Article Abstract

Diagnostic accuracy of enhanced liver fibrosis (ELF) test for significant fibrosis in patients with autoimmune hepatitis

Authors: Merve Sibel Gungoren, Cumali Efe, Taylan Kav, Filiz Akbiyik


Background: Although, liver biopsy is currently the gold standard tool for monitoring fibrosis progression, it is an invasive method and associate with some minor and major complications. Several non-invasive markers have been developed for assessment of liver fibrosis, but their validity has not been well studied in autoimmune hepatitis (AIH). The enhanced liver fibrosis (ELF) test is an alternative, non-invasive method for monitoring fibrosis progression. In this study, we evaluated performance of ELF test for predicting fibrosis stage in patients with AIH.
Methods: Serum samples of 46 consecutive patients who were diagnosed with AIH were analyzed, and calculated for ELF scores. All patients underwent a liver biopsy. Patients with ≥F2 were considered to have a significant fibrosis according to the METAVIR scoring system. Diagnostic accuracy of ELF was evaluated with the receiver operator characteristic (ROC) curves analysis.
Results: The mean ELF scores were significantly higher in patients with significant fibrosis that those with mild fibrosis (10.60±1.39 vs. 8.62±1.05, P<0.001). For significant fibrosis (≥F2), 8.84 cut-off point had 0.92 sensitivity, 0.78 specificity, 0.94 negative predictive values (NPV), 0.70 positive predictive values (PPV) and area under curve (AUC) was 0.89.
Conclusions: The ELF test differentiates significant from non-significant liver fibrosis. Our results suggest that the ELF test can be a promising non-invasive method for monitoring fibrosis progression in AIH.