The performance was compared with five other unpatented scores using ROC curves. Child Pugh Score Calculator for prognosis of liver disease, Lille Score for Alcoholic Hepatitis Calculator. Compared to the Knodell system it provides more detailed information but is less reliable regarding fibrosis. Non-invasive methods of fibrosis assessment, World Health Organization (WHO) guidelines, American Association for the Study of Liver Diseases (AASLD) guidelines, Call TTY if you Fibrosis testing is relevant for the clinical care of patients with chronic liver disease, including hepatitis B, hepatitis C (HCV), non-alcoholic fatty liver disease (NAFLD), co-infections, primary biliary cirrhosis, primary sclerosing cholangitis, and other chronic metabolic diseases of the liver. **Note 8:** If a fibrosis score is stated but the scoring system is not recorded, consult with the physician. High sensitivity and specificity, Acoustic Radiation Force Impulse - measure of liver stiffness. In NAFLD, advanced fibrosis is defined as stage 3 to 4 using the NASH Clinical Research Network system. Liver biopsy has been the gold standard for the assessment of histologic changes in the liver. **Note 2:** FIB-4 is NOT a pathological fibrosis score of 4. Copyright 2018 NAACCR, Inc. All Rights Reserved | See NAACCR Partners and Sponsors. The medical record may show something like "FIB-4 = 3.52." Do not code FIB-4 values in this data item. PBC Score Primary Biliary Cirrhosis This formula developed by investigators at the Mayo Clinic helps calculate the short-term survival probability of a patient with primary biliary cirrhosis. **Note 1:** Physician statement of fibrosis score can be used to code this data item when no other information is available. Do all patients with liver disease need to have fibrosis testing? Cirrhosis, probable or definite Some patients progress slowly for 20 years and then accelerate in later years. [26] Last medically reviewed on April 30, 2019, Hemangiomas of the liver are the most common type of benign liver tumor. Copyright 2001 - 2023 Pediatric Oncall All Rights Reserved. Any of the following histologically confirmed, Clinical statement of advanced/severe fibrosis or cirrhosis, AND, Not applicable: Information not collected for this case. Blockland zombies map pack. **Note 4:** Record the results based on information collected during the initial work-up through the first course surgery, in the absence of neoadjuvant treatment. When to Use Pearls/Pitfalls Why Use Age years BMI kg/m Impaired fasting glucose/diabetes Experts have validated this tool. NAFLD (Non-Alcoholic Fatty Liver Disease) Fibrosis Score - MDCalc Log in to create a list of your favorite calculators! Scientists are also looking for better ways to treat certain causes of liver fibrosis, such as alcohol use or NASH. Prior to the procedure, patients should discontinue all anticoagulants (e.g., coumadin) for at least one week and should not take aspirin or other non-steroidal anti-inflammatory medicines for about one week (patients can take acetaminophen). Although the damage may be limited and reversible when fibrosis is still in an early stage, more advanced fibrosis tends to cause widespread, irreversible damage that eventually leads to cirrhosis. Veterans Crisis Line: Various staging systems for assessment of fibrosis in chronic hepatitis. Treatment can often reverse the effects of mild to moderate fibrosis. The authors argue using a two-step approach of FIB-4 score first could eliminate the need for 87% VCTE examinations and prevent hepatology referrals in 69% of cases. ), Not documented in medical record All Information contained in and produced by the Pediatric Oncall system is provided for educational purposes only. We compared rates of prespecified clinical outcomes of hepatic decompensation and hepatocellular carcinoma across individual Ishak fibrosis stages. Ultrasound-based technique, Moderately convenient if facility has the equipment Advanced/severe fibrosis Batt-Ludwig score 4 Log in NAFLD (Non-Alcoholic Fatty Liver Disease) Fibrosis Score Estimates amount of scarring in the liver based on several laboratory tests. Authors argued that these individuals could potentially have avoided liver biopsy with an overall accuracy of 86%. Ten patients had minimal fibrosis (Ishak score = 1), 9 had mild fibrosis (Ishak score = 2), 10 had moderate fibrosis (Ishak score = 3 or 4), 8 had severe fibrosis and incomplete cirrhosis (Ishak score = 5), and 9 had probable/definite cirrhosis (Ishak score = 6). Some of the most common treatments involve: Scientists have yet to develop medications that directly reverse or treat the damage associated