Bibliographic Info
Recommendation
Recommended in favor
Strong
Certainty of evidence
Moderate
Non-invasive assessment of liver disease stage at baseline and during follow-up. Thresholds to establish the presence of significant fibrosis (≥F2) or cirrhosis (F4) in adults. Evidence of significant fibrosis (≥F2) should be based on an APRI score of >0.5 or transient elastography value of >7.0 kPa, and cirrhosis (F4) should be based on clinical criteria (or an APRI score of >1.0 or transient elastography (FibroScan®) value of >12.5 kPa ). These cut-offs apply to FibroScan® – other elastography techniques do not necessarily have the same cut-offs. Clinical features of decompensated cirrhosis: portal hypertension (ascites, variceal haemorrhage and hepatic encephalopathy), coagulopathy, or liver insufficiency (jaundice). Other clinical features of advanced liver disease/cirrhosis may include: hepatomegaly, splenomegaly, pruritus, fatigue, arthralgia, palmar erythema or oedema.