ORIGINAL ARTICLE

Relationship red distribution width to platelet ratio with fibrosis degrees based on transient elastography in chronic hepatitis B patients

Fauzi Yusuf , Azzaki Abubakar, Desi Maghfirah, Ade Baswin

Fauzi Yusuf
Gastroentero-Hepatology Division, Internal Medicine Department, Syiah Kuala University/Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia. Email: fozi_ysf63@yahoo.co.id

Azzaki Abubakar
Gastroentero-Hepatology Division, Internal Medicine Department, Syiah Kuala University / dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia

Desi Maghfirah
Gastroentero-Hepatology Division, Internal Medicine Department, Syiah Kuala University / dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia

Ade Baswin
Gastroentero-Hepatology Division, Internal Medicine Department, Syiah Kuala University / dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia
Online First: August 31, 2021 | Cite this Article
Yusuf, F., Abubakar, A., Maghfirah, D., Baswin, A. 2021. Relationship red distribution width to platelet ratio with fibrosis degrees based on transient elastography in chronic hepatitis B patients. Bali Medical Journal 10(2): 793-797. DOI:10.15562/bmj.v10i2.2355


Introduction: Chronic hepatitis B virus infection is a major health problem in developing countries like Indonesia. A chronic HBV infection of approx. 40% leads to liver fibrosis and hepatocellular carcinoma. Furthermore, liver biopsy is the gold standard in diagnosing liver fibrosis, but this examination is invasive and has many complications. Transient elastography has been validated to assess fibrosis in several liver diseases including HBV infection. However, not all hospitals have temporary elastography facilities in such a way that cheaper and more affordable examinations are needed. This study aims to examine the relationship between Red cell distribution width to platelet ratio with the degree of liver fibrosis based on transient elastography in chronic hepatitis B patients.

Method: This study was a cross-sectional examination, which involves 48 chronic hepatitis B patients receiving outpatient care from September to November 2020 at dr. Zainoel Abidin Banda Aceh. The routine blood tests were performed using the Sysmex XT 1800i. The red cell distribution width to platelet ratio value is calculated by dividing the Red Distribution Width value by the platelets, and the degree of liver fibrosis was assessed using TE (Fibroscan® 502 Echosens).

Result: In the 48 patients, the mean value of Red cell Distribution Width to Platelet Ratio for various degrees of liver fibrosis F0-1, F2, F3 and F4 were 0.051; 0.050; 0.077 and 0.108, respectively. It was reported that red cell distribution width to Platelet Ratio levels also increased according to the increase in liver fibrosis degree and was statistically significant with a p-value of 0.002. Analysis of the relationship between red cell distribution width to platelet ratio with the degree of liver fibrosis using ordinal regression method, while the red cell distribution width to platelet ratio level variable has a fairly large estimate value that is 31098 with a p-value of 0.003. The p-value of the test of less than 0.05 proves that the red cell distribution width to platelet ratio level affects and has a relationship with the degree of liver fibrosis.

Conclusion: Red cell distribution width to platelet ratio relates to the degree of liver fibrosis in patients with chronic hepatitis B.

References

Chen B, Ye B, Zhang J, Ying L, Chen Y. RDW to platelet ratio: a novel noninvasive index for predicting hepatic fibrosis and cirrhosis in chronic hepatitis B. PLoS One. 2013;8(7):e68780–e68780. Available from: https://pubmed.ncbi.nlm.nih.gov/23874760

Parikh P, Ryan JD, Tsochatzis EA. Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection. Ann Transl Med. 2017;5(3):40. Available from: https://pubmed.ncbi.nlm.nih.gov/28251119

Andiarsa D, Setyaningtyas DE, Hidayat S, Setianingsih I, Haryati E. Spatial effect of refilling drinking water depots toward diarrhea in pagatan, sub district of kusan hilir, tanah bumbu district, south kalimantan [internet]. The International Institute of Knowledge Management (TIIKM); 2018. Available from: http://dx.doi.org/10.17501/24246735.2018.4105

EASL. EASL Clinical Practice Guidelines: Management of chronic hepatitis B virus infection. J Hepatol. 2012;57(1):167–85. Available from: http://dx.doi.org/10.1016/j.jhep.2012.02.010

