LFT's & Platelet Counts as Predictors of Fibrosis

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Subject: NATAP at DDW: LFTs & Platelet Counts as Predictors of Fibrosis

5/22/00

NATAP

www.natap.org

----------------

LIVER TRANSAMINASE LEVELS AND PLATELET COUNTS AS PREDICTORS OF DEGREE OF

FIBROSIS IN CHRONIC HEPATITIS C.

Annette Pohl, Behling, Deanna L. Oliver, Mawra Kilani, Petrea

Monson,

Tarek I. Hassanein, UCSD Med Ctr, San Diego, CA.

A simple, non-invasive test which accurately predicts the degree of

fibrosis,

would assist clinicians to determine which patients with chronic hepatitis C

require liver biopsy. Serum aspartate aminotransferase (AST)-serum alanine

aminotransferase (ALT) ratios in combination with platelet (plt 1000/mm3)

counts were obtained from 180 patients (age 46 ± 8, 60F, 120M) with

pre-treatment liver biopsy. The degree of fibrosis was graded 0-4 by a

single

pathologist who was blinded to lab results. Sixty-seven patients had no

fibrosis (F0), 72 mild to moderate fibrosis (F1 & 2) and 41 patients had pre-

or established cirrhosis (F3 & 4). ALT >AST and AST > ALT combined with

various

platelet levels were used to predict fibrosis stage. In order to

differentiate

between F0 and F1-F4, we used ALT>AST in combination with different platelet

counts as cut-off points. For the differentiation of severe fibrosis (F3 &

F4) versus no to moderate fibrosis (F0-F2), we used AST>ALT, also in

combination with different platelet counts. Sensitivity, specificity,

positive and negative predictive value (PPV and NPV, respectively) were

calculated.

Results: Comparing the two ratios, AST>ALT has better predictive values for

detecting severe fibrosis than ALT>AST for detecting no fibrosis. For

detecting F3 & F4, the optimal cut-off platelet count is <125,000 mm3.

Conclusion: AST>ALT ratio in combination with platelet counts <125,000 mmm3

can be used as simple test to detect F 3 and F4 patients. However, ALT>AST

ratio in combination with platelet counts could not accurately predict F0 in

the clinical setting.

________________________________________________________________________

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[Guest guest]

Subject: NATAP at DDW: LFTs & Platelet Counts as Predictors of Fibrosis

5/22/00

NATAP

www.natap.org

----------------

LIVER TRANSAMINASE LEVELS AND PLATELET COUNTS AS PREDICTORS OF DEGREE OF

FIBROSIS IN CHRONIC HEPATITIS C.

Annette Pohl, Behling, Deanna L. Oliver, Mawra Kilani, Petrea

Monson,

Tarek I. Hassanein, UCSD Med Ctr, San Diego, CA.

A simple, non-invasive test which accurately predicts the degree of

fibrosis,

would assist clinicians to determine which patients with chronic hepatitis C

require liver biopsy. Serum aspartate aminotransferase (AST)-serum alanine

aminotransferase (ALT) ratios in combination with platelet (plt 1000/mm3)

counts were obtained from 180 patients (age 46 ± 8, 60F, 120M) with

pre-treatment liver biopsy. The degree of fibrosis was graded 0-4 by a

single

pathologist who was blinded to lab results. Sixty-seven patients had no

fibrosis (F0), 72 mild to moderate fibrosis (F1 & 2) and 41 patients had pre-

or established cirrhosis (F3 & 4). ALT >AST and AST > ALT combined with

various

platelet levels were used to predict fibrosis stage. In order to

differentiate

between F0 and F1-F4, we used ALT>AST in combination with different platelet

counts as cut-off points. For the differentiation of severe fibrosis (F3 &

F4) versus no to moderate fibrosis (F0-F2), we used AST>ALT, also in

combination with different platelet counts. Sensitivity, specificity,

positive and negative predictive value (PPV and NPV, respectively) were

calculated.

Results: Comparing the two ratios, AST>ALT has better predictive values for

detecting severe fibrosis than ALT>AST for detecting no fibrosis. For

detecting F3 & F4, the optimal cut-off platelet count is <125,000 mm3.

Conclusion: AST>ALT ratio in combination with platelet counts <125,000 mmm3

can be used as simple test to detect F 3 and F4 patients. However, ALT>AST

ratio in combination with platelet counts could not accurately predict F0 in

the clinical setting.

________________________________________________________________________

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