FibroTest-ActiTest

FibroTest-ActiTest assesses the liver for fibrosis and inflammation using two diagnostic scores based on component testing of six biomarkers. It is the most reliable biomarker test available, applies to the largest number of patients (98%),⁴ and outperforms other testing at all stages of fibrosis.⁵

Key testing

• FIBRO | FibroTest-ActiTest, Serum

Advantages

• Noninvasive testing is minimally affected by known risk factors for false positives and false negatives.⁶
• Easy-to-read report shows both proprietary FibroTest and ActiTest scores and METAVIR fibrosis stage and activity grade.

---

NASH, steatosis, and fibrosis/cirrhosis testing

Using a simple blood sample, our nonalcoholic steatohepatitis FibroTest combines 10 standard biomarkers into five scores to provide a complete assessment of the liver condition and the five main causes of liver disease, including hepatic steatosis, NASH, alcoholic steatohepatitis, fibrosis, and liver inflammation.

Key testing

• NSFIB | Nonalcoholic Steatohepatitis (NASH)-FibroTest, Serum and Plasma

Advantages

• Confirms diagnosis and monitoring of liver fibrosis, steatosis, and inflammation.
• Useful for estimating hepatic fibrosis.
• Assesses inflammation of metabolic disease.
• Assesses severity of NASH in patients with NAFLD, as well as steatosis or fatty liver.

---

Alcoholic liver disease confirmation and monitoring

Diagnosing individuals with alcoholic liver disease, which encompasses a spectrum of liver injury, often requires a history of significant alcohol intake, clinical evidence of liver disease, and supporting laboratory testing.⁷ Our menu of direct ethanol biomarker testing accurately assesses alcohol use and includes direct biomarker testing, which enables detection of even small amounts of ethanol eliminated via non-oxidative pathways into ethyl glucuronide (EtG), ethyl sulfate (EtS), and phosphatidylethanol (PEth).⁸

Benefits of biomarker testing include improved analysis of the specific role alcohol plays in an individual’s health; clarity on the actual amounts of recent consumption, which, combined with questionnaires, can support initiating clinical interventions; and verification and monitoring of ethanol abstinence in liver transplant candidates/patients.

Key testing

• ETGR | Ethyl Glucuronide Screen with Reflex, Random, Urine
  • Uses liquid chromatography/tandem mass spectrometry (LC-MS/MS) to measure levels of EtG and EtS in urine.
  • Combined testing provides sensitivity and specificity to low levels of ethanol with a window of detection in urine up to five days.
• PETH | Phosphatidylethanol Confirmation, Blood
  • Uses LC-MS/MS to measure levels of PEth in blood.
  • Measures and reports the two most common PEth homologues: PEth 16:0/18:1 (POPEth) and PEth 16:0/18:2 (PLPEth), which, combined, account for over 60% of all the observed PEth homologues in the blood.

---

References

1. Perumpail BJ, Khan MA, Yoo ER, et al. Clinical epidemiology and disease burden of nonalcoholic fatty liver disease. World J Gastroenterol. 2017 Dec;23(47):8263-8276.
2. CDC estimates nearly 2.4 million Americans living with hepatitis C. Available from: https://www.cdc.gov/hepatitis/statistics/2022surveillance/hepatitis-c/figure-3.1.htm
3. Marengo A, Jouness RIK, Bugianesi E. Progression and natural history of nonalcoholic fatty liver disease in adults. Clin Liver Dis. 2016;20(2):G313–G324. doi:10.1016/j.cld.2015.10.010
4. Poynard T, Munteanu M, Deckmyn O, et al. Applicability and precautions of use of liver injury biomarker FibroTest. A reappraisal at 7 years of age. BMC Gastroenterol. 2011;11:39. doi:10.1186/1471-230X-11-39  
5. Houot M, Ngo Y, Munteanu M, Marque S, Poynard T. Systematic review with meta-analysis: direct comparisons of biomarkers for the diagnosis of fibrosis in chronic hepatitis C and B. Aliment Pharmacol Ther. 2016;43:1.
6. Poynard T, de Ledinghen V, Zarski JP, et al. Performances of Elasto-FibroTest,^® a combination between FibroTest^® and liver stiffness measurements for assessing the stage of liver fibrosis in patients with chronic hepatitis C. Clin Res Hepatol Gastroenterol. 2012;36(5):455-63.
7. O'Shea, RS, Dasarathy, S, McCullough, AJ. Alcoholic liver disease. Hepatology. 51:307-328. https://doi.org/10.1002/hep.23258
8. Chaudhari R, Moonka D, Nunes F. Using biomarkers to quantify problematic alcohol use. J Fam Pract. 2021 Dec;70(10):474-481. doi:10.12788/jfp.0317