In a meta-analysis of 40 studies, investigators concluded that an APRI score greater than 1.0 had a sensitivity of 76% and specificity of 72% for predicting cirrhosis.
In addition, they concluded that an APRI score greater than 0.7 had a sensitivity of 77% and specificity of 72% for predicting significant hepatic fibrosis.
For detection of cirrhosis, using an APRI cutoff score of 2.0 was more specific (91%) but less sensitive (46%).
The lower the APRI score of less than 0.5, the greater the negative predictive value.
The ability to rule out cirrhosis and the higher the value of greater than 1.5 the greater the positive predictive value and ability to rule in cirrhosis.
The APRI alone is likely not sufficiently sensitive to rule out significant disease.
The Aspartate Aminotransferase to Platelet Ratio Index (APRI) score is a non-invasive tool used to assess liver fibrosis, particularly in patients with chronic hepatitis C virus (HCV) infection.
While APRI is a useful tool, transient elastography (TE) demonstrates superior sensitivity and specificity for diagnosing cirrhosis in chronic hepatitis C patients.
Overall, the APRI score is a valuable, cost-effective method for assessing liver fibrosis and can reduce the need for invasive liver biopsies in many cases.