Study of Aspartate Aminotransferase to Platelet Ratio (APRI) Index as a Predictor of Early Virological Response to Interferon Therapy in Chronic HCV Patient in Ismailia

Pegylated interferon in combination with ribavirin is the best therapy for chronic hepatitis C. The large variability of responsiveness to treatment among these patients makes tailoring therapy difficult. Therefore, accurate prediction of response before or very early during therapy may be beneficial. Accurate assessment of fibrosis has become of paramount importance; to guide management decisions, and to predict outcome. Aspartate aminotransferase (AST) to platelet ratio index (APRI) is an easy and non-invasive method to evaluate hepatic fibrosis. Recent studies have shown the importance of this test to decrease the number of liver biopsies, particularly because patients with an APRI of less than 0.40 have very little chance of having significant fibrosis, APRI as a predictive factor of early viral response in hepatitis C chronic naive patients has not been evaluated. Aim of Work: To evaluate the aspartate aminotransferase (AST) to platelet ratio index (APRI) as a predictive factor of early viral response in chronic hepatitis C naive patients. Methods: We reviewed retrospectively medical records of chronic hepatitis C naive patients who were evaluated to start therapy with PEGylated interferon and ribavirin in a random manner. We enrolled 503 patients of age group (20- 55 years) of both sexes. Patients were allocated into two groups, group 1: Hepatitis C patients with early viral response (EVR), group 2: Patients without EVR. Odds ratio (OR) and 95% confidence interval (CI) were calculated to assess the relationship between each risk factor and the EVR in both groups. Results: During the study, 503 patients were analyzed, 158 female (31.4%) and 345 male (68.4%). Their age ranged between 20-60 years old. 277 patient were from urban areas (55.1%) and 266 patients were from rural areas. 281 patient were on peg-INF alpha 2a (55.9%) and the others were on different doses of Peg-INF alpha 2b with 100, 120 and 150 IU with 12.1%, 16.1% and 15.9% respectively. 50 patients were diabetics (9.9%) and 19 patients were hypothyroidism (3.8%) and 180 patients has bilhariziasis (35.8%). In investigating the relation between the APRI score and the response it found that the best chances for the patient to response is between (0.61-0.80) to show (71.8%). Conclusion: The study show that APRI show the best chance to have response when the patient score (0.61-0.80).