Performance of GGT to platelet ratio (GPR) and AST to platelet ratio index (APRI) compared with transient elastography (TE) as reference standard for the diagnosis of advanced fibrosis and cirrhosis in HBV/HIV coinfected patients in West Africa*
| Advanced fibrosis (TE threshold 7.6 kPa) | Cirrhosis (TE threshold 9.4 kPa) | |
|---|---|---|
| GPR | ||
| AUROC (95% CI) | 0.73 (0.61 to 0.85) | 0.71 (0.55 to 0.86) |
| Cut-off values | 0.54 | 0.72 |
| Sensitivity (%) | 61 | 57 |
| Specificity (%) | 72 | 79 |
| Correctly classified (%) | 66 | 77 |
| PPV (%) | 32 | 17 |
| NPV (%) | 89 | 96 |
| Positive LR | 2.2 | 2.7 |
| Negative LR | 0.5 | 0.5 |
| APRI | ||
| AUROC (95% CI) | 0.62 (0.46 to 0.78) | 0.59 (0.32 to 0.85) |
| Cut-off values | 0.57 | 0.70 |
| Sensitivity (%) | 67 | 57 |
| Specificity (%) | 63 | 74 |
| Correctly classified (%) | 64 | 73 |
| PPV (%) | 29 | 14 |
| NPV (%) | 90 | 96 |
| Positive LR | 1.8 | 2.2 |
| Negative LR | 0.5 | 0.6 |
| APRI (WHO threshold)† | ||
| Cut-off values | – | 2.0 |
| Sensitivity (%) | – | 0 |
| Specificity (%) | 99 | |
| Correctly classified (%) | – | 92 |
| PPV (%) | – | 0 |
| NPV (%) | 93 | |
| Positive LR | – | 0 |
| Negative LR | 1.0 | |
*Based on histologically defined interpretive cut-offs for patients with HIV/HBV coinfection as previously described.4
†As recommended in the “Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection (March 2015)”.3
AUROC, area under receiver operating curve; CI, confidence interval; LR, likelihood ratio; NPV, negative predictive value; PPV, positive predictive value.