RESUMEN
Background: Hepatitis C virus infection is on rise in Pakistan
Objective: To evaluate serum aspartate aminotransferase and alanine aminotransferase ratio [AST/ALT ratio] in predicting liver cirrhosis of chronic hepatitis C patients
Patient and Methods: Study Design: Aprospective study. Place and Duration of Study: This study was done in Gasteroenterology department at Sheikh Zayed Hospital Lahore. Duration of study was 6 months from 1[st] January to 30[th] June 2010. Total 80 patients of chronic hepatitis C confirmed by PCR were included in the study. The sera of the patients were tested for AST and ALT. Liver biopsy of each patient was performed. Histological Activity Index [HAI] of the specimens was scored on the basis of Knodell score. AST/ALT ratio was correlated with the histological stage [i.e. degree of fibrosis], and the histological grade [i.e. inflammatory activity]
Results: The mean AST/ALT ratio in 40 cirrhotic patients [1.64 +/- 0.46; p < 0.001]. A ratio = 1 has 96.38% specificity and 93.73% positive predictive value in distinguishing cirrhotic from noncirrhotic patients with 88.26% sensitivity and 94.84% negative predictive value. The ratio correlated positively with histological stage but not with the grade. Two patients out of 17 cirrhotic patients [12%] have no clinical or biochemical features suggestive of chronic liver disease except for an AST/ALT ratio more than one
Conclusion: It is concluded that AST/ALT ratio = 1 is highly specific for the presence of cirrhosis in patients with chronic hepatitis C. This ratio reflects the fibrosis stage in these patients. This ratio may be considered as a marker of fibrosis in patients with chronic hepatitis C