Role of simple biomarkers in predicting fibrosis progression in HCV infection

Rajasekhara R. Mummadi, John R. Petersen, Shu Yuan Xiao, Ned Snyder

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


AIM: To examine the accuracy of the aspartate aminotransferase (AST)/Platelet Ratio Index (APRI) and FIB-4, in predicting longitudinal changes in liver histology in hepatitis C virus (HCV) patients. METHODS: Patients that underwent repeat liver biopsies at least 1 year apart from 1999 to 2007 were identified. Liver fibrosis was staged on needle core biopsies evaluated by a single expert liver pathologist. Only laboratory values within 3 mo of the liver biopsies were used. RESULTS: Thirty-six patients met the inclusion criteria with 50% stage 1 on initial biopsy, 25% stage 2, and 22% stage 3. Nineteen of 36 (53%) had progression of fibrosis on repeat biopsies, while 16 (44%) showed no change in stage, and one (3%) showed improvement. Patients that showed progression of fibrosis had significantly higher alanine aminotransferase and aspartate aminotransferase levels than the group that did not show progression. A significant correlation was seen between change in stage of fibrosis and change in APRI (r2 = 0.39, P = 0.00001) and a change in FIB-4 (r2 = 0.31, P = 0.00004). A change in APRI (ΔAPRI) of 0.18 had 80% positive predictive value (PPV) and 67% negative predictive value (NPV) for progression of fibrosis. A change in FIB-4 (ΔFIB-4) of 0.39 had 75% PPV and 75% NPV for predicting progression of fibrosis. CONCLUSION: ΔAPRI and ΔFIB-4 parallel changes in fibrosis progression, and could be useful tools for clinicians in following patients with active chronic HCV infection.

Original languageEnglish (US)
Pages (from-to)5710-5715
Number of pages6
JournalWorld journal of gastroenterology
Issue number45
StatePublished - Dec 2010


  • Biomarkers
  • Hepatitis C
  • Liver biopsy
  • Liver fibrosis

ASJC Scopus subject areas

  • Gastroenterology


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