الفهرس 
Validation of gamma-glutamyl transpeptidase to platelet ratio (GPR) and absolute count and CD4 cell percentage discordance the prediction of liver fibrosis in HCV/HIV Co-infected patients.
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Abstract
Background: Significant fibrosis is the hallmark of progressive nature of chronic HCV/HIV co-infection. Therefore, it is fundamentally important to detect significant fibrosis accurately for decision on subsequent clinical management. The reliance on invasive liver biopsy to stage disease is diminishing with the advent of robust blood and imaging-based non-invasive methods, which can reliably stage disease in many cases. A recently introduced index GPR and CD4 count/percentage relationship.
Aim of work: To validate the diagnostic accuracy of GPR ratio and CD4 count/percentage relationship in the assessment of liver fibrosis in HCV/HIV co-infected patients.
Methods: In this cross sectional study, 150 eligible patients with confirmed HCV/HIV co-infection were subjected for demographic, clinical, laboratory and abdominal ultrasound for assessment. APRI, FIB4, GPR and CD4 count/percentage relationship were assessed for all patients and compared with Fibroscan results.
Results:Overall, 136 were males (90.7%). The mean age was 33.47±8.16 years. Eighteen patients had significant liver fibrosis (≥ F2) as evident by Fibroscan (12%). APRI, FIB-4, GPR, high and very high discordance showed good performance in prediction of significant fibrosis with AUR 0.954, 0.946, 0.774 and 0.901 for the cutoffs 0.775, 1.66, 0.535 and 7.70 respectively. These results were compared with the performance of the Fibroscan that has diagnostic value 79.8% to liver biopsy.