Aspartate Aminotransferase-to-Platelet Ratio Index as Predictors of Recompensation in Decompensated Cirrhosis.

Abstract

Objective: To explore the relationship between aspartate aminotransferase-to-platelet ratio index (APRI) level and recompensation in patients with hepatitis B-related decompensated cirrhosis.

Study design: Analytical study. Place and Duration of the Study: The Second Hospital of Shandong University, Jian, China, and Weifang People's Hospital, China, from January 2016 to 2024.

Methodology: A total of 166 patients with hepatitis B-related decompensated cirrhosis without antiviral treatment were included. All patients were observed for a minimum of 18 months. The main result is recompensation, defined as the latest Baveno VII restitution standard. The predictive value of the APRI was assessed by using the receiver operating characteristic (ROC) curves and logistics regression model.

Results: In the group with baseline aspartate aminotransferase (AST) ≤40 U/L, APRI was identified as an independent predictor of recompensation in patients with hepatitis B-related decompensated cirrhosis (OR 0.04, 95% CI: 0.002 - 0.686, p = 0.026). For patients treated with nucleos(t)ide analogues (NAs), lower APRI was related to the higher rate of recompensation (OR 0.466, 95% CI: 0.291 - 0.747, p = 0.002). In the baseline AST ≤40 group and in the data one year after antiviral treatment, the AUROCs for APRI diagnosis of liver cirrhosis were 0.813 and 0.723, respectively.

Conclusion: APRI may be used as an independent predictor of recompensation in patients with hepatitis B-related decompensated cirrhosis, particularly in patients undergoing NAs therapy and with low AST levels.

Key words: Aspartate aminotransferase-to-platelet ratio index, Decompensated liver cirrhosis, Recompensation, Chronic hepatitis B.