At the beginning of 2021, South West London Pathology (SWLP) will be introducing the Enhanced Liver Fibrosis (ELF™) Test from Siemens to our repertoire. The test can initially be requested by GPs in the borough of Wandsworth.
The (ELF™) test, which has been developed by Siemens Healthineers, can be used to identify patients with mild to moderate liver fibrosis (usually asymptomatic) in patients with chronic liver disease, allowing clinicians to intervene before significant, irreversible damage occurs. Main causes of liver fibrosis include:
- hepatitis (HBV and HCV) infection
- alcohol abuse
- non-alcoholic liver disease (NAFLD).
As a result of the increasing rates of obesity, NAFLD is now the commonest cause of abnormal liver function tests in the UK, with a third of the population affected. Ten to thirty percent of these patients will develop progressive liver disease, ultimately resulting in cirrhosis. Staging fibrosis is essential in all patients with NAFLD to identify subjects with advanced fibrosis who are at risk of liver-related complications.
TheELF™test is a simple blood test, which can be performed on a single serum sample, to diagnose NAFLD patients at risk of advanced liver fibrosis, without the need for resource-intensive scans or invasive biopsies. Patients diagnosed with mild fibrosis using the ELF™ test can be managed in primary care, while those diagnosed with moderate fibrosis can then be referred to specialists for more detailed investigation of the severity of their condition and treatment.
Evidence from the UK, published in the Journal of Hepatology, indicates that a two-step testing pathway involving standard laboratory liver function tests and ELF™, leads to an 81% reduction in unnecessary referrals, which reduces time and money spent on secondary care investigations.
SWLP Consultant Clinical Scientist and lead on ELF™ testing Sarah Davie says, “The ELF™ test is a relatively simple and quick test which has the potential to have benefits for both the patient and the health service.
“As the number of patients developing NAFLD continues to rise, the ELF™ test means that we can quickly identify those with moderate fibrosis, allowing interventions to be put in place to reduce the progression of the disease.”