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We read with great interest the recent article by Lemoine et al,1 whereby a novel biochemical-based score was able to accurately estimate liver fibrosis among patients chronically infected with HBV in West Africa. The γ-glutamyl transpeptidase (GGT)-to-platelet ratio (GPR) has several attractive features, including parameters that are easy to quantify, a straightforward calculation, and more importantly, much lower cost than other non-invasive methods. Yet as the authors conclude, the GPR needs further evaluation in other patient populations and one of utmost importance in resource-limited settings would be those co-infected with HBV and HIV.2
We explored data from a previous validation study among HIV-HBV co-infected patients in which non-invasive biomarkers were used to predict liver fibrosis. From 2002 to 2005, a subset of patients from the French HIV-HBV Cohort underwent liver biopsies during follow-up, as detailed elsewhere.3 Of them, 95 without additional hepatitis C or D virus infection had available GPR, FibroTest (Biopredictive, Paris, France), aspartate transaminase-to-platelet ratio index (APRI), and fibrosis-4 (Fib-4) scores. Patients were a median 44 years old (IQR=39–48) and almost all male (93.7%). The overwhelming majority were antiretroviral (ARV)-experienced (95.8%) with 81 (85.3%) undergoing ARV-therapy at the time of biopsy. Accordingly, 36 …
Contributors AB and JB were responsible for data management, performed statistical analysis and drafted the manuscript. KL was responsible for oversight of the French HIV-HBV Cohort and provided critical edits of the manuscript. All authors approved the final version of the manuscript.
Funding This work was supported in part by the Institut de Médecine et d'Epidémiologie Appliquée and received additional grants from ANRS (Agence Nationale de Recherche sur le Sida et les Hépatites). Gilead Sciences provided an unrestricted grant for the French HIV-HBV cohort and was not involved in any part of the data collection, analysis, and writing. Postdoctoral fellowships from the ANRS and SIDACTION were awarded to AB.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Hôpital Pitié-Salpêtrière and Hôpital Saint-Antoine Ethics Committees (Paris, France).
Provenance and peer review Not commissioned; externally peer reviewed.
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