Optimized cutoffs improve performance of the aspartate aminotransferase to platelet ratio index for predicting significant liver fibrosis in human immunodeficiency virus/hepatitis C virus co-infection

Optimized cutoffs improve performance of the aspartate aminotransferase to platelet ratio index for predicting significant liver fibrosis in human immunodeficiency virus/hepatitis C virus co-infection

Author Carvalho-Filho, Roberto J. Autor UNIFESP Google Scholar
Schiavon, Leonardo L. Autor UNIFESP Google Scholar
Narciso-Schiavon, Janaina L. Autor UNIFESP Google Scholar
Sampaio, Juliana P. Autor UNIFESP Google Scholar
Lanzoni, Valeria P. Autor UNIFESP Google Scholar
Ferraz, Maria Lucia G. Autor UNIFESP Google Scholar
Silva, Antonio Eduardo B. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Aim: To assess the diagnostic value of modified cutoffs for aspartate aminotransferase to platelet ratio index (APRI) to predict significant liver fibrosis in human immunodeficiency virus (HIV)/hepatitis C virus (HCV) patients. Methods: This retrospective cross-sectional study included consecutive patients with HIV/HCV co-infection who underwent percutaneous liver biopsy. the accuracy of APRI for the diagnosis of significant fibrosis (F2/F3/F4 METAVIR) was evaluated by estimating the positive and negative predictive values (PPV and NPV respectively) and by measuring the area under the receiver operating characteristics curve (AUROC). Results: One hundred and eleven patients were included (73% men, mean age 40.2 +/- 7.8 years). Significant fibrosis was observed in 45 patients (41%). To discriminate these subjects, the AUROC of APRI was 0.774 +/- 0.045. An APRI >= 1.8 showed a PPV of 75% for the presence of significant fibrosis, and an index < 0.6 excluded significant fibrosis with an NPV of 87%. If biopsy indication was based only on APRI and restricted to scores in the intermediate range (>= 0.6 and < 1.8), 46% of liver biopsies could have been avoided as compared with 40% using the classical cutoffs. Conclusion: APRI with adjusted cutoffs can predict significant liver fibrosis in patients with HIV/HCV co-infection and might obviate the need to perform a biopsy in a considerable percentage of those subjects.
Keywords co-infection
fibrosis markers
hepatitis C
HIV
liver fibrosis
Language English
Date 2008-04-01
Published in Liver International. Oxford: Blackwell Publishing, v. 28, n. 4, p. 486-493, 2008.
ISSN 1478-3223 (Sherpa/Romeo, impact factor)
Publisher Blackwell Publishing
Extent 486-493
Origin http://dx.doi.org/10.1111/j.1478-3231.2008.01675.x
Access rights Closed access
Type Article
Web of Science ID WOS:000253980300010
URI http://repositorio.unifesp.br/handle/11600/30585

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