Association Between Red Cell Distribution Width (RDW)/Platelet Ratio and Degree of Fibrosis in Patient with Chronic Hepatitis B

Abstract

Background : Histological examination of the liver remains the gold standard of assessing liver cirrhosis. However, this examination is an invasive method with many complications.Objectives : This study aims to determine the relationship between degree of liver fibrosis with RDW (Red cell Distribution Width) / platelet ratio which can then be used as non invasive diagnostic method of liver fibrosis. Methods : This was a retrospective study, the data of hematological profiles including hemoglobin, RDW, and platelet was taken from medical records of all chronic hepatitis B patients undergoing Fibroscan at Sanglah Hospital in January 2016 to February 2017. Results : Of 58 patients, 9 patients was excluded due to chronic kidney disease, Malignancy and coincide with hepatitis C and HIV. The analysis using Kruskal-Wallis test, found a significant relationship between RDW / platelet ratio with degree of fibrosis in chronic hepatitis B (p<0.05). Of the 49 patients, 23 patients with mild-moderate fibrosis (metavir F0-2) and 26 patients with severe fibrosis (metavir F3-4) were found. In ROC analysis, the AUC was 0.701, using cut off 0,065 RDW/platelet ratio predict severe fibrosis about 73.1% sensitivity, spesificity 73.9%, positive prediction value 73.1%, and negative prediction value 70.8%. Conclusion : the RDW / platelet ratio can be used as a noninvasive diagnostic test of liver fibrosis in chronic hepatitis B patients