Noninvasive Fibrosis Markers for the Prediction of Significant Fibrosis in Patients With Chronic Hepatitis C Virus Infection in Tunisia

Summary: Optimized clinical management of chronic hepatitis C requires precise definition of the stage of liver fibrosis. Liver biopsy is viewed as the criterion standard for staging fibrosis in chronic hepatitis, but simple, noninvasive tests for the detection of significant fibrosis would be beneficial. Aim: To evaluate and compare the diagnostic accuracies of the simple fibrosis tests such as aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), platelet count, and aspartate aminotransferase-to-platelet ratio index (APRI) for the prediction of significant fibrosis in patients with chronic hepatitis C. Methods: We studied 38 patients with chronic hepatitis C who underwent a liver biopsy. To evaluate diagnostic accuracies of the simple fibrosis tests, sensitivity, specificity, and the area under the receiver operating characteristic curve were calculated. Results: The AAR increased and platelet count decreased as liver fibrosis worsened, but there was no significant correlation with the fibrosis score. The receiver operating characteristic curves of AAR, platelet count, and APRI were 0.68, 0.38, and 0.91, respectively. The APRI identified patients with significant fibrosis with a positive predictive value of 86.6%. Conclusions: Our study confirms that the APRI can predict significant fibrosis in chronic hepatitis C patients with a high degree of accuracy.