Optimizing the Use of the Gamma-Glutamyl Transpeptidase-to-Platelet Ratio and Transient Elastography to Identify Liver Cirrhosis in Patients with Chronic Hepatitis B Concurrent with Nonalcoholic Fatty Liver Disease

Table 2

Diagnostic performance of TE, GPR, APRI, and FIB-4 in CHB patients with NAFLD for significant fibrosis and cirrhosis assessment.

Variables	TE	GPR	APRI	FIB-4
Significant fibrosis assessment ()
Cutoff value	5.3 kPa	0.15	0.23	0.46
AUC	0.80 (0.73, 0.86)	0.69 (0.61, 0.76)	0.67 (0.58, 0.74)	0.66 (0.58, 0.74)
Sensitivity (%)	90.3 (81.0, 96.0)	90.3 (81.0, 96.0)	90.3 (81.0, 96.0)	90.3 (81.0, 96.0)
Specificity (%)	38.4 (27.2, 50.5)	27.4 (17.6, 39.1)	13.7 (6.8, 23.8)	15.1 (7.8, 25.4)
PPV (%)	59.1 (49.3, 68.4)	55.1 (45.7, 64.3)	50.8 (41.8, 59.7)	51.2 (42.2, 60.1)
NPV (%)	80.0 (63.1, 91.6)	74.1 (53.7, 89.9)	58.8 (32.9, 81.6)	61.1 (35.7, 82.7)
Positive LR	1.46 (1.2, 1.8)	1.24 (1.1, 1.5)	1.05 (0.9, 1.2)	1.06 (0.9, 1.2)
Negative LR	0.25 (0.1, 0.5)	0.35 (0.2, 0.8)	0.71 (0.3, 1.8)	0.65 (0.3, 1.6)
Cirrhosis assessment ()
Cutoff value	10.7 kPa	0.56	0.68	1.58
AUC	0.95 (0.90, 0.98)	0.85 (0.78, 0.90)	0.77 (0.70, 0.84)	0.77 (0.70, 0.84)
Sensitivity (%)	80.0 (56.3, 94.3)	65.0 (40.8, 84.6)	40.0 (19.1, 63.9)	35.0 (15.4, 59.2)
Specificity (%)	91.2 (84.8, 95.5)	90.4 (83.8, 94.9)	90.4 (83.8, 94.9)	90.4 (83.8, 94.9)
PPV (%)	59.3 (38.8, 77.6)	52.0 (31.3, 72.2)	40.0 (19.1, 63.9)	36.8 (16.3, 61.6)
NPV (%)	96.6 (91.5, 99.1)	94.2 (88.4, 97.6)	90.4 (83.8, 94.9)	89.7 (83.0, 94.4)
Positive LR	9.09 (5.0, 16.7)	6.77 (3.6, 12.7)	4.17 (1.9, 8.9)	3.65 (1.6, 8.1)
Negative LR	0.22 (0.09, 0.5)	0.39 (0.2, 0.7)	0.66 (0.5, 1.0)	0.72 (0.5, 1.0)

The cutoff value was determined to achieve a sensitivity of 90% in predicting significant fibrosis and a specificity of 90% in predicting cirrhosis. Data in parentheses were 95% confidence interval. TE: transient elastography; GPR: gamma-glutamyl transpeptidase-to-platelet ratio; APRI: aspartate aminotransferase- (AST-) to-platelet ratio index; FIB-4: fibrosis-4; AUC: area under the ROC curve; PPV: positive predictive value; NPV: negative predictive value; LR: likelihood ratio.