APRI of limited value in detecting hepatic fibrosis and cirrhosis

A meta-analysis of 9 studies (n=1,798 patients) was performed to determine the value of the aminotransferase-to-platelet ratio index (APRI) as a non-invasive means to detect hepatic fibrosis and cirrhosis.  Of the 1,798 patients, 53.1% and 13.5% had biopsy-proven fibrosis and cirrhosis, respectively.  At APRI cut-off values of 0.5 and 1.5, the sensitivity and specificity for fibrosis were 84% and 41%, and 49% and 84%, respectively.  At APRI cut-off values of 1.0-1.5 and 2.0, the sensitivity and specificity for cirrhosis were 54% and 78%, and 28% and 87%, respectively.  Thus, the APRI has limited value in detecting hepatic fibrosis and cirrhosis.