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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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