Non invasive assessment of liver fibrosis in chronic liver disease

ABSTRACT

Background: Chronic hepatitis C [CMC] infection leads to necroinflammation which causes fibrosis and ultimately cirrhosis in 20% of cases. Liver biopsy is recommended for assessment of hepatic fibrosis and is thought to be the gold standard. Recurrent bouts of hepatocellular necrosis in CMC infection cause episodic rise in aminotransferases especially alanine aminotransferase [ALT]. ALT levels decrease as fibrosis advances and AST levels tend to exceed ALT. This results in increase in AST/ALT ratio >1.0, which can be used as non-invasive marker of hepatic fibrosis and cirrhosis, thus reducing the number of liver biopsies performed in patients with AST/ALT ratio >1.0