Is the aspartate transaminase to platelet ratio index adequate for the assessment of liver fibrosis in patients with chronic liver disease?

We performed the same study but with a different method. The APRI score was calculated in 35 CHB patients, 14 CHC and 13 autoimmune hepatitis (AIH) patients and in 20 controls (2). Liver histopathological parameters were evaluated by the modified Knodell score. All patients compared with the controls had higher mean ± SD APRI index (1.55 ± 1.66 vs. 0.57 ± 0.15; p < 0.001). The results showed that the AUC of the APRI (AUC = 0.840) differed significantly (p < 0.001) between the patients and controls and that patients with higher APRI score had a higher fibrosis stage, and also greater inflammation grades. It seems that we need more precise instruments for staging the liver fibrosis in addition to liver biopsy, since in liver biopsy we are dependent on the available staging systems and all these staging systems (Knodell scoring system, Kleiner system and the METAVIR scale) measure the extent of fibrosis semi-quantitatively and thus overlap between the different reported fibrosis degrees is not unlikely which limits the sensitivity and specificity of APRI score observed in the said article. Therefore, to alleviate this problem, it is proposed to measure the extent of liver fibrosis by computerized histomorphometry and also by transient elastography (fibroscan); it is better that APRI score—as non-invasive methods—be compared Dear Editor,