Aspartate aminotransferase to platelet ratio index a reliable predictor of therapeutic efficacy and improvement of Ishak score in chronic hepatitis B patients treated with nucleoside analogues
ABSTRACT Background No studies have investigated the predictive and monitoring efficacy of aspartate aminotransferase to platelet ratio index in chronic hepatitis B patients undergoing antiviral therapy based on paired Ishak biopsies pre and post treatment. We evaluated the efficacy of aspartate aminotransferase to platelet ratio index in monitoring fibrosis improvement in chronic hepatitis B patients treated with nucleoside analogue or interferon. Methods Pre and post treatment Ishak fibrosis scores of 86 nucleoside analogue and 42 interferon treated patients were retrospectively analyzed. The area under the receiver operating characteristic curve was calculated. Results In nucleoside analogue treated patients, the area under the receiver operating characteristic curve was 0.80 and 0.91 when aspartate aminotransferase to platelet ratio index was used to diagnose fibrosis and cirrhosis, respectively. When the decreased magnitude of aspartate aminotransferase to platelet ratio index was 0.35, the sensitivity and specificity of predicting fibrosis improvement were 75.8% and 75.0% respectively. The area under the receiver operating characteristic curve was 0.53 when aspartate aminotransferase to platelet ratio index was used to diagnose fibrosis in 20 interferon treated patients, while an insufficient patient number in the cirrhosis group prevented the calculation of the area under the receiver operating characteristic curve. The same is true for the remaining 22 interferon treated patients. Conclusions Our study is the first to demonstrate the aspartate aminotransferase to platelet ratio index as a reliable marker in diagnosing and monitoring fibrosis improvement in nucleoside analogue treated patients based on paired Ishak biopsies pre and post treatment, but the test is not applicable in interferon therapy.
Scandinavian journal of clinical and laboratory investigation