Enhanced Liver Fibrosis (ELF™) Test

Assess The Risk of NAFLD/NASH Progression and Liver-Related Events with a Simple Blood Test

Non-alcoholic fatty liver disease (NAFLD) impacts over 1 billion globally and is projected to become the leading cause of liver-related mortality within 20 years.1 As new therapies become available, non-invasive testing is an important tool to help identify patients at risk of developing cirrhosis and liver-related clinical events (LREs).


What is Liver Fibrosis?

NAFLD is a condition in which excess fat is stored in the liver. The buildup of fat that is not caused by heavy alcohol use.

  • There are two types of NAFLD: simple fatty liver (simple steatosis) and non-alcoholic steatohepatitis (NASH).
  • Comorbidities such as obesity, and type 2 diabetes are associated with NAFLD.2
  • NAFLD is predicted to be the leading indication for liver transplantation within a decade.3

Current Challenges in NAFLD Patients

  • Differentiating NASH from simple steatosis (risk-stratification) and identifying NASH patients with advanced fibrosis.
  • Despite being the gold standard for diagnosing liver fibrosis, liver biopsy is a painful and invasive procedure associated with inter- and intra-observer variability, and sampling error, which may make it impractical to use in every patient.4,5,6
  • Currently, there is no available liver fibrosis test that is convenient, objective, reproducible, and widely accessible to all relevant healthcare practitioners.

What is the ELF Test?

The ELF test* is a non-invasive blood test that measures three direct markers of fibrosis: hyaluronic acid (HA), procollagen III amino-terminal peptide (PIIINP), and tissue inhibitor of matrix metalloproteinase 1 (TIMP-1). The ELF test, in conjunction with other laboratory and clinical findings, can be used to assess the risk of progression to cirrhosis and LREs in patients with chronic liver disease.7

  • Access non-invasive testing with a simple blood test available to all healthcare practitioners and patients, including those with type 2 diabetes mellitus and obesity.8,9
  • Improve patient care by identifying NAFLD patients and stratifying those at risk of progressing to cirrhosis and LREs.7
  • Enhance prognostic patient management with a test that has been shown to outperform biopsy for the risk assessment of progression to cirrhosis and LREs.7

National Institute for Health and Care Excellence (NICE) NAFLD guidelines

The European Association for the Study of the Liver (EASL) approves use of non-invasive methods instead of liver biopsy to assess the degree of liver fibrosis in hepatitis C patients.10 The National Institute for Health and Care Excellence (NICE) NAFLD guidelines11 recommend the use of the ELF Test to test for and monitor advanced liver fibrosis in people diagnosed with NAFLD.

  • Consider using the ELF test in people who have been diagnosed with NAFLD to test for advanced liver fibrosis
  • Offer retesting for advanced liver fibrosis for people with an ELF score less than 10.51 every 3 years to adults and every 2 years to children and young people
  • Consider using the ELF test for retesting people with advanced liver fibrosis

Link to NICE Guidelines: NICE Guidelines: Non-Alcoholic Fatty Liver Disease: assessment and management.