Aspartate transaminase to platelet ratio index in hepatitis C virus and Schistosomiasis coinfection

Table 1 Population characteristics and bivariate association with fibrosis

Characteristic	Median (inter-quartile range)	Bivariate analysis1 (P value)
Age	46 (38, 52)	< 0.0001
APRI score	0.63 (0.40, 1.11)	< 0.0001
Anti-schistosoma antibody	128 (0, 512)	0.53
HCV RNA titer (Log10)	5.60 (4.98, 6.17)	0.38
AST	42 (31, 63)	< 0.0001
Platelet (× 103)	192 (147, 232)	< 0.0001
Fibrosis, n (%)		NA
No	26 (7.1)	-
Stage I	112 (30.4)	-
Stage II	138 (37.5)	-
Stage III	75 (20.4)	-
Stage IV	17 (4.6)	-
Grade, n (%)		< 0.00012
0	2 (0.54)	-
I	101 (27.4)	-
II	185 (50.1)	-
III	74 (20.1)	-
IV	7 (1.90)	-

¹Kruskal-Wallis test;

²Fisher exact test. P < 0.05 is considered significant. NA: Not applicable.

Table 2 Odds ratio estimates and Wald confidence intervals of multinomial regression predicting fibrosis status

Predictor	Outcome:fibrosis	Unit	OR	95%CI	P value
APRI_SCORE	Severe/cirrhosis	1	2.41	1.12-5.18	0.025
APRI_SCORE	Mild/moderate	1	0.65	0.31-1.40	0.275
AGE	Severe/cirrhosis	5	1.83	1.37-2.46	< 0.0001
AGE	Mild/moderate	5	1.46	1.14-1.88	0.003
Grade moderate/severe vs no/mild	Severe/cirrhosis	NA	11.63	2.41-56.12	0.002
Grade moderate/severe vs no/mild	Mild/moderate	NA	1.29	0.51-3.28	0.587

NA: Not applicable.

Table 3 Aminotransferase-to-platelet ratio index score AUC, cutoff points and accuracy in determining fibrosis

Characteristic	AUC	Cutoff point1	Sensitivity	Specificity
No fibrosis	63%	0.45	56%	69%
Significant fibrosis	73%	0.64	63%	76%
Severe fibrosis	81%	1.06	64%	86%
Cirrhosis	89%	1.11	88%	79%

¹Based on Youden’s index.

Table 4 Comparison of AUC of models that include aminotransferase-to-platelet ratio index score only, anti-schistosomiasis only or aminotransferase-to-platelet ratio index score plus anti-schistosomiasis in determining fibrosis

Characteristic	AUC
	Model 11	Model 22	Model 33
No fibrosis	63%	54%	60%
Significant fibrosis	73%	55%	73%
Severe fibrosis	81%	54%	81%
Cirrhosis	89%	52%	89%

¹Model includes APRI score;

²Model includes anti-schistosomiasis;

³Model includes APRI score plus anti-schistosomiasis. APRI: Aminotransferase-to-platelet ratio index.