Clinical Efficacy of AST/ALT Ratio and Platelet Counts as Predictors of Degree of Fibrosis in HBV Infected Patients without Clinically Evident Liver Cirrhosis.
- Author:
Soo Young PARK
1
;
Kyung Hee KANG
;
Jee Hyun PARK
;
Jong Hyup LEE
;
Chang Min CHO
;
Won Young TAK
;
Young Oh KWEON
;
Sung Kook KIM
;
Yong Hwan CHOI
Author Information
1. Department of Internal Medicine and Liver Research Institute, Kyungpook National University, College of Medicine, Daegu, Korea. yokweon@knu.ac.kr
- Publication Type:Original Article ; English Abstract
- Keywords:
Hepatitis B;
chronic;
Liver fibrosis;
AST/ALT ratio;
Blood platelets
- MeSH:
Adolescent;
Adult;
Aged;
Alanine Transaminase/*blood;
Aspartate Aminotransferases/*blood;
Biological Markers/blood;
Child;
English Abstract;
Female;
Hepatitis B, Chronic/*complications;
Humans;
Liver/pathology;
Liver Cirrhosis/*diagnosis/pathology/virology;
Male;
Middle Aged;
*Platelet Count;
Predictive Value of Tests;
Sensitivity and Specificity
- From:The Korean Journal of Gastroenterology
2004;43(4):246-251
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Hepatic fibrosis is an important prognostic factor in chronic hepatitis B. Liver biopsy is a gold standard diagnostic tool but an invasive procedure, so it cannot be done on all patients. We evaluated the clinical efficacy of AST/ALT ratio and platelet counts as predictors of fibrosis in chronic hepatitis B. METHODS: We reviewed retrospectively clinical records of 323 patients, who visited Kyungpook National University Hospital for chronic hepatitis B and underwent liver biopsy from September 1998 to May 2002. Correlation with laboratory parameters with hepatic fibrosis stage was identified. RESULTS: Of 323 patients, there were 278 male patients with mean age 27 (9~59). Platelet counts showed a significant correlation (r=-0.343, p=0.000), and AST/ALT ratio showed a weak but significant correlation (r=0.137, p=0.013) with fibrosis stage. Patients with severe fibrosis or cirrhosis (stage 3 and 4) can be identified to have AST/ALT ratio > 1 and platelet counts < 150,000/mm3, which showed with positive predictive value of 66.7%. Sensitivity, specificity, and negative predictive value were 14.6%, 97.5%, and 77.0%, respectively. CONCLUSIONS: In chronic hepatitis B patients without clinical evidence of cirrhosis, severe hepatic fibrosis might be predicted using laboratory parameters of AST/ALT > 1 in combination with platelet counts. However, its sensitivity is too low to replace liver biopsy.
