Performance of GPR score for non-invasive assessment of liver fibrosis in chronic hepatitis B Tunisian patients

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Published Oct 8, 2024
https://doi.org/10.62438/tunismed.v102i10.5091
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Vol. 102 No. 10 (2024): Tunis Med oct 2024

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Ikbel Ghachem
Medical analysis laboratory, Mohamed Taher Maamouri Hospital, Nabeul. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis,Tunisia
https://orcid.org/0000-0003-3909-3868
Lamine Hamzaoui
Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis,Tunisia
Asma Bachali
Medical analysis laboratory, Mohamed Taher Maamouri Hospital, Nabeul. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis,Tunisia
Chayma Rhimi
Medical analysis laboratory, Mohamed Taher Maamouri Hospital, Nabeul. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis,Tunisia
Mouna Medhioub
Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis,Tunisia
Moufida Mahmoudi
Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis,Tunisia
Amal Khsiba
Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis,Tunisia
Mohamed Msaddak Azouz
Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis,Tunisia

Abstract

Introduction: Several non-invasive tests (NIT) have been reported for predicting liver fibrosis to avoid percutaneous liver biopsy (PLB).


Aim: To evaluate the performance of NIT in Tunisian patients with chronic hepatitis B (CHB).


Methods : We calculated the ASAT/platelet ratio index (APRI), GGT-to-platelet ratio (GPR), Fibrosis-4 score (FIB-4), and RDW/platelet ratio (RPR). The accuracy of NIT was compared with the Metavir score for the detection of liver fibrosis stage using the area under the ROC curves (AUROC).


Results : Seventy-seven CHB patients were included. For predicting significant fibrosis, the AUROC of GPR (0.81; CI95% [0.68-0.93]; P < 0.001) was significantly higher than that of RPR (0.67; CI95% [0.52-0.82]; P = 0.03) and FIB-4 (0.746; CI95% [0.61-0.88]; P = 0.002), but was similar to APRI (0.88; CI95% [0.79-0.97]; P < 0.001). For advanced fibrosis, the AUROC of GPR (0.93; CI95% [0.84–1]; P < 0.001) was higher than that of RPR (0.83; CI95% [0.69–0.97]; P < 0.001) and FIB-4 (0.88; CI95% [0.76–0.99]; P < 0.001), but similar to APRI (0.93; CI95% [0.87–0.99]; P < 0.001). For predicting cirrhosis, the AUROC of GPR (0.98; CI95% [0.95-1]; P < 0.001) was higher than that of APRI (0.95; CI95% [0.90-1]; P = 0.02), similar to RPR (0.99; CI95% [0.98-1]; P < 0.001) but lower than that of FIB-4 (1; CI95% [1-1]; P < 0.001). In multivariate analysis, APRI (OR = 3.78; P = 0.002) and FIB-4 (OR = 2.65; P = 0.01) were independent predictors of significant fibrosis...( abstract truncated at 250 words).

Keywords:

chronic hepatitis B, liver fibrosis, gamma-glutamyl transpeptidase-to-platelet ratio, non-invasive biomarker

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