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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Elias Tarigan
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Medicine & Pharmacology

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Aspartate Aminotransferase to Platelet Ratio Index and FibroScan for Predicting Liver Fibrosis with Chronic Hepatitis B Elias Tarigan; Rustam Effendi Yusuf; Leonardo Basa Dairy; Juwita Sembiring; Mabel HM Sihombing; Gontar Alamsyah Siregar; Lukman Hakim Zain
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 3, December 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (533.298 KB) | DOI: 10.24871/1432013139-144

Abstract

Background: Non-invasive test have been constructed and evaluated mainly for binary diagnoses. The accuracy of non-invasive tests such as aspartate aminotransferase to platelet ratio index (APRI) and transientelastography/FibroScan should be evaluated especially in clinical practice. The aim of the study was to evaluate the accuracy of detailed fibrosis classification available for APRI and FibroScan to liver biopsy in chronichepatitis B patients.Method: A cross sectional study was conducted in 51 patients with chronic hepatitis B. The patients underwent laboratory test, FibroScan and liver biopsy between April 2011 and July 2013 at Adam Malik Hospital, Medan.Liver biopsy was assessed based on the METAVIR score. Area under receiver operating characteristic curve (AUROC) predictive value was used to evaluate the accuracy of APRI and FibroScan. All data were analyzedusing SPSS 20.0.Results: APRI versus METAVIR diagnosed severe fibrosis and cirrhosis with sensitivity 40% and specificity 83.9%, positive predictive value (PPV) 61.5%, negative predictive value (NPV) 68.4%, positive likelihood ratio(LR) 2.48 and negative LR 0.72 with diagnostic accuracy 66.7%. The AUROC value was 0.619 (95% CI = 0.446 – 0.715); kappa = 0.255; p 0.05. FibroScan versus METAVIR predictive value with sensitivity 75% andspecificity 67.6% were PPV 60%, NPV 67.7%, positive LR 2.31 and negative LR 0.36 with diagnostic accuracy 70.6%. The AUROC value was 0.714 (95% CI = 0.567–0.861); kappa 0.409; p 0.05.Conclusion: FibroScan has better accuracy than APRI for predicting severe fibrosis and cirrhosis in patientswith chronic hepatitis B.Keywords: APRI, FibroScan, liver biopsy, chronic hepatitis B
S-Index and APRI Score to Predict Liver Fibrosis Chronic in Hepatitis B and C Patients Elias Tarigan; Leonardo Basa Dairy; Juwita Sembiring; Mabel Sihombing; Gontar Alamsyah Siregar; Lukman Hakim Zain
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (389.107 KB) | DOI: 10.24871/142201364-68

Abstract

Background: A great interest has been dedicated to the development of non invasive predictive models in recent years to substitute liver biopsy for fibrosis assessment and follow-up. The aim of this study was to comparethe accuracy between S-index and aspartate aminotransferase to platelet ratio index (APRI) to FibroScan for predicting liver fibrosis in chronic hepatitis B and C patients.Method: A cross-sectional study was conducted in 40 patients with chronic hepatitis B and C between January 2010 - May 2011 at Division of Gastroentero-hepatology, Department of Internal Medicine, Adam Malik Hospital, Medan. Patients underwent laboratory examination and FibroScan, then used predictive values to assess the accuracy of S-index scores and APRI compared to FibroScan. The analysis was performed using SPSS 15.0.Results: S-index identified significant fibrosis in 87.5% patients with sensitivity (Se) 87.5% and specificity (Sp) 100%. About 67.5% of 40 patients could be identified correctly. S-index also could accurately predict the absence or presence of cirrhosis in 87.5% of the total 40 patients, with NPV 91.7% and PPV 81.25%, respectively. APRI for significant fibrosis has Se 85.7%, Sp 88%, PPV 88.8%, NPV 69.2%; while Se 53%, Sp 88%, PPV 72.7%, NPV 75.8% for liver cirrhosis. AUROC value for S-index was higher than APRI in predicting significant fibrosis and cirrhosis, i.e. 0.938 vs. 0.917 and 0.873 and 0.707, respectively.Conclusion: The S-index has a higher accuracy than APRI in predicting significant fibrosis and cirrhosis in patients with chronic hepatitis B virus and hepatitis C virus infection.Keywords: S-index, APRI score, FibroScan, chronic hepatitis B and C
Co-Authors Gontar Alamsyah Siregar Gontar Alamsyah Siregar Juwita Sembiring Leonardo Basa Dairy Lukman Hakim Zain Mabel HM Sihombing Mabel HM Sihombing, Mabel HM Mabel Sihombing Rustam Effendi Yusuf Rustam Effendi Yusuf, Rustam Effendi