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

Ben Jazia, Elhem MD*; Kaabia, Naoufel MD*; Benabdelkader, Atef MD; Khalifa, Mabrouk MD*; Harrabi, Imed MD; Braham, Ahlem MD*; Bahri, Fethi MD*; Letaief, Amel MD*

Infectious Diseases in Clinical Practice: November 2009 - Volume 17 - Issue 6 - p 385-387
doi: 10.1097/IPC.0b013e3181bf60d3
Original Articles

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.

From the Departments of *Internal Medicine and Infectious Diseases, Unit of Research: 04/UR/08-21, †Anatomical Pathology, and ‡Epidemiology, University Hospital F. Hached, Sousse, Tunisia.

Reprints: Elhem Ben Jazia, MD, Department of Internal Medicine and Infectious Diseases, UR: 04/ur/08-21, University Hospital F. Hached, 4000 Sousse, Tunisia. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.