with liver fibrosis. Additionally, funding for this web site content was made possible in part by a cooperative agreement with Federal funds from the Centers for Disease Control and Prevention Cooperative Agreement number 5NU58DP006458. Not histologically confirmed or unknown if histologically confirmed, Not applicable: Information not collected for this case Healthcare providers can use several scales to define the stages of fibrosis. The choice of fibrosis test should take into account: The history, physical exam, routine laboratory tests, and routine abdominal imaging (ultrasound, CT scan, or MRI) will sometimes reveal clear morphological changes of cirrhosis, but are insufficient for determining other stages of fibrosis. While originally developed to detect liver fibrosis among patients with Hepatitis C and HIV, FIB-4 scoring has been increasingly used by the diabetes and NAFLD/NASH communities. Until recently, liver biopsy was the only technique available to detect and stage the degree of fibrosis. **Note 8:** If a fibrosis score is stated but the scoring system is not recorded, consult with the physician. Historically, liver disease has been staged based on the amount of hepatic fibrosis. F2: portal fibrosis with infrequent septa, 1: an expansion of some portal areas, possibly with short, fibrous septa, 2: an expansion of most portal areas, possibly with short, fibrous septa, 3: an expansion of portal areas with sporadic portal-to-portal bridging, 4: an expansion of portal areas with significant portal-to-portal and portal-to-central bridging, 5: significant portal-to-portal and portal-to-central bridging with sporadic nodules, reduce overall function, including the purifying of blood, storing of energy, and clearing of infections, discomfort or mild pain in the upper right abdomen, increased sensitivity to medications and their side effects, problems with certain cognitive functions, such as memory, concentration, or sleeping, nonalcoholic steatohepatitis (NASH), a subtype of NAFLD, stopping or limiting alcohol use and using supportive therapies to help with this in the long-term, treating chronic viral hepatitis infections with antiviral medications, treating NAFLD and NASH by balancing the diet, losing at least, taking medications that remove heavy metals, such as iron and copper, from the body, dissolving or removing bile duct obstructions, stopping the use of medications linked with fibrosis, taking medications that reduce the activity of the immune system, taking medications to remove excess fluid from the body, taking medications to remove toxins from the brain, taking medications that reduce pressure in the veins of the stomach and esophagus, having transplantation surgery to replace the damaged liver with a healthy one from a donor. The most advanced stage of fibrosis is cirrhosis. In contrast, a FIB-4 >3.25 would have a 97% specificity and a positive predictive value of 65% for advanced fibrosis. ARFI generates the shear waves differently and takes different measurements. Hepatology 2006;43:1317-1325. As a result of this, fibrosis can reduce overall liver function and impair the organs ability to regenerate. The advantages of TE include its very rapid results, highly accurate, is non-invasive, reproducible, and is relatively easy to train technicians. Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. Hepatology 1994; 29:15. The advantages of the FIB-4 are the convenience and the low cost as the test is based on AST, ALT, platelet count, and age. Information collected after the start of treatment may not be used to code this data item. This can starve and eventually kill healthy liver cells, creating more scar tissue in the process. Cost is a factor for the FibroSure test as it is expensive. The most common causes of liver fibrosis in the U.S. are: NAFLD and NASH tend to develop in people with excess weight, diabetes, or prediabetes and high levels of fat and cholesterol circulating in the blood. Liver fibrosis often progresses non-linearly, so it is important to be able to re-assess fibrosis trends in individual patients over time. Funding for this web site content was made possible in part by a contract with Federal funds from the National Cancer Institute, National Institutes of Health and Department of Health & Human Services under Contract number 75N91021D00018 / 75N91021F00001. Ishak fibrosis score definition. **Note 4:** AJCC classifies Ishak fibrosis scores 0-4 (none to moderate fibrosis) as F0, and Ishak fibrosis scores 5-6 (cirrhosis/severe fibrosis) as F1. Given the multiple components that go into the NAS and fibrosis scores and the evidence of both intra- and