APRI/P3NP: CAN IT BE AN ACCURATE MARKER FOR NONINVASIVE EVALUATION OF LIVER FIBROSIS IN CHRONIC HCV.

Background and aim:- Hepatitis C virus (HCV) is a major health problem worldwide. Fibrosis is the major complication of HCV infection and has a significant influence on defining the prognosis and indications for therapy. Our study evaluated non-invasive markers in testing progression of hepatic fibrosis in patients with chronic HCV. Material and Methods:- HCV patients (20) of at least 6 months duration with normal kidney function, no ongoing drug or alcohol use, no evidence of malignancy or autoimmune hepatitis. Liver fibrosis was staged according to Sequential algorithm for fibrosis evaluation (SAFE) algorithm. HCV RNA, Alpha fetoprotein(AFP),Antinuclear antibody(ANA), liver and kidney functions, Fibrotest-Actitest , Fibro- quotient(FIBROQ), Four fibrosis indirect biomarker(FIB-4),AST/platelet ratio(APRI)and Amino-terminal type III procollagen (P3NP) were tested. Results:- APRI / P3NP identified significant fibrosis with 90.1% accuracy (area under the receiver operating characteristic curve 0.987; 0.974- 1). APRI/P3NP& FIB-4 index were superior to FIBROQ &Fibrotest in detecting significant fibrosis. Conclusion:- APRI/P3NP is a reliable and relatively cheap marker for fibrosis.