Akurasi Diagnostik Fibrosis Hati Berdasarkan Rasio Red Cell Distribution Width (RDW) dan Jumlah Trombosit dengan Fibroscan pada Penderita Hepatitis B Kronik

Abstract

Background : Chronic hepatitis B was still a global problem. Indonesia is one of countries with a high prevalence of chronic hepatitis B. Limitation of liver biopsy as an invasive method, is a reason for many studies on non invasive method for diagnosing liver fibrosis. Chen et al have examined that RDW to Platelet Ratio can be used to predict liver fibrosis in chronic hepatitis B. Objective : To determine the accuracy of RDW to Platelet Ratio in predicting the degree of liver fibrosis in chronic hepatitis B. Methods : The study was conducted by means of a diagnostic test of cross sectional. HBsAg examination and complete blood count was examined in laboratory of H. Adam Malik Hospital, Medan, and fibroscan was performed in Division of Gastroenterology and Hepatology, H. Adam Malik Hospital, Medan from January, 2015 until March, 2015. RDW to Platelet Ratio was calculated. The degree of liver fibrosis assessed by the measurement results of fibroscan on a scale of F0 - F4. The accuracy of RDW to Platelet Ratio and compared by fibroscan was evaluated by constructing ROC (Receiver Operating Characteristic) and the AUC (Area Under the Curve) for diagnostic liver fibrosis. Results : From 34 cases, there were divided in two groups : 20 subjects (58,8%) in group of mild-moderate liver fibrosis(F:S2) and 14 subjects (41,2%) in group of severe liver fibrosis (F>2). The result of analysis using ROC (Receiver Operating Characteristic) and the AUC (Area Under the Curve). The value of accuracy 72,3 % (95% CI: 84,1% - 97 %). By using a cut off value 0,0591, Sensitivity 71,4%, Specificity 60%, Positif Predictive Value 55,6%, Negatif Predictive Value 75%, Positif Possibility Ratio is 1,79, and Negatif Possibility Ratio is 0,48. Conclusion : RDW to Platelet Ratio can be predicting grade of liver fibrosis in chronic hepatitis B with a moderate degree of accuracy ( 72,3%)