Aspartate aminotransferase to platelet ratio index – a reliable predictor of therapeutic efficacy and improvement of Ishak score in chronic hepatitis B patients treated with nucleoside analogues

ABSTRACT

Background No studies have investigated the predictive and monitoring efficacy of aspartate aminotransferase to platelet ratio index in chronic hepatitis B patients undergoing antiviral therapy based on paired Ishak biopsies pre- and post-treatment. We evaluated the efficacy of aspartate aminotransferase to platelet ratio index in monitoring fibrosis improvement in chronic hepatitis B patients treated with nucleoside analogue or interferon. Methods Pre- and post-treatment Ishak fibrosis scores of 86 nucleoside-analogue- and 42 interferon-treated patients were retrospectively analyzed. The area under the receiver operating characteristic curve was calculated. Results In nucleoside-analogue-treated patients, the area under the receiver operating characteristic curve was 0.80 and 0.91 when aspartate aminotransferase to platelet ratio index was used to diagnose fibrosis and cirrhosis, respectively. When the decreased magnitude of aspartate aminotransferase to platelet ratio index was ≥ 0.35, the sensitivity and specificity of predicting fibrosis improvement were 75.8% and 75.0%, respectively. The area under the receiver operating characteristic curve was 0.53 when aspartate aminotransferase to platelet ratio index was used to diagnose fibrosis in 20 interferon-treated patients, while an insufficient patient number in the cirrhosis group prevented the calculation of the area under the receiver operating characteristic curve. The same is true for the remaining 22 interferon-treated patients. Conclusions Our study is the first to demonstrate the aspartate aminotransferase to platelet ratio index as a reliable marker in diagnosing and monitoring fibrosis improvement in nucleoside-analogue-treated patients based on paired Ishak biopsies pre- and post-treatment, but the test is not applicable in interferon therapy.

Key Words:

• Aspartate aminotransferase
• hepatitis B
• chronic
• Ishak score
• liver fibrosis
• liver cirrhosis
• liver biopsy
• non-invasive tests
• nucleoside analogue
• interferon therapy

Disclosure statement

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.