Evaluation of Red Cell Distribution Width (RDW) to Platelet Ratio as A Novel Non-Invasive Index for Predicting Hepatic Fibrosis in Patients with Chronic Hepatitis C before and after Antiviral Treatment

Abstract

Background: For the purpose of making decisions and providing treatment for individuals infected with HCV, liver
fibrosis must be accurately staged. Prior to starting medication, the degree of the fibrosis should be evaluated. cirrhosis
patients must be identified in order to establish treatment plans and to monitor HCC patients after treatment.
Objective: This study aimed to find a readily accessible haematological CBC markers, a regular, low-cost method of
predicting severe fibrosis and cirrhosis.
Patients and methods: The study included 50 patients with chronic hepatitis C virus. They were divided into two
groups: Group I included 25 Non-cirrhotic patients having chronic HCV infection and group II that included 25 cirrhotic
CHILD A patients having chronic HCV infection.
Results: Before treatment, sensitivity and specificity for RDW/Platelet ratio, APRI and FIB_4 for fibrosis cases (F1,
F2 & F3) were evaluated by constructing ROC curve, which showed an excellent (in FIB_4) and good (in RDW/Platelet
ratio & APRI) degree of accuracy. The areas under the ROC curve for RDW/Platelet ratio, APRI and FIB_4 were
(0.857, 0.821 and 0.911) respectively. For APRI at cut off point 0.35, the sensitivity was 75%. For FIB_4 at cut off
point 1.39, the sensitivity was 100%. After treatment, sensitivity and specificity for RDW/Platelet ratio, APRI, FIB_4
for fibrosis cases (F1, F2) and sensitivity & specificity for RDW/Platelet ratio, APRI, FIB_4 for cirrhotic cases (F3, F4)
were evaluated. For APRI at cut off point 0.65, the sensitivity was 100% For FIB_4 at cut off point 1.895, the sensitivity
was 100%. Conclusion: According to our findings, RDW/PLT might accurately determine the degree of liver fibrosis
and cirrhosis prior to HCV therapy. While following HCV therapy, we may rely on RDW/PLT to predict the degree of
advanced liver fibrosis and cirrhosis (F3 & F4) with great accuracy.