The predictive role of AST level, prothrombin time, and platelet count in the detection of liver fibrosis in patients with chronic hepatitis C

Abstract

Aim: We aimed to assess the predictive value of a combination some of basic serum biochemical markers for the diagnosis of clinically significant fibrosis in chronic hepatitis C. Materials and Methods: Blood samples from 68 patients with chronic hepatitis C infection were analyzed for aspartate aminotransferase, prothrombin INR, and platelet count. The liver histopathology was evaluated using the Knodell protocol. The relationship between the serum biochemical markers and severity of the stages were examined. Results: A strong association was found between the fibrosis stage and platelet count and GUCI (P < 0.001, P = 0.035 respectively) but not APRI ([AST/ULN] / Platelet count [ x109 /L]) x 100) (P = 0.052). The relationship between the platelet count <147 x 109 /L and the age, which is greater than 50, and severe fibrosis was significant (AUC = 0.779, P < 0.001). In this cut off value the negative predictive value (NPV) and the positive predictive value (PPV) were 66.7% and 86.7%, respectively. An index GUCI (Göteborg University Cirrhosis Index) was calculated using the AST, platelet count, and prothrombin-INR. Using the cut of value 0.26, the sensitivity of this index was found as 58.33% and the specificity 72.7% for diagnosis of severe fibrosis (stage 3-4); NPV and PPV were 76.2% and 53.8%, respectively. Conclusion: Peripheral platelet count and GUCI can discriminate to some degree of accuracy patients with severe fibrosis (stage 3-4) from those without severe fibrosis (stage 0-2). © TÜBİTAK.