non-invasive markers of liver fibrosis in children with chronic hepatic disorders

Background: the applicability of non-invasive markers for predicting hepatic fibrosis in the pediatric population with chronic liver abnormalities is unclear. objectives: we investigated the applicability of common non-invasive liver fibrosis parameters for detecting liver fibrosis in children with chronic hepatitis. methods: this was a double-center study in amir-almomenin hospital of zabol and namazi hospital of shiraz (2015 - 2017). liver fibrosis was confirmed by biopsy examination. ast to platelet ratio (apri), ast to alt ratio (aar), and fibrosis-4 (fib-4) were evaluated. results: out of 47 patients, 23 (48.9%) were females, and 24 (51.1%) were males. the mean age was 9.8±11.3 months. apri and fib-4 correlated with fibrosis stages (r = 0.1 and r = 0.2, respectively). apri showed an auc of 0.541 for detecting non-advanced fibrosis (stages 0, 1, and 2). aar and fib-4 represented aucs of 0.622 and 0.592 for advanced fibrosis and cirrhosis, respectively. the highest sensitivity of apri (70%) was obtained at the cut-off point of 0.81 for cirrhosis. the highest specificities for apri were observed at 0.66 (68%) and 1.37 (68%) for fibrotic stages 0 and 2, respectively. at the thresholds of 0.71 and 0.59, aar rendered 78% sensitivity and 90% specificity for advanced fibrosis (stages 3 and 4) and no fibrosis (stage = 0), respectively. fib-4 showed the highest sensitivity and specificity (70% and 60%) at the cut-off point of 0.21 for detecting cirrhosis. conclusions: apri, fib-4, and aar can be regarded as useful markers in predicting fibrotic transformation in children with various etiologies of chronic hepatitis.