inter-pathologist variability in scoring, there is a need for a precise, efficient,. In 2016, chronic liver disease and cirrhosis led to the deaths of 40,545 people in the U.S. Liver fibrosis develops when chronic injury or inflammation causes scar tissue to build up in the organ, limiting its ability to function and repair itself. **Note 3:** FIB-4 is NOT a pathological fibrosis score of 4. METAVIR score F4 The NAFLD can reduce liver biopsies in those patients predicted to have a low risk of fibrosis by their score: a liver biopsy to determine severity of fibrosis would be required in only 25% of patients with NAFLD, that is, those identified as indeterminate.. For those with progressive fibrosis, the rate of progression can be variable. The APRI does not report on the differing stages of fibrosis. It will appear in the oval on the far right (highlighted in yellow). No to moderate fibrosis Commonly used scoring systems are the Knodell score/Histological Activity Index (HAI), the METAVIR score, and the Ishak score (modified Knodell score). A Word From Verywell The METAVIR score, while having limitations, is a common way to detect and monitor the progression of fibrosis in people with chronic liver disease. 2011 Jan;53(1):325-35. (n.d.). 12 Staging fibrosis is also important so that patients with cirrhosis can be identified early . al. FIB-4 was developed to correlate with Ishak levels of fibrosis (by biopsy) with 3 levels: While liver biopsy is the gold standard for the diagnosis of liver fibrosis, it is not ideal; biopsy only evaluates a minute portion of the liver itself, so sampling errors can occur. At a cutoff of <1.45 in the validation set, the negative predictive value to exclude advanced fibrosis (stage 4-6) was 90% with a sensitivity of 70%. Medical data comprised baseline demographics [race (White, Black, or Other), sex, age at diagnosis (65 years old or >65 years old), year of diagnosis (2010-2011, 2012-2013, or 2014-2015), marital status (married or other), preoperative alpha- fetoprotein (AFP) status (negative/normal or positive/elevated), and fibrosis score (Ishak 0 . Cirrhosis, NOS Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCI and CDC. The blood test "HCV-FibroSure" is a panel of six biochemical markers associated with hepatic fibrosis: alpha-2-macroglobulin, haptoglobin, GGT, apolipoprotein A1, total bilirubin, and ALT. Advanced/severe fibrosis It was developed in a cohort of subjects that did not include the young or very old, so it may not perform as well in those populations given that age is in the numerator. You can read more about the Fibrosis 4 index, its components and formula and about liver fibrosis below the form. . Transient elastography (TE) is an ultrasound-based method that measures the velocity of an elastic shear wave moving through the liver. These initial symptoms can vary, but some of the most common indicators of early cirrhosis include: Some common signs of more advanced cirrhosis include: The best way to treat liver fibrosis is to address the root cause. Other pathological scoring systems in use include the Batts-Ludwig system, which uses scores of 0-4, and the METAVIR system which uses scores of F0-F4. 2. **Note 5:** If a fibrosis score is stated but the scoring system is not recorded, consult with the physician. **Note 1:** Physician statement of fibrosis score can be used to code this data item when no other information is available. How are liver function and cholesterol production linked? How much time does it take for fibrosis progression to occur? The absolute Scheuer staging score difference in 22.22% of . The picture in the upper left of the slide is of a cirrhotic liver. Using Your Liver Stiffness Result to Find YourFibrosis Score Your healthcare provider will use your liver stiffness result and medicalhistory to find out your fibrosis score. The Ishak system [23] is also known as the modified Knodell or modified histology activity index (HAI) score. visit VeteransCrisisLine.net for more resources. Fibrosis score stated but cannot be assigned to codes 0 or 1 There are several scoring systems for evaluating chronic hepatitis, and they all include 2 components: inflammatory activity and degree of fibrosis. The medical record may show something like "FIB-4 = 3.52." (n.d.). **Note 4:** Record the results based on information collected during the initial work-up. The Ishak fibrosis scoring system is more complex, and it typically runs from 0 to 6: Using the Ishak scale, the most advanced stage of fibrosis a person can have before developing cirrhosis is stage 5. It assesses the level of fibrosis (a) where scores range from 0 (no fibrosis). If