Relationship red distribution width to platelet ratio with fibrosis degrees based on transient elastography in chronic hepatitis b patients

Abstract

Introduction: Chronic hepatitis B virus infection is a major health problem in developing countries like Indonesia. A chronic HBV infection of approx. 40% leads to liver fibrosis and hepatocellular carcinoma. Furthermore, liver biopsy is the gold standard in diagnosing liver fibrosis, but this examination is invasive and has many complications. Transient elastography has been validated to assess fibrosis in several liver diseases including HBV infection. However, not all hospitals have temporary elastography facilities in such a way that cheaper and more affordable examinations are needed. This study aims to examine the relationship between Red cell distribution width to platelet ratio with the degree of liver fibrosis based on transient elastography in chronic hepatitis B patients. Method: This study was a cross-sectional examination, which involves 48 chronic hepatitis B patients receiving outpatient care from September to November 2020 at dr. Zainoel Abidin Banda Aceh. The routine blood tests were performed using the Sysmex XT 1800i. The red cell distribution width to platelet ratio value is calculated by dividing the Red Distribution Width value by the platelets, and the degree of liver fibrosis was assessed using TE (Fibroscan® 502 Echosens). Result: In the 48 patients, the mean value of Red cell Distribution Width to Platelet Ratio ​for various degrees of liver fibrosis F0-1, F2, F3 and F4 were 0.051; 0.050; 0.077 and 0.108, respectively. It was reported that red cell distribution width to Platelet Ratio levels also increased according to the increase in liver fibrosis degree and was statistically significant with a p-value of 0.002. Analysis of the relationship between red cell distribution width to platelet ratio with the degree of liver fibrosis using ordinal regression method, while the red cell distribution width to platelet ratio level variable has a fairly large estimate value that is 31098 with a p-value of 0.003. The p-value of the test of less than 0.05 proves that the red cell distribution width to platelet ratio level affects and has a relationship with the degree of liver fibrosis. Conclusion: Red cell distribution width to platelet ratio relates to the degree of liver fibrosis in patients with chronic hepatitis B.