Research Article
Volume 7 Issue 3 - 2020
Role of APRI and FIB4 as a Non Invasive Tests for Assessment of Liver Fibrosis in Chronic HCV Infection
Mohamed Sayed1*, Mona amin2, May Fawzi2, Manal kamal3 and Samia Gabal4
1Assistant Professor of Internal Medicine, Cairo University, Egypt
2Professor of internal medicine, Cairo University, Egypt
3Professor of chemical pathology, Cairo University, Egypt
4Professor of pathology, Cairo University, Egypt
*Corresponding Author: Mohamed Hassan, Department of Gastroenterology, Cairo University, Egypt.
Received: May 15, 2019; Published: February 28, 2020


Background: Liver biopsy is considered the reference method for assessing hepatic fibrosis in chronically infected hepatitis C virus (HCV) patients, but unfortunately has many complications.

Aim: This study aimed to assess the role of the aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis 4 (FIB-4) tests as non-invasive alternatives to liver biopsy.

Methods: Our study recruited 757 patients with a median age of 42.6 ± 10.3 years. All patients underwent liver biopsy for fibrosis stage estimation, and the APRI and FIB-4 tests were performed. The liver biopsies were scored using the METAVIR system: 13 patients were F0 (1.7%), 356 (47%) were F1, 227 (30%) were F2, 160 (21%) were F3, and 1 (0.1%) was F4.

Results. For predicting fibrosis stages F ≥ 3, APRI and FIB-4 had a specificity of 90% at cut-off values of 1.1 and 2.7, respectively and a specificity of 95% at cut-off values of 1.67 and 3.3 respectively. The area under the receiver operating characteristic curve (AUC) was 0.663 (95% confidence interval [CI], 0.617 - 0.709) for APRI and 0.673 (95% CI, 0.627 - 0.719) for FIB-4. For predicting F ≥ 2, APRI and FIB-4 had a specificity of 90% at cut-off values of 0.94 and 2.4 respectively, a specificity of 95% at cut-off values of 1.14 and 2.7 respectively. The AUC was 0.642 (95% CI, 0.603 - 0.681) for APRI and 0.676 (95% CI, 0.638 - 0.714) for FIB-4. 

Conclusion: For accurate non-invasive assessment of liver fibrosis stage, taking higher cut-off values for APRI and FIB-4 is recommended to improve their specificities.

Keywords: APRI; FIB4; Liver Fibrosis; HCV


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Citation: Mohamed Sayed., et al. “Role of APRI and FIB4 as a Non Invasive Tests for Assessment of Liver Fibrosis in Chronic HCV Infection”. EC Gastroenterology and Digestive System 7.3 (2020): 01-09.

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