The γ-glutamyl transpeptidase-to-platelet ratio as a predictor of liver fibrosis in patients co-infected with HBV and HIV

Boyd, Anders; Bottéro, J.; Lacombe, Karine

doi:10.1136/gutjnl-2015-310607

Cited by 15 publications

(17 citation statements)

References 8 publications

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“…Some researchers have done studies to validate the diagnostic accuracy of the GPR in CHB patients with such conditions. For example, Boyd et al reported that in a French HBV/HIV co-infected cohort, the GPR showed reasonable performance for identifying significant liver fibrosis [9]. Stockdale and colleagues subsequently reported that the GPR shows poor correlation with FibroScan measurements of liver fibrosis in HBV/HIV co-infected patients in West Africa [10].…”

Section: Introductionmentioning

confidence: 99%

The gamma-glutamyl transpeptidase to platelet ratio for non-invasive assessment of liver fibrosis in patients with chronic hepatitis B and non-alcoholic fatty liver disease

et al. 2017

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Background/AimThe gamma-glutamyl transpeptidase-to-platelet ratio (GPR) is a novel serum model, which was reported more accurate than aspartate transaminase-to-platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4) for diagnosing significant fibrosis and cirrhosis in HBV mono-infection in West Africa. We aimed to evaluate the diagnostic performance of GPR for liver fibrosis in patients with chronic hepatitis B (CHB) and non-alcoholic fatty liver disease (NAFLD).ResultsOf 131 patients, 41 (31.3%), 20 (15.3%), and 10 (7.6%) were classified as having significant fibrosis, severe fibrosis and cirrhosis, respectively. To predict significant fibrosis, the AUROC of GPR was higher than that of APRI (0.86 vs 0.75, p = 0.001) and FIB-4 (0.86 vs 0.66, p < 0.001). To predict severe fibrosis, the AUROC of GPR was also higher than that of APRI (0.89 vs 0.77, p = 0.002) and FIB-4 (0.89 vs 0.72, p = 0.001). To predict cirrhosis, no difference was found between the AUROC of GPR and that of APRI (0.92 vs 0.86, p = 0.104).Materials and Methods131 patients with CHB-NAFLD were included, and the diagnostic performances of GPR, APRI and FIB-4 were compared by receiver operating characteristic (ROC) curves and the area under ROC curves (AUROCs).ConclusionsThe GPR could be used as a non-invasive marker to predict liver fibrosis and cirrhosis in CHB-NAFLD individuals.

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Section: Introductionmentioning

confidence: 99%

The gamma-glutamyl transpeptidase to platelet ratio for non-invasive assessment of liver fibrosis in patients with chronic hepatitis B and non-alcoholic fatty liver disease

et al. 2017

Oncotarget

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“…In the study by Lemoine et al., GPR showed higher accuracy than APRI and Fib‐4 in identifying significant fibrosis and cirrhosis in West Africa (Gambia cohort and Senegal cohort), but was not superior to APRI and Fib‐4 in a French cohort. Subsequently, in November 2015, Boyd and colleagues reported that GPR showed reasonable performance in identifying significant fibrosis in a French HBV/HIV co‐infected cohort . In January 2016, Stockdale and colleagues subsequently reported that in a West Africa HBV/HIV co‐infected cohort, GPR showed poor correlation with liver fibrosis, and GPR could not be recommended for the diagnosis of advanced fibrosis and cirrhosis in HIV/HBV co‐infected populations in West Africa .…”

Section: Introductionmentioning

confidence: 99%

“…only used transient elastography as a reference, and the difference in reference standards might be the major reason for reaching a contrary conclusion. Furthermore, HIV/HBV infection patients have specific conditions that might predispose to altered GGT or platelet counts, because thrombocytopenia is a common manifestation of HIV infection, and GGT increases with the use of non‐nucleoside reverse transcriptase inhibitors . In a word, GPR was identified as a novel biochemical‐based score, which was able to accurately estimate significant fibrosis and cirrhosis in CHBVI patients in West Africa.…”

Section: Introductionmentioning

confidence: 99%

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The gamma‐glutamyl transpeptidase‐to‐platelet ratio predicts liver fibrosis and cirrhosis in HBeAg‐positive chronic HBV infection patients with high HBV DNA and normal or mildly elevated alanine transaminase levels in China

