EVALUATION OF AST/ ALT RATIO AS A MARKER OF LIVER FIBROSIS AND CIRRHOSIS IN PATIENTS WITH CHRONIC HEPATITIS C

Marker of Liver Fibrosis and Cirrhosis

Abstract

Objective: To assess the relation between serum AST/ALT ratio (AAR) and hepatic fibrosis and cirrhosis associated with chronic hepatitis C.

Study Design: A cross sectional study.

Place and Duration of Study: The study was conducted in the department of medicine Military Hospital Rawalpindi from Sep 2004 to Feb 2005.

Materials and Methods: Fifty diagnosed patients of chronic hepatitis C were selected whose liver biopsy was performed as a workup plan for treatment. Serum AST/ ALT ratio (AAR) was determined and degree of liver fibrosis noted on histopathology, using Knodell scoring system. ANOVA was applied to study the difference in AAR in different stages of liver fibrosis.

Results:   The mean AAR was found to be higher with each increasing stage of liver fibrosis. The mean AAR in cirrhotics (1.34) was significantly higher compared to noncirrhotics (0.77), p< 0.001.  AAR ≥ 1 had 100% sensitivity and negative predictive value in distinguishing cirrhotic from non-cirrhotic patients with 87% specificity and 45% positive predictive value.

Conclusion: There is only a modest relation between AAR and early hepatic fibrosis (stages 1-3) in patients with chronic hepatitis C, while AAR is significantly higher in patients with advanced fibrosis/ cirrhosis.