BACKGROUND/AIMS: An ideal noninvasive diagnostic test for hepatic fibrosis should be simple, inexpensive, and accurate. We aimed to find the simple marker for predicting hepatic fibrosis and to compare the accuracy of AST, platelet, AST/ALT ratio and AST to platelet ratio index (APRI) in chronic hepatitis B patients without clinical evidence of cirrhosis. METHODS: A total of one hundred and twenty-six chronic hepatitis B patients who underwent liver biopsy at the Ajou University Hospital from August 1998 to December 2003 were enrolled. Hepatic fibrosis was assessed using the Ludwig classification. Significant fibrosis was defined as fibrosis score of 3 or more. The AST/ALT ratio and APRI were calculated and correlations with hepatic fibrosis were analyzed. RESULTS: APRI showed a significant correlation (r=0.501, p=0.000) with hepatic fibrosis, and was superior to AST, AST/ALT ratio and platelet in predicting fibrosis. Patients with significant fibrosis (fibrosis stage 3, 4) can be identified to have APRI=1 with sensitivity 71.2% and specificity 70.3%. The sensitivity and specificity of an APRI = 1.5 for cirrhosis (stage 4) were 83.3% and 75.0%. CONCLUSIONS: Simple index using AST and platelet value can predict the presence of significant fibrosis and cirrhosis in chronic hepatitis B patients without clinical evidence of cirrhosis.
Adult ; Alanine Transaminase/blood ; Aspartate Aminotransferases/*blood ; Female ; Hepatitis B, Chronic/blood/enzymology/*pathology ; Humans ; Liver/pathology ; Liver Cirrhosis/*pathology/virology ; Male ; *Platelet Count ; Sensitivity and Specificity

<b>OBJECTIVEb>To explore the change of serum gamma-glutamyltransferase (GGT) and its diagnosis value in chronic hepatitis B (CHB) patients with different degrees of liver damage.

<b>METHODSb>Alanine-aminotransferase (ALT), aspartate-aminotransferase (AST) and GGT were measured in 221 CHB patients. Liver biopsy was conducted simultaneously to determine the inflammation grade and fibrosis stage of the liver tissues.

<b>RESULTSb>The rate of normal GGT in pathologically diagnosed mild and severe CHB patients was 90.4% and 12.3%, respectively (P<0.01). Increased level of GGT was parallel to the degree of liver pathological change (P<0.01). In active CHB patients, GGT rose with the ALT increase with a positive linear correlation between them (r=0.464, P<0.001). In pathologically diagnosed mild CHB patients, GGT had a tendency of rapidly declining to normal levels with ALT. In moderate CHB patients, GGT fluctuated at a relatively high level, and in severe CHB patients GGT exhibited a deviation from GGT.

<b>CONCLUSIONSb>GGT is conducive to improve the coincident rate between the clinical and pathological diagnosis of CHB.

Adult ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Female ; Fibrosis ; Hepatitis B, Chronic ; diagnosis ; enzymology ; pathology ; Humans ; Male ; Predictive Value of Tests ; Severity of Illness Index ; Time Factors ; gamma-Glutamyltransferase ; blood