Mean platelet volume to platelet ratio (MPR) may be an easily obtained and practical biomarker that allows preliminary insight into advanced fibrosis in patients with chronic hepatitis C virus (HCV), according results of a study published in the European Journal of Gastroenterology & Hepatology.

Chronic HCV infection is an important health problem that can progress to liver cirrhosis and hepatocellular carcinoma. While percutaneous liver biopsy is the gold standard method for the evaluation of liver fibrosis, it is an invasive procedure that can cause serious complications and is contraindicated in patients with severe ascites and bleeding tendency. Novel inflammatory biomarkers (eg mean platelet distribution, red cell distribution width, mean platelet volume) derived from complete blood count parameters have previously been used as precursors of outcome in many clinical conditions.

Therefore, researchers investigated whether these complete blood count parameters could be useful in predicting advanced liver fibrosis. Researchers retrospectively analyzed from 81 patients who underwent percutaneous liver biopsy due to chronic HCV infection. Of these patients, 38 were in the mild fibrosis group and 43 were in the severe fibrosis group.

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Results found that mean platelet volume, mean platelet volume to lymphocyte ratio, MPR, and red cell distribution width to platelet ratio of the severe fibrosis group were significantly higher than those of the mild fibrosis group (p<0.05 for all). In the Receiver operating characteristic (ROC) curve analysis, MPR showed the biggest area under the curve in the prediction of advanced fibrosis, and was therefore found to be superior to the aspartate aminotransferase to platelet ratio index and fibrosis-4 (FIB-4).

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The study authors concluded that, “As a simple and practical biomarker, MPR was found to be useful in predicting severe fibrosis in chronic HCV.” However, large prospective studies are needed to validate the correlation between MPR and fibrosis in chronic HCV patients.


Gozdas HT, Ince N. Elevated mean platelet volume to platelet ratio predicts advanced fibrosis in chronic hepatitis C. Eur J Gastroenterol Hepatol 2020:32:524–527.