multiple histologic assessments of the liver (biopsies or resections) are taken and have conflicting scores, record the highest score. Biopsy fragmentation and length as well as number of portal tracts were recorded. For grading, these assign numbers to the severity of the necroinflammatory features (interface . However, research into antifibrotic drugs, which will reduce or prevent the fibrotic process, is ongoing. This is not the same as METAVIR score F0 or F1. For identification of cirrhosis, a platelet count of 140-155 x 109 cells/L is associated with a specificity of 87% and a sensitivity of 78%. * Information collected after the start of neoadjuvant treatment or primary systemic or radiation therapy may not be used to code this data item NASH varies in severity with the most serious cases leading to cirrhosis. The medical record may show something like "FIB-4 = 3.52." Do not code FIB-4 values in this data item. (2D-SHE) identified subjects with significant fibrosis (Ishak score 3) and cirrhosis (Ishak score 5) with a high-performance level (AUC 0.92). Hepatology. Furthermore, biopsy should only be performed after written informed consent has been obtained. **Note 3:** AJCC classifies Ishak fibrosis scores 0-4 (none to moderate fibrosis) as F0, and Ishak fibrosis scores 5-6 (cirrhosis/severe fibrosis) as F1. 5 Diagrammatic representation of the seven stages (0-6) of the Ishak fibrosis score compared to the five stages (0-4) of the Metavir fibrosis score and three stages (1, 3 and 4) of the Knodell score. **Note 5:** To use codes 0 and 1, you must have a histological (microscopic) confirmation of fibrosis/cirrhosis. The METAVIR scoring system is a system used to assess the extent of inflammation and fibrosis by histopathological evaluation in a liver biopsy of patients with hepatitis C . Fibrosis was staged with the Ishak scale (ranging from 0 = no fibrosis to 6 = cirrhosis). However, code 7 when the physician statement of fibrosis score is not based on histologic examination of the liver. Advanced fibrosis and cirrhosis can also cause severe health complications, such as liver cancer, liver failure, and death. The index is calculated as FI = 8.0 - 0.01 PLT (10 9 /l) - serum albumin (g/dL), with an F-Index <2.1 indicating no or minimal fibrosis; F-index 2.1, significant fibrosis, and if F-Index 3.3, significant cirrhosis. All trademarks used are the properties of their respective owners. Developing cirrhosis and subsequently called the Ishak score [16]. 2023 Healthline Media UK Ltd, Brighton, UK. Understanding the fibrosis stage impacts clinical care decisions. Scientists use genetic rewiring to increase lifespan of cells, Beyond amyloid and tau: New targets in developing dementia treatments, Napping longer than 30 minutes linked to higher risk of obesity and high blood pressure, Activity 'snacks' could lower blood sugar, complication risk in type 1 diabetes. In O'Brien et al. This leads to irreversible damage and may cause conditions such as cirrhosis. No input variables or data is transmitted between your computer and our servers. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, https://www.researchgate.net/profile/Raffaele_Capasso/publication/326868514_Milk_thistle_Silybum_marianum_A_concise_overview_on_its_chemistry_pharmacological_and_nutraceutical_uses_in_liver_diseases_Milk_Thistle_and_liver_diseases/links/5be2ab90a6fdcc3a8dc401dd/Milk-thistle-Silybum-marianum-A-concise-overview-on-its-chemistry-pharmacological-and-nutraceutical-uses-in-liver-diseases-Milk-Thistle-and-liver-diseases.pdf, https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis, https://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/evaluation-staging/core-concept/all, https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_05.pdf, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721971/, https://www.sciencedirect.com/science/article/pii/S016882781200044X, http://labmed.ucsf.edu/uploads/472/227_Ferrell,%20LiverUpdateOnStagingOfFibrosisAndCirrhosis.pdf, https://www.karger.com/Article/FullText/445269, https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis/symptoms-causes, https://liverfoundation.org/for-patients/about-the-liver/the-progression-of-liver-disease/, https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/treatment, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721971/table/T2/?report=objectonly, One-hour endoscopic procedure could eliminate the need for insulin for type 2 diabetes, New clues to slow aging? Ishak uses a scale of 0-6 with 6 indicating cirrhosis. (Fig.2F; 2F; Materials and Methods). This is not the same as METAVIR score F0 or F1. This information should not be used