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Performance of the AST-to-Platelet Ratio Index as a Noninvasive Marker of Fibrosis in Pediatric Patients With Chronic Viral Hepatitis

McGoogan, Katherine E*; Smith, P Brian; Choi, Steve S||; Berman, Wallace; Jhaveri, Ravi§

Journal of Pediatric Gastroenterology and Nutrition: March 2010 - Volume 50 - Issue 3 - p 344–346
doi: 10.1097/MPG.0b013e3181aed725
Short Communications

We investigated the performance of aspartate aminotransferase to platelet ratio index (APRI) as a noninvasive marker of fibrosis and cirrhosis in children with chronic viral hepatitis. All of the patients 0 to 20 years old with chronic hepatitis B or C presenting at a tertiary medical center from 1992 to 2008 were identified. Thirty-six patients were evaluated with 48 biopsy results. The areas under the receiver operating characteristic curve were 0.71 for fibrosis and 0.52 for cirrhosis. When examining subgroups, the APRI performed better in older patients and in those with vertically transmitted hepatitis C virus. Further research into APRI and the other noninvasive markers of fibrosis in children with chronic viral hepatitis is warranted.

*Department of Pediatrics, USA

Divisions of Quantitative Sciences, USA

Gastroenterology, USA

§Infectious Diseases, USA

||Department of Medicine, Division of Gastroenterology, Duke University Medical Center, Durham, NC. At the time of writing, Dr McGoogan was in the DUMC Department of Pediatrics; she is now in the Department of Pediatrics, Division of Gastroenterology, University of Florida, Gainesville, USA.

Received 14 January, 2009

Accepted 11 May, 2009

Address correspondence and reprint requests to Ravi Jhaveri, MD, Division of Pediatric Infectious Diseases, DUMC Box 3499, Duke University Medical Center, Durham, NC 27710 (e-mail:

The authors report no conflicts of interest.

© 2010 Lippincott Williams & Wilkins, Inc.