Gastroenterology General Medicine Infectious Disease Strong — WHO-endorsed for use in resource-limited settings; validated in HCV

AST to Platelet Ratio Index (APRI)

Non-invasive marker of hepatic fibrosis and cirrhosis, most validated in chronic hepatitis C. Also used in NAFLD, hepatitis B, and alcoholic liver disease.

Used in: Liver Disease & Cirrhosis

Score interpretation

Significant Fibrosis Unlikely 0–0.5

APRI < 0.5: Significant fibrosis (F2+) unlikely. NPV ~88%.

→ Low likelihood of significant fibrosis. Annual monitoring of LFTs and platelets. Treat underlying cause (HCV: DAA therapy; NAFLD: lifestyle).

Indeterminate — Possible Fibrosis 0.5–1

APRI 0.5–1.0: Indeterminate range for significant fibrosis.

→ Hepatology referral. Consider FibroScan or liver biopsy. Treat underlying aetiology. FIB-4 as complementary test.

Significant Fibrosis Likely 1–1.5

APRI 1.0–1.5: Significant fibrosis likely. PPV ~70%.

→ Hepatology review. Non-invasive staging (FibroScan). Liver biopsy if discordant results. Screen for complications of portal hypertension.

Cirrhosis Likely ≥ 1.5

APRI > 1.5: Cirrhosis likely. PPV for cirrhosis ~86%.

→ Hepatology referral. FibroScan or biopsy to confirm. Cirrhosis monitoring: 6-monthly USS + AFP for HCC, endoscopy for varices, clinical staging.

Interpretation bands for the APRI. Apply clinical judgement and local guidance.

References

Wai CT, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology. 2003;38(2):518–526.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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