APRI (AST to Platelet Ration Index) and (Fibrosis-4 Index) Performance to assess liver fibrosis against predefined fibroscan values in chronic Hepatitis C Virus Infection.

Abstract

Objective: To compare the performance of Fibrosis-4 index (FIB-4), and the AST to platelet ratio index (APRI) versus Fibroscan in chronic hepatitis C virus (CHCV) infection. Study Design: Cross-sectional study. Setting: Department of Gastroenterology, Liaquat National Hospital and Medical College, Karachi, Pakistan. Period: July 2024 to December 2024. Methods: A total of 250 patients aged 20-70 years, and having CHCV were analyzed. APRI and FIB-4 scores were calculated according. The discriminative ability of APRI, and FIB-4 was evaluated drawing area under the curve (AUC) utilizing receiver operating characteristic (ROC) curve. Based on the optimal cut-off value, the sensitivity and specificity of both scoring systems were computed. Results: For a total of 250 patients, the median scores for APRI, FIB-4, and Fibroscan were 0.63 (0.39-1.05), 2.33 (1.13-3.60), and 9 (5.50-23.92), respectively. Fibrosis stages were noted as 98 (39.2%) F0-F1, 18 (7.2%) F2, 30 (12%) F3, and 104 (41.6%) F4. The AUC indicated that the FIB-4 score was a better predictor of chronic severity than the APRI score (AUC=0.994 vs AUC=0.866) among CHCV patients. The optimal cutoff for the FIB-4 score was 2.440 (sensitivity=92.5%, specificity=100%), 1.550 (sensitivity=100%, specificity=91.4%), and 2.565 (sensitivity=85.1%, specificity=100%). Conclusion: In the context of chronic HCV infection, FIB-4 was better than APRI at differentiating between individuals with and without severe fibrosis and cirrhosis.