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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2016; 22(4): 1711-1720
Published online Jan 28, 2016. doi: 10.3748/wjg.v22.i4.1711
Published online Jan 28, 2016. doi: 10.3748/wjg.v22.i4.1711
Non-invasive assessment of liver fibrosis: Between prediction/prevention of outcomes and cost-effectiveness
Cristina Stasi, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
Stefano Milani, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, 50134 Florence, Italy
Author contributions: Stasi C designed the review, wrote and revised the manuscript; Milani S critically revised the manuscript for important intellectual content and has given final approval of the version to be published.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Cristina Stasi, MD, PhD, Department of Experimental and Clinical Medicine, Largo Brambilla 3, University of Florence, 50141 Firenze, Italy. cristina.stasi@gmail.com
Telephone: +39-55-7947922 Fax: +39-55-7947922
Received: July 27, 2015
Peer-review started: July 30, 2015
First decision: September 9, 2015
Revised: September 26, 2015
Accepted: December 12, 2015
Article in press: December 14, 2015
Published online: January 28, 2016
Peer-review started: July 30, 2015
First decision: September 9, 2015
Revised: September 26, 2015
Accepted: December 12, 2015
Article in press: December 14, 2015
Published online: January 28, 2016
Core Tip
Core tip: The results of several studies have shown that non-invasive methods are becoming increasingly precise in predicting non-significant and advanced liver fibrosis, thus reducing the need for liver biopsy in a relevant number of patients. However, when both serum markers and transient elastography values fall, liver biopsy may be still needed. Recently, the guidelines for the screening, care, and treatment of hepatitis C virus infected patients produced by the World Health Organization suggested that the AST-to-platelet ratio index or FIB-4 test could be used for the evaluation of liver fibrosis rather than other, more expensive non-invasive tests in a resource-limited setting.