assessment for advanced liver fibrosis in people with NAFLD

Last reviewed 08/2020

Assessment for advanced liver fibrosis in people with NAFLD

Identifying people with advanced liver fifibrosis

  • testing should be offered for advanced liver fibrosis to people with NAFLD
  • consider using the enhanced liver fibrosis (ELF) test in people who have been diagnosed with NAFLD to test for advanced liver fibrosis
  • do not use routine liver blood tests to assess for advanced liver fibrosis in people with NAFLD

  • diagnose people with advanced liver fibrosis if they have:
    • an ELF score of 10.51 or above
    • and NAFLD

  • refer adults and young people diagnosed with advanced liver fibrosis to a relevant specialist in hepatology

  • if an ELF score below 10.51 then:
    • explain that are unlikely to have advanced liver fibrosis
    • reassessment for advanced liver fibrosis every 3 years for adults and every 2 years for children and young people is sufficient for regular monitoring
    • no interim tests are needed
  • consider using ELF for retesting people with advanced liver fibrosis

Extra-hepatic conditions

  • NAFLD is a risk factor for type 2 diabetes, hypertension and chronic kidney disease
  • in people with type 2 diabetes, NAFLD is a risk factor for atrial fibrillation, myocardial infarction, ischaemic stroke and death from cardiovascular causes

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