Prevalence of liver fibrosis and risk factors in a general population using non-invasive biomarkers (FibroTest)

Abstract

BackgroundFibroTest and elastography have been validated as biomarkers of liver fibrosis in the most frequent chronic liver diseases and in the fibrosis screening of patients with diabetes. One challenge was to use them for estimating the prevalence of fibrosis, identifying independent risk factors and to propose screening strategies in the general population.MethodsWe prospectively studied 7,463 consecutive subjects aged 40 years or older. Subjects with presumed advanced fibrosis (FibroTest greater than 0.48) were re-investigated in a tertiary center.ResultsThe sample characteristics were similar to those of the French population. FibroTest was interpretable in 99.6%. The prevalence of presumed fibrosis was 2.8%, (209/7,463), including cirrhosis in 0.3% (25/7,463); 105/209 (50%) subjects with presumed fibrosis accepted re-investigation. Fibrosis was confirmed in 50, still suspected in 27, indeterminate in 25 and not confirmed with false positive FibroTest or false negative elastography in 3 subjects. False negative rate of FibroTest estimated using elastography was 0.4% (3/766). The attributable causes for confirmed fibrosis were both alcoholic and nonalcoholic fatty liver disease (NAFLD) in 66%, NAFLD in 13%, alcohol in 9%, HCV in 6%, and other in 6%. Factors independently associated (all P < 0.003) with confirmed fibrosis were age, male gender, waist circumference, HCV antibody and alcohol consumption estimated using carbohydrate-deficient transferrin, enabling efficient screening-oriented strategies to be compared and proposed.ConclusionsBiomarkers have permitted to estimate prevalence of advanced fibrosis around 2.8% in a general population aged 40 years or older, and several risk factors which may be used for the validation of selective or non-selective screening strategies.

Hepatic Steatosis, Fibrosis, and Cancer in Elderly Cadavers

“…This incidence is higher than the 10% incidence observed in Asian young adults with NASH or 14.4 % (septal/bridging fibrosis combined) in NAFLD patients, as assessed by histopathology (Gramlich et al, 2004;Tsang et al, 2006). It is also markedly higher than the 2.8% bridging fibrosis reported in French young adults or 6% in European young adult HCV patients coinfected with HIV, as estimated by FibroTest V R (Martín-Carbonero et al, 2009;Poynard et al, 2010).…”

Developing a ‘traffic light’ test with potential for rational early diagnosis of liver fibrosis and cirrhosis in the community

“…A French study of FibroTest (known as FibroSure in the US, is a patented biomarker test that uses the results of six blood serum tests to generate a score that is correlated with the degree of liver damage in people with a variety of liver disease) and elastography in 7463 normal subjects found that 2.8% had evidence of liver fibrosis. 14 In the ALDDeS study, around 14% of hazardous drinkers had a red traffic light. 15 The study considers their range of estimates for fibrosis of 8-20% is reasonable for a high-risk community group.…”

Concordance of transient elastography and shear wave elastography for measurement of liver stiffness

“…1 Liver injury arises from a wide range of causes such as alcohol and drug abuse, viral hepatitis, medications and obesity that cause excessive accumulation of extracellular matrix proteins within the liver parenchyma leading to fibrosis and eventually cirrhosis. 2 Historically, the gold standard for determining the degree of fibrosis was liver biopsy; which can be painful, expensive, has a risk of haemorrhage and requires assessment by a pathologist.…”