Tools for the diagnosis of hepatitis C virus infection and hepatic fibrosis staging

Table 5 Serum-based tests recommended in the clinical practice for the detection of significant fibrosis

Serum-based tests	Parameters considered	Ref.
Tests combining direct markers of liver fibrosis
Enhanced liver Fibrosis test (ELF™)	HA, PIIINP, TIMP-1, age	[88]
MP3™	MMP-1, PIIINP	[89]
Fibrospect II™	HA, TIMP-1, alpha-2-macroglobulin	[90]
Tests including indirect markers of liver fibrosis
AST to platelet ratio index (APRI)	AST, platelet count	[91]
AST/ALT ratio	AST, ALT	[92]
Forns index	GGT, platelet count, cholesterol, age	[93]
Tests including combinations of direct and indirect markers of fibrosis
Hepascore™	Bilirubin, GGT, HA, alpha-2-macroglobulin, gender, age	[94]
Fibrometer™	HA, AST, platelet count, prothrombin index, alpha-2-macroglobulin, urea, age	[95]
FibroTest™	alpha-2-macroglobulin, haptoglobin, apolipoprotein A1, GGT, total bilirubin	[96]

HA: Hyaluronic acid; PIIINP: Pro-collagen III amino-terminal peptide; TIMP-1: Tissue inhibitor of matrix metalloproteinase-1; MMP-1: Matrix metalloproteinase-1; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; GGT: Gamma-glutamyltransferase.