Diagnostic accuracy of enhanced liver fibrosis test to assess liver fibrosis in patients with chronic hepatitis C

Catanzaro, R; Milazzo, Michele; Arona, S.; Sapienza, C.; Vasta, D.; Arcoria, D; Marotta, Francesco

doi:10.1016/s1499-3872(13)60079-x

Cited by 18 publications

(23 citation statements)

References 26 publications

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“…Moreover, NIBMs are less accurate in detecting intermediate stages of fibrosis than cirrhosis with a mean standardized AUROC for diagnosis of fibrosis/cirrhosis of 0.76-0.89 and the sensitivities and specificities ranged between 50 and 90%. 8,10,13,[58][59][60][61][62][63][64][65] Resolution of established liver fibrosis might take several years to occur. 66,67 Earlier findings from animal models of chronic liver disease alongside a growing evidence from clinical studies evaluated early changes in dynamic fibrosis-related parameters during DAA based therapy using the enhanced liver fibrosis (ELF) panel, combined with liver stiffness measurement.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive biomarkers predict improvement in liver fibrosis after successful generic DAAs based therapy of chronic hepatitis C in Egypt

El‐Wahab

Ayoub

Shorbila

et al. 2020

Clinical Epidemiology and Global Health

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Background: The scale of HCV problem in Egypt prioritized the development of a national control strategy that employs the use of locally manufactured generic direct-acting antivirals (DAAs). Achieving sustained virologic response in chronic HCV patients is the key for preventing fibrosis progression and ultimately its resolution. Objective(s): To evaluate impact of generic DAAs on liver fibrosis in chronic HCV patients using some noninvasive biomarkers (NIBMs). Methods: A total of 280 chronic HCV patients (18 treatment experienced and 262 naive) were enrolled and received the standard of care. All patients were clinically evaluated before starting treatment and at 4, 12 and 24 weeks of treatment. Results: The sensitivity and the specificity of the tested NIBMs for predicting cirrhosis versus liver ultrasound ranged between 75.0-79.6% and 59.4-67.2% respectively. All NIBMs showed significant linear decline during the treatment and follow up periods among responders but tended to fluctuate in values toward an increase among non-responders. In cox regression analysis, normal baseline ALT, AST, total serum cholesterol, serum albumin, WBCS, prothrombin activity and early stages of liver fibrosis predicted improvement in liver fibrosis by 1.5-2 folds. The mean probability of recovery at 1, 3, 6 months varied between the different scores and ranged from 0.059 to 0.637, 0.125-0.741, 0.538-0.951 respectively. Conclusion:The results provide prognostic data on the improvement in liver fibrosis over the treatment course and follow up periods without the need for a liver biopsy. Early detection and management of HCV infection should be emphasized to maximize the benefits of the treatment. Recently many noninvasive biomarkers (NIBMs) for assessing liver fibrosis have been developed, and are frequently used in clinical

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Section: Discussionmentioning

confidence: 99%

Noninvasive biomarkers predict improvement in liver fibrosis after successful generic DAAs based therapy of chronic hepatitis C in Egypt

El‐Wahab

Ayoub

Shorbila

et al. 2020

Clinical Epidemiology and Global Health

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“…Therefore, the premise of this scoring system is that a higher score will indicate a higher rate of fibrogenesis. ELF ® has been shown to have good performance for the detection of significant fibrosis in chronic HCV (93% sensitivity and 83% specificity)[58] but also in NAFLD (sensitivity 89% and specificity 96%) and ALD (100% sensitivity and 16.7% specificity)[59], although results for the latter two have been less rigorously evaluated. Results also need to be adjusted appropriately as scores can be influenced by gender, age, and sex[60].…”

Section: Non-invasive Techniquesmentioning

confidence: 99%

Hepatic steatosis and fibrosis: Non-invasive assessment

Karanjia¹,

Crossey²,

Cox³

et al. 2016

WJG

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Chronic liver disease is a major cause of morbidity and mortality worldwide and usually develops over many years, as a result of chronic inflammation and scarring, resulting in end-stage liver disease and its complications. The progression of disease is characterised by ongoing inflammation and consequent fibrosis, although hepatic steatosis is increasingly being recognised as an important pathological feature of disease, rather than being simply an innocent bystander. However, the current gold standard method of quantifying and staging liver disease, histological analysis by liver biopsy, has several limitations and can have associated morbidity and even mortality. Therefore, there is a clear need for safe and non-invasive assessment modalities to determine hepatic steatosis, inflammation and fibrosis. This review covers key mechanisms and the importance of fibrosis and steatosis in the progression of liver disease. We address non-invasive imaging and blood biomarker assessments that can be used as an alternative to information gained on liver biopsy.

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“…Further investigation of ELF in HCV in populations where the spectrum of disease reflects that seen in primary care is required. The heterogenous aetiology of this cohort has also been criticized, 56 and subsequently, further validation in HCV exclusive cohorts has been undertaken. One independent validation study recruited patients in three different cohorts.…”

Section: Current Clinical Uses Of Elfmentioning

confidence: 99%

A review of the clinical utility of the Enhanced Liver Fibrosis test in multiple aetiologies of chronic liver disease

Patel¹,

Connoley

Rhodes³

et al. 2019

Ann Clin Biochem

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The rising incidence of chronic liver disease continues to be an increasing health burden. The morbidity and mortality associated with chronic liver disease typically occur in patients with advanced fibrosis. Hence, early identification of those at-risk is of vital importance to ensure appropriate ongoing management. Currently, tools for appropriate risk stratification remain limited. Increasing awareness of the limitations of liver biopsy has driven research into alternative non-invasive methods of fibrosis assessment including serological markers assessing functional changes. One such biomarker, the Enhanced Liver Fibrosis test, was initially validated in a cohort of 1021 patients with mixed aetiology chronic liver disease and shown to perform well. Since this pathfinder study, it has been independently validated in cohorts of hepatitis C, non-alcoholic fatty liver disease, alcoholic liver disease, primary biliary cirrhosis and primary sclerosing cholangitis. In addition to performing well as a diagnostic tool, the Enhanced Liver Fibrosis test has been shown to outperform liver biopsy in prognostic studies and is the only non-invasive marker to do so. However, questions remain regarding the use of this test, particularly regarding the possible effect age and alcohol may have on test scores. This review examines the current literature published in relation to the Enhanced Liver Fibrosis test and its clinical utility and highlights areas requiring further study.

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Diagnostic accuracy of enhanced liver fibrosis test to assess liver fibrosis in patients with chronic hepatitis C

Cited by 18 publications

References 26 publications

Noninvasive biomarkers predict improvement in liver fibrosis after successful generic DAAs based therapy of chronic hepatitis C in Egypt

Noninvasive biomarkers predict improvement in liver fibrosis after successful generic DAAs based therapy of chronic hepatitis C in Egypt

Hepatic steatosis and fibrosis: Non-invasive assessment

A review of the clinical utility of the Enhanced Liver Fibrosis test in multiple aetiologies of chronic liver disease

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