Evidence map›Paper›PMID 26109530›Full record

ArticleGut2016

The gamma-glutamyl transpeptidase to platelet ratio (GPR) predicts significant liver fibrosis and cirrhosis in patients with chronic HBV infection in West Africa.

Maud Lemoine, Yusuke Shimakawa, Shevanthi Nayagam, Mustapha Khalil, Penda Suso, Jo Lloyd, Robert Goldin, Harr-Freeya Njai, Gibril Ndow, Makie Taal and 7 more

Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Gut, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02129829 (Prevention of Liver Fibrosis and Cancer in Africa. Observational Study of Screening, Assessment and Treatment for Chronic Hepatitis B Virus Infection), which is not on this map. Cited by 192 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
192citing papers in PubMed, 4 pooled it
17.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02129829 completednot on this map

Prevention of Liver Fibrosis and Cancer in Africa. Observational Study of Screening, Assessment and Treatment for Chronic Hepatitis B Virus Infection

TypeobservationalSponsorImperial College LondonRan2011 to 2018Enrolled1,079ConditionsHepatitis B, Chronic, Hepatocellular CarcinomaArmsTenofovir disoproxil
3 · Its place in the literature

Who cites it

192 citing papers in PubMed, 4 syntheses or guidelines pooled it, 357 citations in OpenAlex.

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  6. Increased Frequency of Dysfunctional Siglec-7Frontiers in immunology · 2021
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132 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 9 institutions in 5 countries.

Maud LemoineDepartment of Hepatology, Imperial College London, St Mary's Hospital, London, UK The Gambia Unit, Liver Unit, Medical Research Council, Fajara, The Gambia.
Yusuke ShimakawaThe Gambia Unit, Liver Unit, Medical Research Council, Fajara, The Gambia Emerging Disease Epidemilogy Unit, Institut Pasteur, Paris, France.
Shevanthi NayagamDepartment of Hepatology, Imperial College London, St Mary's Hospital, London, UK.
Mustapha KhalilDepartment of Histopathology, Edward Francis Small Teaching Hospital, Banjul, The Gambia.
Penda SusoDepartment of Histopathology, Edward Francis Small Teaching Hospital, Banjul, The Gambia.
Jo LloydCentre for Pathology, Imperial College London, London, UK.
Robert GoldinCentre for Pathology, Imperial College London, London, UK.
Harr-Freeya NjaiThe Gambia Unit, Liver Unit, Medical Research Council, Fajara, The Gambia.
Gibril NdowThe Gambia Unit, Liver Unit, Medical Research Council, Fajara, The Gambia.
Makie TaalMinistry of Health and Social Welfare, Banjul, The Gambia.
Graham CookeDepartment of infectious disease, Imperial College London, St Mary's Hospital, London, UK.
Umberto D'AlessandroThe Gambia Unit, Liver Unit, Medical Research Council, Fajara, The Gambia.
Muriel VrayEmerging Disease Epidemilogy Unit, Institut Pasteur, Paris, France.
Papa Saliou MbayeDepartment of Hepatology and Gastroenterology, Principal Hospital, Dakar, Senegal.
Ramou NjieThe Gambia Unit, Liver Unit, Medical Research Council, Fajara, The Gambia.
Vincent MalletUniversité Paris Descartes, APHP, Groupe Hospitalier Cochin Port Royal, Institut Pasteur, Paris, France.
Mark ThurszDepartment of Hepatology, Imperial College London, St Mary's Hospital, London, UK.
MRC Unit the Gambia · GMSt Mary's Hospital · GBEdward Francis Small Teaching Hospital · GMImperial College London · GBGroupe Hospitalier Cochin - Port-Royal, Hôtel-Dieu, Broca - La Collégiale · FRHôpital Principal de Dakar · SNInstitut Pasteur · FRMedical Research Council · GBMinistry of Health and Social Welfare · GM

Funding

Medical Research Council MC_UP_A900_1119Medical Research Council MC_UP_A900_1120Medical Research Council MR/L002086/1
6 · The paper itself

Abstract

backgroundSimple and inexpensive non-invasive fibrosis tests are highly needed but have been poorly studied in sub-Saharan Africa.

methodsUsing liver histology as a gold standard, we developed a novel index using routine laboratory tests to predict significant fibrosis in patients with chronic HBV infection in The Gambia, West Africa. We prospectively assessed the diagnostic accuracy of the novel index, Fibroscan, aspartate transaminase-to-platelet ratio index (APRI), and Fib-4 in Gambian patients with CHB (training set) and also in French and Senegalese CHB cohorts (validation sets).

resultsOf 135 consecutive treatment-naïve patients with CHB who had liver biopsy, 39% had significant fibrosis (Metavir fibrosis stage ≥F2) and 15% had cirrhosis (F4). In multivariable analysis, gamma-glutamyl transpeptidase (GGT) and platelet count were independent predictors of significant fibrosis. Consequently, GGT-to-platelet ratio (GPR) was developed. In The Gambia, the area under the receiver operating characteristic curve (AUROC) of the GPR was significantly higher than that of APRI and Fib-4 to predict ≥F2, ≥F3 and F4. In Senegal, the AUROC of GPR was significantly better than Fib-4 and APRI for ≥F2 (0.73, 95% CI 0.59 to 0.86) and better than Fib-4 and Fibroscan for ≥F3 (0.93, 0.87 to 0.99). In France, the AUROC of GPR to diagnose ≥F2 (0.72, 95% CI 0.59 to 0.85) and F4 (0.87, 0.76 to 0.98) was equivalent to that of APRI and Fib-4.

conclusionsThe GPR is a more accurate routine laboratory marker than APRI and Fib-4 to stage liver fibrosis in patients with CHB in West Africa. The GPR represents a simple and inexpensive alternative to liver biopsy and Fibroscan in sub-Saharan Africa.

Indexed as

gamma-GlutamyltransferaseHepatitis B, ChronicLiver CirrhosisAdultAfrica, WesternArea Under CurveBiomarkersBiopsyDimensional Measurement AccuracyFemaleHumansLiverMaleMiddle AgedPatient AcuityPlatelet CountBiomarkersgamma-GlutamyltransferaseFIBROSISHEPATITIS B

Identifiers

PMID26109530
PMCPMC4975834
OpenAlexW1945511967

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.