ASPARTATE PLATELET RATIO INDEX AS A PREDICTOR OF SEVERITY OF FIBROSIS IN CHRONIC HEPATITS C

Hepatitis C is an important emerging cause for chronic liver disease in India, with high risk for chronicity and hepatocellular carcinoma. Chronic hepatitis C is the most common cause for chronic liver disease and cirrhosis , and liver transplantation. Liver biopsy is the gold standard for evaluation of fibrosis- however it remains fraught with drawbacks and limitations. The aspartate amino transferase to platelet ratio index (APRI), a tool with limited expense and widespread availability is a promising non invasive alternative to liver biopsy for detecting hepatic fibrosis in chronic hepatitis C.Objectives- 1. To determine the association between APRI and severity of fibrosis in Hepatits C. 2. To describe the clinical profile of patients with Hepatitis C. Materials and methods -  A cross sectional descriptive study in 60 patients diagnosed with hepatitis C for more than six months admitted to the General Medicine and Medical Gastroenterology departments of Govt Medical College, Kottayam. Data was collected with a structured proforma and analysed using SPSS. Results – 35 of 60 patients belonged to METAVIR F3 ( severe fibrosis) and F4 ( cirrhosis). An APRI of 0.5 was associated with a finding of F3 or F4 with a sensitivity of 97.14% and a specificity of 88%. 31 of the 60 patients belonged to F4. An APRI of 1.5 or more was a predictor for cirrhosis with a sensitivity of 93.1% and specificity of 96.77%. The positive predictive value of cirrhosis APRI threshold > 1.5 is 96.4%