FibroMeters: a family of blood tests for liver fibrosis

FibroMeters are blood tests for liver fibrosis with several specificities: two main diagnostic targets (fibrosis stage and area of fibrosis); adaptation to specific causes; and results confirmed by an expert system. Thus, FibroMeters comprise six different tests: one for staging and one for quantitation of liver fibrosis in each of the three main causes of chronic liver disease—chronic viral hepatitis, alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). FibroMeters display a high overall diagnostic accuracy and are the only tests to correctly classify 100% of HCV patients without fibrosis or with cirrhosis. They have 90% predictive values in a higher proportion of patients than with other usual blood tests. A 90% correct classification is available in 100% of HCV patients with the following reliable diagnostic intervals: F0/1, F1/2 , F2±1, F3±1. In real-life conditions, the reproducibility of FibroMeters is higher than that of liver biopsy or ultrasonographic elastometry. FibroMeters are robust tests with the most stable diagnostic performance across different centers. Optional tests are also available, such as a specific one for cirrhosis, which has a diagnostic accuracy of 93.0% (AUROC: 0.92) and a 100% positive predictive value for diagnosis of HCV cirrhosis. Determination by FibroMeters of the area of fibrosis – the only direct, non-invasive, quantitative measurement of liver fibrosis – are especially useful for following-up cirrhosis as it correlates well with clinical events. FibroMeters are also very accurate in HVB or HIV-HCV co-infected patients. The tests specific for ALD and NAFLD also have a high diagnostic accuracy (AUROCs: 0.96 and 0.94, respectively, for significant fibrosis). Les FibroMètres sont des tests sanguins de fibrose hépatique avec plusieurs spécificités : deux cibles diagnostiques -stade et aire de fibrose-, adaptation à la cause, et résultats sécurisés par un système expert. Ainsi, il y a six principaux FibroMètres : un pour les stades et un pour la quantification de la fibrose dans chacune des trois principales causes d’hépatopathies : virus, alcool et stéatose. Le FibroMètre a une performance diagnostique globale très élevée et est le seul test à classer correctement 100% des patients infectés par le virus de l’hépatite C (VHC) sans fibrose ou avec cirrhose. Le FibroMètre a des valeurs prédictives à 90% chez une proportion élevée de patients. Une classification correcte à 90% est observée chez 100% des