Aspartate transaminase to platelet ratio index in hepatitis C virus and Schistosomiasis coinfection

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Derbala M.; Elbadri M.E.; Amer A.M.; Alkaabi S.; Sultan K.H.; Kamel Y.M.; Elsayed E.H.S.; Avades T.Y.; Chandra P.; Shebl F.M.

Journal: World Journal of Gastroenterology

Publisher: WJG Press

Publication Date: 2015

Volume / Issue: Volume 21 / Issue 46

Pages: 13132–13139

ISSN: 10079327

DOI: 10.3748/wjg.v21.i46.13132

Scopus: View on Scopus

PubMed: 26674154

Document Type: Article

Access: All Open Access; Green Open Access; Hybrid Gold Open Access

Authors and Affiliations

Derbala M., Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha, 00974, Qatar, Gastroenterology and Hepatology, Theodor Bilharz Research Institute, Giza, 12411, Egypt, Medical Department, Weill Cornell Medical College, Doha, 00974, Qatar; Elbadri M.E., Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha, 00974, Qatar; Amer A.M., Laboratory Medicine and Pathology, Hematology Section, Hamad Medical Corporation, Hamad General Hospital, Doha, 00974, Qatar; Alkaabi S., Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha, 00974, Qatar; Sultan K.H., Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha, 00974, Qatar; Kamel Y.M., Gastroenterology and Hepatology, Hamad Medical Corporation, Hamad General Hospital, Doha, 00974, Qatar; Elsayed E.H.S., General Medicine, Medical Education, Hamad Medical Corporation, Hamad General Hospital, Doha, 00974, Qatar; Avades T.Y., Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Hamad General Hospital, Doha, 00974, Qatar; Chandra P., Medical Research Center, Hamad Medical Corporation, Hamad General Hospital, Doha, 00974, Qatar; Shebl F.M., Chronic Disease, Epidemiology Department, Yale School of Public Health, New Haven, 06510, CT, United States

Abstract

AIM: To assess the diagnostic accuracy, of aminotransferaseto-platelet ratio index (APRI) alone and with antischistosomal antibody (Ab) in patients with hepatitis C virus (HCV) and schistosomiasis coinfection. METHODS: This retrospective study included medical records of three hundred and eighty three Egyptian men patients who had undergone percutaneous liver biopsy between January 2006 to April 2014 in tertiary care hospital in Qatar for diagnosis or monitoring purpose were selected. Data of patients > 18 years of age were included in the study. The values of HCV RNA titer and antischistosomal antibody titer were also taken into consideration. Patients were excluded from the study if they had any other concomitant chronic liver disease, including; history of previous antiviral or interferon therapy, immunosuppressive, therapy, chronic hepatitis B infection, human immunodeficiency virus co-infection, autoimmune hepatitis, decompensated liver disease, hepatocellular carcinoma, prior liver transplantation, and if no data about the liver biopsy present. RESULTS: Median age of patients was 46 years. About 7.1% had no fibrosis, whereas 30.4%, 37.5%, 20.4%, and 4.6% had fibrosis of stage I, II, III, and IV respectively. In bivariate analysis, APRI score, levels of AST, platelet count and age of patient showed statistically significant association with liver fibrosis (p < 0.0001); whereas antischistosomal antibody titer (p = 0.52) and HCV RNA titer (p = 0.79) failed to show a significant association. The respective AUC values for no fibrosis, significant fibrosis, severe fibrosis and cirrhosis of APRI score were 63%, 73.2%, 81.1% and 88.9% respectively. This showed good sensitivity and specificity of APRI alone for grading of liver fibrosis. But the inclusion of anti-Schistosoma antibody did not improve the prediction of fibrosis stage. CONCLUSION: The study results suggest that noninvasive biochemical markers like APRI are sensitive and specific in diagnosing the degree of fibrosis and cirrhosis in patients with coinfection of HCV and schistosomiasis as compared to biopsy. The addition of antischistosomal Ab to APRI did not improve sensitivity for predicting the degree of cirrhosis. © 2015 Baishideng Publishing Group Inc. All rights reserved.

Keywords

Aspartate transaminase to platelet ratio index; Hepatitis C; Liver biopsy; Liver fibrosis; Schistosomiasis; Antibodies, Protozoan; Area Under Curve; Aspartate Aminotransferases; Biomarkers; Biopsy; Blood Platelets; Clinical Enzyme Tests; Coinfection; Egypt; Humans; Liver Cirrhosis; Male; Middle Aged; Platelet Count; Predictive Value of Tests; Qatar; Reproducibility of Results; Retrospective Studies; Risk Factors; RNA, Viral; ROC Curve; Serologic Tests; Severity of Illness Index; Tertiary Care Centers; Viral Load; antibody; aspartate aminotransferase; schistosomal antibody; unclassified drug; biological marker; protozoon antibody; virus RNA; adult; age; aminotransferase to platelet ratio index; antibody titer; Article; diagnostic accuracy; diagnostic test accuracy study; hematological parameters; Hepatitis C virus; human; human tissue; major clinical study; mixed infection; sensitivity and specificity; staging; tertiary care center; thrombocyte; thrombocyte count; area under the curve; blood; comparative study; complication; enzyme assay; evaluation study; parasitology; predictive value; receiver operating characteristic; reproducibility; retrospective study; risk factor; serology; virology; virus load

Citation Information

Scopus Citations: 10

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