Influence of Sustained Virological Response on APRI in Chronic Hepatitis C: is APRI a Marker of Only the Stage of Fibrosis?

Objectives: Aspartate transaminase (AST) to platelet ratio index (APRI) is widely used to predict the stage of liver fibrosis in patients with chronic hepatit C virus (HCV) infection. In this study, we aimed to evaluate changes in APRI scores in patients with chronic HCV infection who received pegylated interferon (PEG IFN) + ribavirin or direct acting antiviral (DAA) ± ribavirin. Materials and Methods: We retrospectively reviewed our data of patients with chronic HCV infection who received PEG IFN + ribavirin or DAA ± ribavirin. Patients were classified into 3 groups according to sustained virological response (SVR) by treatment regimens: a) SVR with PEG IFN + ribavirin (PEG IFN-SVR), b) non SVR with PEG IFN + ribavirin (PEG IFN-non SVR), c) SVR with DAA ± ribavirin (DAA-SVR). Results: The study included 156 patients. APRI scores decreased significantly in PEG IFN-SVR (1.17±1.37 vs 0.38±0.35) and DAA-SVR groups (0.99±0.88 vs 0.31±0.16) (both p=0.001), whereas it did not change in PEG IFN-non SVR group (1.26±1.07 vs 1.33±1.36) (p=0.810) after treatment. In PEG IFN-SVR and DAA-SVR groups, proportions of patients who had APRI scores ≤0.5 and ≤1 increased, while proportions of patients who had APRI scores >1.5 and >2 decreased significantly after treatment (all p