assessment for advanced liver fibrosis in people with NAFLD

Last reviewed 09/2021

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

Reference:

• NICE (July 2016). Non-alcoholic fatty liver disease (NAFLD): assessment and management