Amir Rizwan Chohan, Syed Fahd Shah, Muhammad Umar, Hamama tul Bushra Khaar, Zahid Mahmood, Asad Nasir, Shakeel Ahmed, Muhammad Ajmal, Umar Riaz, Asad Akram.
AST / ALT Ratio: A Diagnostic Tool to Diagnose Cirrhosis in Patients with Chronic Hepatitis - C Infection.
Pak J Gastroenterol Jan ;17(1):17-9.

Liver biopsy is the standard diagnostic procedure to diagnose cirrhosis but there are some cases in which the biopsy is contraindicated. In recent years, much research has been done in West on AST/ ALT ratio (AAR) >/= 1 for diagnosis of cirrhosis. Emerging data support that AAR >/= 1 has high specificity and sensitivity in diagnosis of cirrhosis. Keeping in view the complications of liver biopsy, we designed this study to see the relationship of AAR in cirrhosis caused by hepatitis -C and to use this supportive tool for diagnosis along with other parameters. 202 patients entered in Liver Database with chronic liver disease (CLD) due to HCV infection were analyzed from November 1999 to December 2002. The patients were divided into chronic hepatitis, compensated and de-compensated cirrhosis groups. The AST/ALT ratio was determined for each patient and grouped accordingly. Using Liver Database Software Ver. 01 and SPSS Ver. 10 did the statistical analysis. Out of 202 patients, there were 164 males and 89 females with mean age of 44.56 +/- 7.23 years. 26 (12.87%) patients were chronic hepatitis, 125 (61.87%) were compensated cirrhosis diagnosed on ultrasound and 51 (25.24%) were de-compensated cirrhosis on the basis of clinical presentation like encephalopathy, hematemesis and ascites. The mean AST level was 93.02 +/- 106.14 and ALT level was 108.06 +/- 136.53. The results of AST/ ALT ratio >/= 1 were found 52.7%, 27.45% and 27.27% in compensated cirrhosis, de-compensated cirrhosis and chronic hepatitis - C patients respectively. We conclude that AAR is a non-invasive and supportive tool and has high specificity in compensated cirrhosis (52.7%) as compared to de-compensated cirrhosis (27.45%) and chronic hepatitis (27.27%).

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