Lubna Meraj, Omar Haider, Muhammad Khurram.
Association of AST/ALT ratio with hepatic fibrosis in chronic hepatitis C patients.
Pak J Gastroenterol Jan ;22(1):10-4.

OBJECTIVE: To compare the aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT) in hepatitis C patients with and without high Knodell fibrosis score on liver biopsy. DESIGN: Cross sectional, analytical. PLACE AND DURATION OF STUDY: Department of Internal Medicine, Rawalpindi Medical College, Rawalpindi from March 2007 to August 2007. PATIENTS AND METHODS: Hundred patients with diagnosis of chronic hepatitis C infection were included. Diagnostic criteria for chronic hepatitis C included: 1) evidence of HCV infection indicated by rtPCR for HCV-RNA or demonstration of anti-HCV antibody by 3rd Generation ELISA method, 2) elevation of liver enzymes for >6months, 3) negative history of alcohol consumption, and 4) negative serologic/biochemical tests/markers for autoimmune chronic hepatitis, primary biliary cirrhosis, Wilson’s disease, and alpha-one antitrypsin deficiency. AST/ALT ratio of every patient was calculated. Additionally each patient underwent percutaneous liver biopsy in standard way. Presence or absence of high hepatic fibrosis was ascertained on basis of the fibrosis score component of the Knodell Histology Activity Index (HAI). Mean AST/ALT ratio of patients with and without high fibrosis were compared using independent sample t-test. P value <0.05 was considered significant. RESULTS: Of the hundred patients, 52 were female and 48 male. Mean patient age was 42.4±9.45 years. Mean AST/ALT ratio was 1.215±0.67. Based on histopathology, 24 patients were noted to have high and 76 low hepatic fibrosis. A statistically significant (p<0.001) association existed between AST/ALT ratio and a high fibrosis score. An AST/ALT ratio =1 was 91.7% sensitive and 55.3% specific for predicting a high fibrosis score. CONCLUSIONS: AST/ALT ratio =1 is associated with a high degree of fibrosis in patients with chronic hepatitis C infection.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com