for the diagnosis or treatment of any health problem or disease. Not all patients develop fibrosis and those who do may not progress to advanced stages. This is a health tool designed to determine significant fibrosis and cirrhosis of the liver with the FIB 4 index in conditions such as NASH (non-alcoholic steatohepatitis) or HCV (hepatitis C virus). METAVIR score F0-F3 This is a non invasive method based on clinical determinations that indicate the level of fibrosis/ scarring of the liver. This Fibrosis 4 Fib4 score calculator employs the following formula: Fib 4 score = ( Age xAST) / ( Platelet count x ( square root of ALT )). Procedure: A liver biopsy can usually be safely performed as an outpatient procedure. . Conversely, patients may also have elevated ALT levels but no significant fibrosis. All liver biopsy specimens were imaged by Genesis200 TM . Enter the required values to calculate the FIB-4 value. Scar tissue from fibrosis can also block or limit the flow of blood within the liver. Is the ketogenic diet right for autoimmune conditions? No to moderate fibrosis In addition to an accurate reproduction of fibrosis staging by human pathologists, the model predicts the overall NASH CRN and Ishak fibrosis scores for each pixel within the image, which enables computation of continuous measures of disease severity summarizing their disease state (Fig. Fibrosis Score not assessed or unknown if assessed. Fibrosis stage 2 is considered significant fibrosis. Nonalcoholic fatty liver disease (NAFLD) is now the leading cause of chronic liver disease in the world. Cirrhosis, NOS, Clinical statement of advanced/severe fibrosis or cirrhosis, AND Patients with already-decompensated liver disease by clinical or imaging evidence were also excluded. In HCV infection, advanced fibrosis is defined as either stage 4 to 6 using the Ishak system 10 or stage 3 to 4 using the Meta-analysis of Histological Data in Viral Hepatitis (META-VIR) system. There are four criteria to be followed in the model as explained below: Age There is a correlation between age increase and the progression of fibrosis in the liver, especially in the case of hepatitis C and chronic alcohol consumption but the biological mechanism behind is yet to be established. The formula for FIB-4 is: . The AST to Platelet Ratio (APRI) test is a calculator tool that inputs routine laboratory values to assess the risk for advanced fibrosis. The first score was introduced as the Delta Fibrosis Score (DFS) by Lutterkort et al., in 2017, but this was aimed at detecting advanced fibrosis (Ishak fibrosis 3) ( Lutterkort et al., 2017). Our understanding of fibrosis regression is evolving and emerging data is encouraging. When compared to liver biopsy, histology results in a sample population in which 38% had significant fibrosis (F2, F3, or F4 by METAVIR), the negative predictive value of clinically significant fibrosis was 91% and the positive predictive value for presence of significant fibrosis was 61%-76%. In some chronic liver diseases, such as HCV, ALT levels do not correlate with the amount of liver tissue damage. Advanced/severe fibrosis Marchenko pastur equation for volume. The medical record may show something like "FIB-4 = 3.52." Do not code FIB-4 values in this data item. Logo kroon oil advies. Incomplete cirrhosis Hepascore is a blood test developed in Australia combining the following clinical and laboratory variables: age, gender, bilirubin, GGT, hyaluronic acid, alpha 2 macroglobin to create a score. To enter and activate the submenu links, hit the down arrow. METAVIR score F4 Background Liver fibrosis stage is an important factor in determining prognosis and need for treatment in patients infected with hepatitis B virus (HBV). The METAVIR scoring system has 5 stages of fibrosis, from F0 to F4, as depicted below: Fibrosis progression is variable. Physical exam findings: enlarged spleen, spider angioma, Laboratory findings: Low platelet count (<140,000/mm3), Abdominal imaging: Nodularity of the liver, splenomegaly, varices, caudate lobe hypertrophy, portal and splenic vein distension, and ascites are features of cirrhosis. Stated in medical record that patient does not have advanced cirrhosis/advanced fibrosis, not histologically confirmed or unknown if histologically confirmed However, code 7 when the physician statement of fibrosis score is not based on histologic examination of the liver. Learn more about the foods and drinks that are good for liver health here. For example, an Ishak score of 0 to 4 indicates fibrosis and an Ishak score of 5 or 6 indicates cirrhosis, and then there are finer determinations once cirrhosis occurs. Based