Assessment of liver fibrosis with the gamma-glutamyl transpeptidase to platelet ratio: a multicentre validation in patients with HBV infection

We read with interest the study by Lemoine et al 1 in which the gamma-glutamyl transpeptidase (GGT) to platelet ratio (GPR) was developed to stage fibrosis in patients with chronic hepatitis B (CHB). This study concluded that GPR is more accurate than the aspartate aminotransferase to platelet ratio index (APRI) and Fib-4 to stage liver fibrosis in patients with CHB. As China is a highly endemic area of CHB with estimated >74 million hepatitis B surface antigen (HBsAg)-positive patients,2 3 we conducted this multicentre study to validate the diagnostic performance of GPR in Chinese patients with CHB. Treatment-naive patients with positive HBsAg who underwent liver biopsy, Fibroscan (FS402, Echosens, France) and blood tests were included from three centres (Huai’an Fourth People’s Hospital, Huai’an, China (January 2012–April 2016), Beijing You-An Hospital, Capital Medical University, Beijing, China (January 2014–June 2016) and Hepatology Hospital of Jilin …