Noninvasive assessment of hepatic fibrosis in Egyptian patients with chronic hepatitis C virus infection

Table 1 The demographic and laboratory data of all patients (mean ± SD)

Item	Non-cirrhotic group (F0, F1, F2 and F3)	Cirrhotic group (F4)	P value
	n (124)	n (30)
Age, yr	37.19 ± 9.58	47.87 ± 7.76	0.0002
Gender, n (%)
Male	86 (69.35)	18 (60)
Female	38 (30.65)	12 (40)
AST (IU/mL)	48.84 ± 42.7	61 ± 20.4	0.01
ALT (IU/mL)	60.235 ± 42.3	57.7 ± 24.69	0.68
Alkaline phosphatase (U/L)	81.654 ± 38.4	111 ± 42.5	0.004
Total bilirubin (mg/dL)	0.787 ± 0.30	1.003 ± 0.38	0.07
Albumin (g/dL)	5.803 ± 0.789	4.1 ± 0.42	0.004
INR	1.127 ± 0.092	1.254 ± 0.12	0.0001
Platelet count (/mm3)	213.75 ± 66.1	151.87 ± 73.79	0.001
HCV viraemia, IU/mL	893 015.72 ± 1 571 254.86	347 974.86 ± 536 542.77	0.23

AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; INR: International normalized ratio; HCV: Hepatitis C virus.

Table 2 Mean values (± SD) of aspartate aminotransferase-to-alanine aminotransferase ratio, aspartate aminotransferase-to-platelet ratio index, age platelet index, cirrhosis discriminating score and Göteborg University Cirrhosis Index in non-cirrhotic and cirrhotic groups of chronic hepatitis C virus infected patients

Variable	Non-cirrhotic group (F0, F1, F2 and F3), n (124)	Cirrhotic group (F4), n (30)	P value
AAR	0.84 ± 0.31	1.23 ± 0.47	0.001
APRI	0.078 ± 0.09	0.118 ± 0.07	0.02
API	2.98 ± 2.21	5.87 ± 1.99	0.0001
CDS	5.48 ± 1.36	6 ± 1.31	0.17
GUCI	0.913 ± 1.27	1.6573 ± 0.89	0.001
Pohl score	+ve 12 (9.67%)	+ve 12 (40%)	0.004
	-ve 112 (90.3%)	-ve 18 (60%)

AAR: Aspartate aminotransferase-to-alanine aminotransferase ratio; APRI: Aspartate aminotransferase-to-platelet ratio index; API: Age platelet index; CDS: Cirrhosis discriminating score; GUCI: Göteborg University Cirrhosis Index.

Table 3 The correlation between age and variable laboratory data, and the stage of fibrosis and grade of necroinflammatory activity

Variable	Stage of fibrosis		Grade of activity
	Correlation coefficient	P value	Correlation coefficient	P value
Age	0.4	0.0003	0.3	0.005
AST	0.3	0.003	0.3	0.006
ALT	0.2	0.07	0.9	0.1
Alkaline phosphatase	0.3	0.006	0.2	0.08
Total bilirubin	0.2	0.07	0.3	0.003
Albumin	-0.3	0.002	-0.2	0.08
INR	0.4	0.001	0.2	0.13
Platelet count	-0.5	0.000001	-0.4	0.0002
HCV RNA load	-0.07	0.5	0.07	0.5

AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; INR: International normalized ratio; HCV: Hepatitis C virus.

Table 4 The correlation between the aspartate aminotransferase-to-alanine aminotransferase ratio, aspartate aminotransferase- to-platelet ratio index, age platelet index, cirrhosis discriminating score and Göteborg University Cirrhosis Index and the grade of necroinflammatory activity and the stage of fibrosis

Variable	Stage of fibrosis		Grade of activity
	Correlation coefficient	P value	Correlation coefficient	P value
AAR	0.2	0.054	0.1	0.23
APRI	0.4	0.00006	0.4	0.001
API	0.6	0.000001	0.5	0.00002
CDS	0.4	0.0002	0.2	0.056
GUCI	0.5	0.0001	0.3	0.003

AAR: Aspartate aminotransferase-to-alanine aminotransferase ratio; APRI: Aspartate aminotransferase-to-platelet ratio index; API: Age platelet index; CDS: Cirrhosis discriminating score; GUCI: Göteborg University Cirrhosis Index.

Table 5 The accuracy of different ratios and indices in the diagnosis of early liver cirrhosis

Item	Cutoff value	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	Accuracy (%)	AUROC	P value
AAR	1.2	46	88.7	50	87.3	80.5	0.761	0.002
APRI	1.36	46.7	87.1	46.7	87.1	79.2	0.697	0.018
API	5.5	60	80.6	42.9	89.3	76.6	0.826	0.000
GUCI	1.56	60	85.5	50	89.8	80.5	0.783	0.001

AAR: Aspartate aminotransferase-to-alanine aminotransferase ratio; APRI: Aspartate aminotransferase-to-platelet ratio index; API: Age platelet index; GUCI: Göteborg University Cirrhosis Index; PPV: Positive predictive value; NPV: Negative predictive value; AUROC: Area under the receiver operating characteristics.