In the studies by Dong et al.44 and Peng et al.45 for HBeAg-positive CHB, GPR was better than APRI in predicting advanced fibrosis and cirrhosis but was comparable to FIB-4 in distinguishing significant fibrosis, advanced fibrosis and cirrhosis; however, for HBeAg-negative CHB, the predictive performance of GPR in assessing significant fibrosis, advanced fibrosis and cirrhosis was comparable to that of FIB-4 and APRI. This evidence concerns the gene ALDH18A1 and fibrosis.