Influence of Sustained Virological Response on APRI in Chronic Hepatitis C: is APRI a Marker of Only the Stage of Fibrosis?
Journal Title: Viral Hepatitis Journal - Year 2020, Vol 26, Issue 3
Abstract
Objectives: Aspartate transaminase (AST) to platelet ratio index (APRI) is widely used to predict the stage of liver fibrosis in patients with chronic hepatit C virus (HCV) infection. In this study, we aimed to evaluate changes in APRI scores in patients with chronic HCV infection who received pegylated interferon (PEG IFN) + ribavirin or direct acting antiviral (DAA) ± ribavirin. Materials and Methods: We retrospectively reviewed our data of patients with chronic HCV infection who received PEG IFN + ribavirin or DAA ± ribavirin. Patients were classified into 3 groups according to sustained virological response (SVR) by treatment regimens: a) SVR with PEG IFN + ribavirin (PEG IFN-SVR), b) non SVR with PEG IFN + ribavirin (PEG IFN-non SVR), c) SVR with DAA ± ribavirin (DAA-SVR). Results: The study included 156 patients. APRI scores decreased significantly in PEG IFN-SVR (1.17±1.37 vs 0.38±0.35) and DAA-SVR groups (0.99±0.88 vs 0.31±0.16) (both p=0.001), whereas it did not change in PEG IFN-non SVR group (1.26±1.07 vs 1.33±1.36) (p=0.810) after treatment. In PEG IFN-SVR and DAA-SVR groups, proportions of patients who had APRI scores ≤0.5 and ≤1 increased, while proportions of patients who had APRI scores >1.5 and >2 decreased significantly after treatment (all p<0.05). Conclusion: APRI score is not indicator of only the stage of fibrosis. Hepatic necroinflammation also influences APRI score by increasing AST levels and decreasing platelet levels.
Authors and Affiliations
Özgür Bahadır, Serhat Özer, Ayça Gökçen Değirmenci Saltürk, Halil Şahin, Mevlüt Kıyak, Emine Kanatsız, Cüneyt Saltürk, Fatih Güzelbulut
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