Brown NA, Boehme RE. Current treatment of patients with chronic hepatitis B virus infection [Internet]. Hepatitis Prevention and Treatment. Birkhäuser Basel; 2004. p. 125–40. Available from: http://dx.doi.org/10.1007/978-3-0348-7903-3_7

Fung J, Lai C-L, But D, Wong D, Cheung T-K, Yuen M-F. Prevalence of Fibrosis and Cirrhosis in Chronic Hepatitis B: Implications for Treatment and Management. Am J Gastroenterol. 2008;103(6):1421–6. Available from: http://dx.doi.org/10.1111/j.1572-0241.2007.01751.x

Pradella P, Bonetto S, Turchetto S, Uxa L, Comar C, Zorat F, et al. Platelet production and destruction in liver cirrhosis. J Hepatol. 2011;54(5):894–900. Available from: http://dx.doi.org/10.1016/j.jhep.2010.08.018

Kawamoto M, Mizuguchi T, Katsuramaki T, Nagayama M, Oshima H, Kawasaki H, et al. Assessment of liver fibrosis by a noninvasive method of transient elastography and biochemical markers. World J Gastroenterol. 2006;12(27):4325–30. Available from: https://pubmed.ncbi.nlm.nih.gov/16865773

Lee KG, Seo YS, An H, Um SH, Jung ES, Keum B, et al. Usefulness of non-invasive markers for predicting liver cirrhosis in patients with chronic hepatitis B. J Gastroenterol Hepatol. 2010;25(1):94–100. Available from: http://dx.doi.org/10.1111/j.1440-1746.2009.05953.x

Lou Y, Wang M, Mao W. Clinical usefulness of measuring red blood cell distribution width in patients with hepatitis B. PLoS One. 2012/05/23. 2012;7(5):e37644–e37644. Available from: https://pubmed.ncbi.nlm.nih.gov/22649548

de Lédinghen V, Vergniol J. Transient elastography (FibroScan). Gastroentérologie Clin Biol. 2008;32(6):58–67. Available from: http://dx.doi.org/10.1016/s0399-8320(08)73994-0

Huang R, Jiang N, Yang R, Geng X, Lin J, Xu G, et al. Fibroscan improves the diagnosis sensitivity of liver fibrosis in patients with chronic hepatitis B. Exp Ther Med. 2016/03/09. 2016;11(5):1673–7. Available from: https://pubmed.ncbi.nlm.nih.gov/27168788

Hu Z, Sun Y, Wang Q, Han Z, Huang Y, Liu X, et al. Red blood cell distribution width is a potential prognostic index for liver disease. Clin Chem Lab Med. 2013;51(7). Available from: http://dx.doi.org/10.1515/cclm-2012-0704

Dou J, Lou Y, Wu J, Lu Y, Jin Y. Thrombocytopenia in patients with hepatitis B virus-related chronic hepatitis: Evaluation of the immature platelet fraction. Platelets. 2013;25(6):399–404. Available from: http://dx.doi.org/10.3109/09537104.2013.832742

Ebrahimi H, Naderian M, Sohrabpour AA. New Concepts on Pathogenesis and Diagnosis of Liver Fibrosis; A Review Article. Middle East J Dig Dis. 2016;8(3):166–78. Available from: https://pubmed.ncbi.nlm.nih.gov/27698966

Yuyun D, Zhihua T, Haijun W, Zhaoping L, Xiaoli Z, Wenfang X, et al. Predictive value of the red blood cell distribution width-to-platelet ratio for hepatic fibrosis. Scand J Gastroenterol. 2019;54(1):81–6. Available from: http://dx.doi.org/10.1080/00365521.2018.1558786

Tubung J, Mariadi IK, Wibawa IDN. Red Cell Distribution Width to Platelet Rasio is not inferior than Aspartate Aminotransferase to Platelet Ratio Index Score in Predicting Liver Fibrosis in Chronic Hepatitis B Patients at Sanglah General Hospital Denpasar. Indones J Gastroenterol Hepatol Dig Endosc. 2018;19(3):137. Available from: http://dx.doi.org/10.24871/1932018137-140


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