LIVERFASt the new screening tool we are using for the SUNN SCREEN PROJECT.
Just a minor point which may interest some. The report below are the results of my personal test. You may know that I was diagnosed with stage F4 cirrhosis in 2015. I have managed my disease successfully and am now a stable F3 with no active NASH. I wanted to see if this reported my status accurately before offering it to you. I'm very pleased with these results as they are consistent with all of the other testing I've done. Personally, I plan to use this to monitor my status going forward and have made arrangements with Fibronostics, the company who does the test, to make it available to FLF members.
Where to get it:
The link is to an active PDF form so it loads slowly. Fill out the information with the red asterisks and you will be contacted to answer any questions and to make arrangements.
What it measures: steatosis, inflammatory activity, fibrosis
Who should take this: anyone concerned about their liver, diagnosed NAFLD/NASH patients, or people interested in monitoring their liver status may benefit from this test. It is not diagnostic but provides useful perspective on various aspects of liver health.
Medicare and most major insurances will pay for the test.
Your doctor may not use this test, and many don't know about it yet since it is only recently approved by Medicare. Here is a link to information that you might share with your doctor.
For anyone who is interested, we have also created a new Facebook group for people interested in this test so we invite you to join.
This is a new test so it is not yet being used by most physicians or local labs and must be ordered through a Quest office rather than just doing it through your neighborhood lab. To find a Quest lab near you go here appointment.questdiagnostics.com/patient/lab/search to find a location in your zipcode. There are COVID rules in place so you will have to make an appointment for the blood draw. You will need to take the completed lab order form with you and give it to Quest so that they have the correct paperwork. They are very careful to keep everyone safe. Several of us have taken the test ourselves to make sure that the process works and is safe.
LIVERFASt is a blood-based diagnostic test developed by Fibronostics that looks at steatosis, activity, and fibrosis using an algorithm to analyze 10 distinct biomarkers. Like a classic SAF score, LIVERFASt measures the presence and extent of steatosis (fattiness), activity (inflammation and ballooning), and fibrosis (scarring) to determine level of NAFLD/NASH. The algorithm is key to LIVERFASt and has been trained and tested on thousands of patient cases around the world.  Once a lab draws blood and assess the 10 biomarkers, the results can be inputted into the LIVERFASt online portal, which uses the algorithm to calculate scores. The use of the algorithm helps improve consistency in results, which has proven to be a challenge for human pathologists. The algorithm analyzes the biomarker results, assigning patients a score for each category of analysis, as seen in the following graphic.
These scores, in combination with demographic information (age and gender), are used to classify patients into different levels of NAFLD/NASH as follows.
- NAFLD, only: fibrosis stage is 0, activity stage is <2, steatosis stage is 0
- NAFLD or initial NASH: fibrosis stage is 0, activity stage is 2, steatosis stage is 0
- Moderate NASH: fibrosis stage is 1 or 2, activity stage is >2, steatosis stage is >0
- Advanced NASH: fibrosis stage is 3 or 4, activity stage is >2, steatosis stage is >0
The ability of the LIVERFASt test to distinguish between levels of severity of NAFLD and NASH addresses one of the more challenging aspects of diagnosis. With its user-friendly results and graphics (shown in the first image), LIVERFASt allows this information to be obtained simply and affordably enough to encourage regular retesting and restaging. The accessibility of this technology has the potential to improve disease management and understanding of progress in a manner both attainable for and accessible to patients and providers.
Fibronostics has recently published a document on using LIVERFASt for clinical management. To see and download the document, click here.
 Aravind et al., Machine Learning Technology for Evaluation of Liver Fibrosis, Inflammation Activity and Steatosis (LIVERFASTÔ), Journal of Intelligent Learning Systems and Applications, April 2020, doi: 10.4236/jilsa.2020.122003
 Tangvoraphonkchai et al., Comparative assessment liver lesions using non-invasive serum biomarkers LIVERFAStTM , FIB4, APRI and liver stiffness measurement (LSM, Fibroscan) in chronic hepatitis C (CHC) patients with liver biopsy, Fibronostics, September 2020.