Validity and Clinical Utility of the Aspartate Aminotransferase–Alanine Aminotransferase Ratio in Assessing Disease Severity and Prognosis in Patients With Hepatitis C Virus–Related Chronic Liver Disease

Giannini, Edoardo G.; Risso, Domenico; Botta, Federica; Chiarbonello, Bruno; Fasoli, Alberto; Malfatti, Federica; Romagnoli, Paola; Testa, Emanuela; Ceppa, Paola; Testa, Roberto

doi:10.1001/archinte.163.2.218

Cited by 315 publications

(260 citation statements)

References 39 publications

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“…APRI, AST/ALT, platelets, AST, albumin, total bilirubin and alkaline phosphatase which are well-known predictors of advanced liver diseases (9)(10)(11)(12)(13)(14)(15) (9). In this study, the cutoff values of APRI were set at 0.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Evaluation of Serum Markers APRI and AST/ALT for Assessing Liver Fibrosis and Cirrhosis in Chronic Hepatitis B and C Patients with Hepatocellular Carcinoma

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Retrospective Evaluation of Serum Markers APRI and AST/ALT for Assessing Liver Fibrosis and Cirrhosis in Chronic Hepatitis B and C Patients with Hepatocellular Carcinoma

et al. 2008

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“…Several serum markers, and their combination in scores, have been reported as predicting the presence of cirrhosis with a high degree of accuracy. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] However, most of them have been evaluated only in patients infected with hepatitis C virus (HCV), and few have been validated. In addition, these markers could be influenced by extrahepatic conditions, and their overall diagnostic value for cirrhosis is less than optimal.…”

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confidence: 99%

Accuracy of liver stiffness measurement for the diagnosis of cirrhosis in patients with chronic liver diseases

et al. 2006

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A proper diagnosis of cirrhosis is essential for the management of patients with chronic liver diseases. We assessed the accuracy of liver stiffness measurement by Fibroscan for the diagnosis of cirrhosis in 1,257 patients with chronic liver diseases of various causes enrolled in a prospective multicenter study as well as clarified causes of discrepancies between liver histology and Fibroscan. One hundred thirty-two patients had unsuitable biopsy specimens, and 118 had unreliable liver stiffness measurements. Because 232 patients overlapped with a previous study, analysis was performed in the 775 new patients then derived in the whole population (1,007; 165 cirrhosis). Diagnostic accuracy was assessed by receiver operator curve (ROC) analysis. Liver samples were re-analyzed in case of discrepancies. The area under the ROC (AUROC) was 0.95 (95% CI, 0.93-0.96) for the diagnosis of cirrhosis in either 775 or 1,007 patients. The cutoff value with optimal diagnosis accuracy was 14.6 kPa in 1,007 patients (positive and negative predictive values, 74% and 96%) with discrepancies among the etiological groups. Eighty patients were misclassified: (1) among 45 patients without cirrhosis with liver stiffness 14.6 kPa or greater, 27 (60%) had extensive fibrosis and 10 (22%) significant perisinusoidal fibrosis; and (2) among 35 patients with cirrhosis and liver stiffness less than 14.6 kPa, 10 (29%) had a macronodular pattern and 25 (71%) either none or mild activity. In conclusion, Fibroscan is a reliable method for the diagnosis of cirrhosis in patients with chronic liver diseases, better at excluding than at predicting cirrhosis using a threshold of 14.6 kPa. False-negatives are mainly attributable to inactive or macronodular cirrhosis. (HEPATOLOGY 2006;44:1511-1517

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“…The ratio of AST to ALT may indicate specific diseases (e.g. AST > ALT), and it is usually seen in patients with Wilson's disease and those with fatty liver or chronic hepatitis C virus (HCV) liver diseases (7,8). An isolated disproportionately increased AST level may indicate; hemolysis (including difficult venipuncture), acute rhabdomyolysis (during viral illnesses), myopathies, myocardial disease, or recent rigorous physical activity (long duration running or weight lifting) (9, 10).…”

Section: Introductionmentioning

confidence: 99%

Approach to Liver Function Tests in Children

Haghighat

2014

J Compr Ped

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The liver is a multifactorial organ which is involved in a number of critical excretory, synthetic and metabolic functions. Although the term 'liver function test' is commonly used, it is imprecise since many of the tests, such as transaminase, do not measure liver function. Therefore, these tests should be referred to as 'liver enzyme tests', and 'liver function tests' should be the term used to measure hepatocyte synthetic functions, such as serum albumin and prothrombin time. Furthermore, commonly used biochemical tests may be normal in a patient with liver disease (compensated cirrhosis) or be abnormal in a case with a healthy liver. In this article different aspects of liver function tests and the approach to abnormal liver function tests are reviewed. Keywords: Liver Disease; Children; TestsImplication for health policy/practice/research/medical education: Since commonly used biochemical tests, referred to as liver function tests, may be normal in a patient with liver disease or abnormal in a patient with a healthy liver, the approach taken to liver function tests is very important, particularly in children. This paper reviews the different aspects of liver function tests.

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Validity and Clinical Utility of the Aspartate Aminotransferase–Alanine Aminotransferase Ratio in Assessing Disease Severity and Prognosis in Patients With Hepatitis C Virus–Related Chronic Liver Disease

Cited by 315 publications

References 39 publications

Retrospective Evaluation of Serum Markers APRI and AST/ALT for Assessing Liver Fibrosis and Cirrhosis in Chronic Hepatitis B and C Patients with Hepatocellular Carcinoma

Retrospective Evaluation of Serum Markers APRI and AST/ALT for Assessing Liver Fibrosis and Cirrhosis in Chronic Hepatitis B and C Patients with Hepatocellular Carcinoma

Accuracy of liver stiffness measurement for the diagnosis of cirrhosis in patients with chronic liver diseases

Approach to Liver Function Tests in Children

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