Evaluation of APRI test as a liver fibrosis marker

Abstract

Objective: to evaluate the performance of APRI test as an indirect marker of liver fibrosis in patients of FSCMPA with chronic viral hepatitis. Methods: laboratorial and histopathological (METAVIR) data of 102 patients were collected with the aim of comparing biopsy reports to test results, considering: F0-F1 as absent/ insignificant fibrosis and F2-F4 as presence of expressive fibrosis; F0-F3 and F4 as absence and presence of cirrhosis, respectively. The evaluation was based on the use of simultaneous cut-off points suggested by Wai et al. (2003) and also the development of single cut-off points, through ROC curves, for this sample. Results: the specificities found through the original cut-off points were 96% and 87% for significant fibrosis and cirrhosis, respectively. A superior performance was detected for the diagnosis of expressive fibrosis (PPV 90%) and for the exclusion of liver cirrhosis (NPV 95%). The only advantages accomplished with the use of the single cutoff points defined for this study were the classification of all patients and an increase in sensibility, which do not justify their applicability. Conclusion: APRI test is able to confirm the existence of significant fibrosis and exclude cirrhosis, what makes it available, as an alternative, in clinical practice.