Large-scale multicentre comparison of three algorithms combining serum non-invasive markers for liver fibrosis in chronic hepatitis C

Background. Non-invasive serum markers have been proposed as surrogate of liver fibrosis, but their diagnostic accuracy is not such to substitute liver biopsy. Recent data suggest that their performance may improve when combined. Three algorithms based on combination of Fibrotest, Forns’index and/or AST-to-platelet ratio (APRI) have been proposed with the strategy to reduce rather than completely avoid liver biopsy (sequential algorithm for fibrosis evaluation; safe biopsy; fibropaca algorithm; Leroy algorithm).