and OPD for theevaluation of chronic hepatitis were enrolled in this research study after giving preference andavoiding criteria. Clinical data was collected at the time of liver biopsy and blood samples forliver function tests, blood glucose and complete blood picture with platelet count were collectedbefore the biopsy (only AST and platelet count are needed for APRI score) a core biopsy needleof 14 gauge was used and the procedure was conducted under ultrasound guidance. Fibrosisstage was determined according to the METAVIR group scoring system. The patients wereexamined in a very comfortable manner and all the information collected from the patients waskept confidential and entered in the predesigned proforma. Results: A total of 51 patients wereselected for this study. Out of these 31 (60.78%) were male and 20(39.22%) were female. Themean age was 42.53 years (±11.2 SD). The positive predictive value for APRI score between0.5 to 1.0 was 58.82% whereas the positive predictive values for APRI score 1.1-1.5 was 70.58%.Conclusion: The positive predictive values of APRI score in the ranges of 0.5 to 1.5 were notindicative of the presence of significant liver fibrosis in this research study. However, additionaldata are required to authenticate or disprove the usefulness of APRI score for the prediction ofsignificant hepatic fibrosis in chronic hepatitis C patients.