Red Cell Volume Distribution Width to Platelet Ratio is an Important Predictor of Liver Fibrosis and Cirrhosis in Chronic Hepatitis B

Objective: In recent years, a lot of non-invasive tests have been examined for estimating the severity of liver fibrosis in patients with chronic hepatitis B (CHB). We aimed to evaluate the role of simple and valuable platelet-derived indices in estimating the stage of fibrosis and cirrhosis in patients with CHB. Materials and Methods: A total of 434 biopsy-proven naive CHB patients were included in the study. Liver biopsy samples were examined using the ISHAK scoring system. Age, sex, complete blood count parameters and the stage of fibrosis of the patients were recorded. The patients were evaluated according to the severity of fibrosis (stage 0-2: No fibrosis/mild fibrosis and stage 3-6: Significant fibrosis) and the presence of cirrhosis (stage 0-4: No cirrhosis, stage 5-6: Cirrhosis). Results: Of the 434 patients included in the study, 252 (58.1%) were men and 182 (41.9%) were women. The mean age of the patients was 42.7±12.2 years. Significant liver fibrosis was found in 108 (24.9%) patients and cirrhosis in 43 (9.9%) patients. In dual analysis, alterations in many platelet-derived parameters were observed. Receiver operating characteristic curve analysis revealed that red blood cell distribution width to platelet ratio index was the highest area under the curve value (0.777) in predicting significant liver fibrosis and the cutoff value was 0.0814, sensitivity was 56% and specificity was 87%. Conclusion: Platelet-derived indices may play an important role in observing the progression of liver fibrosis and cirrhosis. Platelet ratio index is significantly increased in advanced liver fibrosis in patients with CHB, and can be defined as independent predicting factor in liver fibrosis.