AST-platelet ratio index cannot be used in the exclusion of significant fibrosis in chronic hepatitis B patients.

Guzelbulut et al. (1) demonstrated that the aspartate aminotransferase (AST)-platelet ratio index (APRI) may be a useful noninvasive marker in the exclusion of both significant fibrosis and cirrhosis because of the high negative predictive values (NPVs) in chronic hepatitis B (CHB). However, the NPVs for significant fibrosis and cirrhosis were 68% and 86%, respectively, for the same thresholds of the APRI in a recent meta-analysis (2). Because of this discrepancy, we retrospectively reviewed 229 CHB patients (142 males, 87 females) who had been followed up between 2009 and 2011 at our clinic.