Use of Enhanced liver fibrosis test (ELF) in Egyptian patients with chronic hepatitis C virus (HCV) infection to identify severity of liver fibrosis

Objective: To evaluate the role of enhanced liver fibrosis test (ELF) in identification of the stage of liver fibrosis in chronic HCV patients. Patients and Methods: This study included 75 chronic HCV patients and 25 age and sex matched healthy subjects (control group). All patients were investigated by ELF, fibroscan and liver biopsy. ELF markers included hyaluronic acid (HA), tissue inhibitor of metalloproteinase (TIMP) and procollagen III amino terminal peptide (PIIINP). Results: HA and TIMP in HCV patients showed no significant difference from controls, while PIIINP in HCV patients showed a highly significant difference from controls (P>0.001). The value of ELF test was elevated in HCV patients with a significant difference from controls (P<0.05). In HCV patients, there was a highly significant difference among the stages of fibrosis as regards PIIINP, TIMP and ELF test (P<0.001). There was a significant correlation between ELF score and AST, ALT and all ELF markers (P<0.001). The sensitivity of ELF test in relation to biopsy is 85.3%, while the sensitivity of fibroscan test in relation to biopsy is 54.7%. Conclusion: ELF test could be a useful screening tool for detection of the stage of liver fibrosis in HCV patients. This test is more sensitive than fibroscan in assessment of the severity of liver fibrosis.