Huang

et al. 2016

Journal of Viral Hepatitis

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The gamma-glutamyl transpeptidase-to-platelet ratio (GPR) is a new serum diagnostic model, which is reported to be more accurate than aspartate transaminase-to-platelet ratio index (APRI) and fibrosis index based on the four factors (Fib-4) for the diagnosis of significant fibrosis and cirrhosis in chronic HBV infection (CHBVI) patients in West Africa. To evaluate the performance of the GPR model for the diagnosis of liver fibrosis and cirrhosis in HBeAg-positive CHBVI patients with high HBV DNA (≥5 log copies/mL) and normal or mildly elevated alanine transaminase (ALT) (≤2 times upper limit of normal (ULN)) in China. A total of 1521 consecutive CHBVI patients who underwent liver biopsies and routine laboratory tests were retrospectively screened. Of these patients, 401 treatment naïve HBeAg-positive patients with HBV DNA≥5 log copies/mL and ALT≤2 ULN were included. The METAVIR scoring system was adopted as the pathological diagnosis standard of liver fibrosis. Using liver histology as a gold standard, the performances of GPR, APRI, and Fib-4 for the diagnosis of liver fibrosis and cirrhosis were evaluated and compared by receiver operating characteristic (ROC) curves and the area under the ROC curves (AUROCs). Of 401 patients, 121 (30.2%), 49 (12.2%) and 17 (4.2%) were classified as having significant fibrosis (≥F2), severe fibrosis (≥F3) and cirrhosis (=F4), respectively. After estimating the AUROC to predict significant fibrosis, the performance of GPR (AUROC=0.66, 95% CI 0.60-0.72) was higher than APRI (AUROC=0.58, 95% CI 0.52-0.64, P=.002) and Fib-4 scores (AUROC=0.54, 95% CI 0.47-0.60, P<.001). After estimating the AUROC to predict severe fibrosis, the performance of GPR (AUROC=0.71, 95% CI 0.63-0.80) was also higher than APRI (AUROC=0.65, 95% CI 0.56-0.73, P=.003) and Fib-4 scores (AUROC=0.67, 95% CI 0.58-0.75, P=.001). After estimating the AUROC to predict cirrhosis, the performance of GPR (AUROC=0.73, 95% CI 0.56-0.88) was higher than APRI (AUROC=0.69, 95% CI 0.54-0.83, P=.041) and Fib-4 scores (AUROC=0.69, 95% CI 0.55-0.82, P=.012) too. The GPR is a new serum model for the diagnosis of liver fibrosis and cirrhosis and shows obvious advantages in Chinese HBeAg-positive patients with HBV DNA≥5 log copies/mL and ALT≤2 ULN compared with APRI and Fib-4, thus warranting its widespread use for this specific population.

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“…In their letter, Boyd and colleagues subsequently reported that in a French HBV/HIV coinfected cohort, GPR showed reasonable performance for identifying significant liver fibrosis. 2 HBV and HIV are highly co-endemic in West Africa, and chronic liver disease is an emerging threat to the long-term health of HIV-positive patients in this region. 3 Since 2010, we have been following a prospective cohort of patients attending the HIV clinic at the Komfo Anokye Teaching Hospital in Kumasi, Ghana, where prevalence of HBV co-infection is 14% (95% CI 12.4% to 15.8%).…”

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confidence: 99%

The gamma-glutamyl transpeptidase to platelet ratio (GPR) shows poor correlation with transient elastography measurements of liver fibrosis in HIV-positive patients with chronic hepatitis B in West Africa. Response to: ‘The gamma-glutamyl transpeptidase to platelet ratio (GPR) predicts significant liver fibrosis and cirrhosis in patients with chronic HBV infection in West Africa’ by Lemoineet al

Stockdale

Phillips

Geretti

2016

Gut

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The γ-glutamyl transpeptidase-to-platelet ratio as a predictor of liver fibrosis in patients co-infected with HBV and HIV

Cited by 15 publications

References 8 publications

The gamma-glutamyl transpeptidase to platelet ratio for non-invasive assessment of liver fibrosis in patients with chronic hepatitis B and non-alcoholic fatty liver disease

The gamma-glutamyl transpeptidase to platelet ratio for non-invasive assessment of liver fibrosis in patients with chronic hepatitis B and non-alcoholic fatty liver disease

The gamma‐glutamyl transpeptidase‐to‐platelet ratio predicts liver fibrosis and cirrhosis in HBeAg‐positive chronic HBV infection patients with high HBV DNA and normal or mildly elevated alanine transaminase levels in China

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