Comparison of the non-invasive ADVIA Centaur ELF test results and FibroScan fibrosis stage results to develop appropriate diagnosis of severity of liver fibrosis

Abstract

Background: Progressive liver fibrosis is a major cause of morbidity and mortality throughout the world. The transient elastography (FibroScan) is a new, non-invasive, rapid, and reproducible method allowing evaluation of liver fibrosis by measurement of liver stiffness. In cirrhotic patients, liver stiffness measurements range from 12.5 to 75.5 kPa. The ADVIA Centaur ELF test measures liver fibrosis based on concentrations of PIIINP, a marker of early fibrogenesis and inflammation, TIMP-1, the circulating inhibitor ofMMPenzymes that canenhancefibrogenesis, and HA, a glycosaminoglycan that is produced by hepatic stellate cells; together, they are a good measure for qualitative and quantitative changes in the liver extracellular matrix (ECM). Methods: This study included 43 patients with chronic HCV, 5 patients with HIV and HCV, and 2 patients with HBV, for whom FibroScan results were investigated for ELF test. ELF score =2.278+0.851 ln(CHA) +0.751 ln(CPIIINP) + 0.394 ln(CTIMP-1), where C is concentration (ng/mL). Findings: According the ELF score, HIV/HCV infected patients had a little higher fibrosis stage compared with the results of the FibroScan. In HCV-infected patients, much more characteristic fibrosis stage was observed compared with FibroScan. The biggest alteration was found in HBV infected patients with escape mutations. According the ELF score, these patients had severe fibrosis stage, but according to the FibroScan, the fibrosis was at F0 stage. In these patients, about 2000 IU/mLHBsAg titerwas regularlymeasured. Higher HA/PIIINP ratio was observed in patients with higher ELF score than FibroScan stage, and the TIMP-1/PIIINP ratio was characteristically lower in HIV/HCV infected patients. Interpretation: In conjunction with other laboratory findings and clinical assessments, the non-invasive ELF test is an aid in the diagnosis and assessment of the severity of liver fibrosis in patients with signs and symptoms of chronic liver disease.