In Australia, 30% of adults have non-alcoholic fatty liver disease and it is set to become one of our most prevalent chronic diseases.

The Enhanced Liver Fibrosis test (ELF) measures chemicals in the bloodstream that indicate the degree of fibrosis (scar tissue) caused by chronic liver disease. Significant fibrosis suggests progression towards cirrhosis, where scarring is so severe the liver can fail. This can lead to liver cancer or transplant. 264 Australians received a liver transplant in 2015.

Chronic liver diseases that can cause fibrosis include viral hepatitis and alcohol induced damage. However, the prevalence of non-alcoholic fatty liver disease is predicted to sky-rocket as obesity increases.

Brisbane Hepatologist {liver specialist} Professor Elizabeth Powell says:

“Non-alcoholic fatty liver disease will soon surpass viral hepatitis as the leading cause of liver transplant in Australia. Detecting liver damage is important to allow monitoring for complications such as liver cancer.”

The test’s co-creator, London based Professor William Rosenberg says,

“This test potentially has great benefits to patients and the safety, speed and simplicity of a blood test means people can be easily monitored over time.”

Liver biopsies analysed in pathology laboratories are currently used to assess fibrosis. However, this invasive procedure may be painful and carries a risk of internal bleeding. They therefore cannot be used repeatedly to monitor response to treatment.

Professor Powell adds,

“A lot of resources are going into developing drug treatments for non-alcoholic fatty liver disease. When those come to fruition, this test may play a huge role in identifying and monitoring patient response to these therapies.”

A/Professor Graham Jones is a Sydney-based Pathologist. He says,

“Australians have access to some of the world’s highest quality pathology services. Moving towards minimally invasive tests is a great example of innovation that could help reduce patient anxiety, discomfort and health risks.”

Whilst the test is available in Australia, patients must currently pay for it. Australian medical experts are still understanding how the test fits in with existing Australian treatment guidelines for liver disease.

The post New test could offer easier monitoring for millions with emerging chronic liver disease first appeared on Know Pathology Know Healthcare.

Rates of liver disease are rising globally and pathology is central to detection and reducing risk of serious damage.

Liver damage can be caused by viral infections, drugs of abuse, long-term medication and chronic alcoholism. Over time, the cells die and form scar tissue called fibrosis. Severe fibrosis is called cirrhosis and often requires a liver transplant. Prospective Victorian Senator and media personality Derryn Hinch knows this only too well.

Traditional blood tests to indicate liver health include

• ALT, AST, ALP are enzymes found in high concentrations in liver cells. When a liver cell dies, its cell membrane splits, releasing its contents into the blood stream. High levels of the enzymes indicate damage.
• Bilirubin is a pigment from dying blood cells as they pass through the liver.
• GGT is another liver enzyme that increases when the bile duct is blocked- sometimes indicating alcohol-related damage.

These tests provide an indication of liver health, but sometimes doctors will need more information via a liver biopsy – an involved procedure usually reserved for patients with serious liver disease.

New blood tests are beginning to replace biopsy for evaluation of fibrosis and cirrhosis. Recently the Enhanced Liver Fibrosis (ELF) test has become available in Australia, and provides a clear picture of damage from non-alcoholic fatty liver disease. The test developer, London-based Professor William Rosenberg, says:

“Chronic liver disease is the fifth most common cause of death in Britain. Of those top five causes, it is the only one that is on the rise. By the time symptoms of liver disease appear, it can be too late to repair damage. Catching liver damage early gives the patient a better chance of avoiding transplantation.”

Dr Rosenberg is presenting study findings on the ELF test at the AIMS meeting in Brisbane in September.

Australian medical research continues to make advances in liver disease diagnosis. HepaScore is a formula developed through a Perth based collaboration between Hepatologists and the PathWest Pathology laboratory. The HepaScore formula is based on a series of four blood test results that together with age and sex of the patient gives doctors a score from 0-1.0 to predict the amount of fibrosis present. The formula is becoming popular among Western Australian doctors working in hospitals.

The post Diagnosis of cirrhosis – new approaches to liver disease detection first appeared on Know Pathology Know Healthcare.