A still simple but improved Index to exclude fibrosis in chronic hepatitis C: Higher sensitivity of the APRI- Score by adding Serum-Cholesterinesterase

Treatment decisions in chronic hepatitis C are based on the extent of fibrosis in the liver. Interferon-based therapies are recommended if at least stage-F2 is present. To avoid unnecessary liver biopsies, one would need a serum marker to exclude significant fibrosis with a PPV value for Ishak F0–2 of close to 100% to safely withhold antiviral therapy. A simple non-invasive fibrosis index considering AST levels and platelets was presented in 2003 (AST/ULN/platelets*100; APRI, Hepatology;38: 518). An APRI index of F2 is present. To examine the role of cholinesterase to improve the sensitivity of the APRI-score, w…