• Mary Jane Burton, Imran Sunesara, Alan Penman, Huan Pham, Nora Oliver, Casey A Young, Novell McGloster, and Brendan M McGuire.
• Veterans Affairs Medical Center, Jackson, MS, USA. mary.burton2@va.gov
• South. Med. J. 2011 May 1; 104 (5): 309-14.

ObjectivesThe study of noninvasive markers of fibrosis, such as aspartate aminotransferase (AST) to platelet ratio index (APRI), have been limited in African American populations. Given the disparate outcomes of chronic hepatitis C in African American populations, comparative analyses of the APRI score should be undertaken. Compare the diagnostic accuracy of the APRI score for significant fibrosis and cirrhosis in a sample of African American and white veterans with chronic hepatitis C in the southeastern United States.MethodsWe identified 268 veterans with chronic hepatitis C who had received a liver biopsy. The APRI score was calculated using laboratory values obtained within 180 days of liver biopsy and compared to the fibrosis stage (F0-F4). Performance characteristics of the APRI score for determining stages of fibrosis were compared in African American (n = 142) and white (n = 117) individuals.ResultsAn APRI score of 0.99 had a comparably high negative predictive value for significant fibrosis (F3-F4) in African American 0.90 and white veterans (0.83). For cirrhosis (F4), an APRI score of 1.0 provided a negative predictive value of 0.96 in the African American subset and 0.94 in the white subset. We did not detect any difference in the performance of the APRI score for predicting stages of fibrosis between the two groups.ConclusionThe APRI score displayed similar performance in African Americans and whites. A threshold of 1.0 can reliably exclude cirrhosis in African American veterans with chronic HCV infection.

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