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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
  1. Anders Boyd1,
  2. Julie Bottero1,2,
  3. Karine Lacombe2,3
  1. 1 INSERM, UMR_S1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
  2. 2 Service des maladies infectieuses et tropicales, Hôpital Saint-Antoine, AP-HP, Paris, France
  3. 3 Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (iPLESP UMRS–1136), Paris, France
  1. Correspondence to Dr Anders Boyd, Service des Maladies Infectieuses et Tropicales; Hôpital Saint-Antoine, 184 rue du Fbg. St. Antoine, Paris Cedex 12 75571, France; anders.boyd{at}

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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 …

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