1 HIFIH Laboratory, Angers University, Angers, France.
2 Hepato-Gastroenterology Department, Angers University Hospital, Angers, France.
3 Department of Gastroenterology and Hepatology, Antwerp University Hospital, Antwerp, Belgium.
4 Translational Research in Inflammation and Immunology (TWI2N), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Nonalcoholic fatty liver disease (NAFLD) has become extremely common, now affecting 25% of the worldwide population.(1) All physicians, regardless of their specialty, are seeing NAFLD patients in their daily clinical practice, and all are challenged by the identification of the small subgroup having an advanced form of the disease. As with the other causes of chronic liver disease, it is now well established that liver fibrosis is the main predictor of the prognosis in NAFLD,(2) justifying the interest in diagnosing fibrosis. Because it is not conceivable to perform liver biopsy (currently the best reference, albeit imperfect, for liver fibrosis evaluation) in large populations, noninvasive testing represents an attractive option for the diagnosis and screening of NAFLDpatients with advanced liver disease in need of specialized management. The noninvasive tests currently available are mainly represented by blood tests, either simple blood tests combining common indirect markers of liver fibrosis or specialized blood tests, including direct markers of liver fibrogenesis and fibrolysis, and elastography devices.