on the REACH-B risk calculator, long-term therapy with TDF was associated with a reduced incidence of HCC among patients without cirrhosis who met treatment criteria. Long-term clinical follow-up data were used to calculate the slopes (change over time) for autoantibodies, platelet count, Ishak fibrosis score, biopsy copper, and number of portal areas with bile ducts. Calcs that help predict probability of a disease, Subcategory of 'Diagnosis' designed to be very sensitive, Disease is diagnosed: prognosticate to guide treatment. The C-index of using the radiographic TBS to predict the . It can also be used to detect the stage of fibrosis, as well as monitor response to NAFLD treatment. APRI = [(AST (IU/L)/AST_ULN (IU/L))x100]/ platelet count (109/L). Patients with known liver fibrosis should have their fibrosis trended over time to evaluate for progression or stabilization. Can fibrosis scores improve after successful HCV treatment? Note 3: AJCC classifies Ishak fibrosis scores 0-4 (none to moderate fibrosis) as F0, and Ishak fibrosis scores 5-6 (cirrhosis/severe fibrosis) as F1. While FIB-4 offers an easy and essentially free assessment of liver fibrosis, it is not without limitations. The FIB-4 Index is a blood-based diagnostic test that looks at underlying fibrosis that can be used as a measure to help determine NAFLD/NASH status. An important fact is that . Do not code FIB-4 values in this data item. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links. It is a scoring method using the patient's age and relevant lab values to calculate a score. It is a scoring method using the patient's age and relevant lab values to calculate a score. with the Ishak fibrosis stage (C-statistic .87, 95% CI: 0.82-0.93). Liver fibrosis is the most important factor in the prognosis and treatment plan of patients with chronic hepatitis B (CHB). Fibrosis score stated but cannot be assigned to codes 0 or 1 METAVIR score F4 Hit enter to expand a main menu option (Health, Benefits, etc). This version of the MELD calculator includes United Network for Organ Sharing (UNOS) modifications of the original model. The Fibrosis-4 (FIB-4) test is a calculator tool that also inputs routine laboratory values in addition to age to predict cirrhosis. **Note 7:** If a fibrosis score is stated but the scoring system is not recorded, consult with the physician. A score below 238 dB/m means the amount of fatty change in your liver is not higher than normal. The National Institute for Health and Care Excellence (NICE) recommends considering the use of the Enhanced Liver Fibrosis (ELF) test to assess the risk of advanced liver fibrosis in people with suspected non-alcoholic fatty liver disease (NAFLD) [].Later recommendations also suggest using the NAFLD Fibrosis score (NFS) or the Fibrosis 4 score [Newsome, 2018a], [Royal College of General . Cookie Preferences. Stiffer livers have faster shear wave propagation. . The overall FibroSure score is calculated using a proprietary formula that combines the results of all 6 markers in addition to patient age and gender. The results are reported in kilopascals (kPa) from 2.5 - 75 kPa and a normal value is approximately 5 kPa. Diagnosing and treating fibrosis in its early stages can greatly improve a persons chance of making a full recovery. **Note 7:** If no score is mentioned, descriptive terms may be used to assign codes 0 and 1 - see specific terms in the table below. The medical record may show something like "FIB-4 = 3.52." Do not code FIB-4 values in this data item. The test is performed by using a piston that is used to lightly push the skin over an intercostal space, resulting in a shear wave that travels through the liver. Developing cirrhosis Fibrosis was staged with the Ishak scale (ranging from 0=no fibrosis to 6=cirrhosis). Liver fibrosis occurs when excessive amounts of scar tissue build up in the liver due to repetitive or long-lasting injury or inflammation. Fibrosis Score not assessed or unknown if assessed. You seem to have a popup blocker enabled. Use of any information is solely at the user's own risk. Can diet help improve depression symptoms? Not histologically confirmed or unknown if histologically confirmed, Not applicable: Information not collected for this case These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients. The FibroTest score is calculated from the results of a six-parameter blood test, combining six serum markers with the age and gender of the patient: Alpha-2-macroglobulin, Haptoglobin, Apolipoprotein A1, Gamma-glutamyl transpeptidase (GGT), Total bilirubin, and Alanine transaminase (ALT).
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