Liver Fibrosis, FibroTest-ActiTest




Test Mnemonic

LIVFIB

CPT Codes

  • 81596 - QTY (1)

LOINC ®

Not available

Aliases

  • FibroTest
  • Liver Acti
  • Liver Fibrosis
  • Necroinflammatory Activity Score

Includes

  • Alanine aminotransferase (ALT)
  • Alpha 2-Macroglobulin
  • Apolipoprotein A1
  • Bilirubin, Total
  • Gamma-glutamyl Transferase (GGT)
  • Haptoglobin
  • Fibrosis Score
  • Necroinflammat Act Score

Performing Laboratory

Cleveland Clinic Laboratories

FDA Category

Laboratory Developed Test


Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
Volume2 mLTypeSerumContainerSST (Gold)Collect Temperature Transport TemperatureRefrigeratedSpecial InstructionsCentrifuge within 2 hours from collection. Protect serum from light after centrifugation. Overnight fasting is preferred.

Alternate Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
Volume2 mLTypeSerumContainerNo additive (Red)Collect Temperature Transport TemperatureRefrigeratedSpecial InstructionsCentrifuge within 2 hours from collection. Transfer serum into a standard or amber aliquot tube. Protect serum from light after centrifugation. Overnight fasting is preferred.

Minimum Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
Volume1 mLType Container Collect Temperature Transport Temperature Special Instructions 

Stability

Environmental Condition Description
Environmental ConditionAmbientDescription24 hours
Environmental ConditionRefrigeratedDescription7 days
Environmental ConditionFrozenDescription-20 C: Not acceptable; -70 C: 28 days

Days Performed

Mon - Sat

Turnaround Time

2 - 5 days

Methodology

Name Description
NameSpectrophotometry (S)Description 
NameColorimetric Enzyme AssayDescription 
NameImmunoturbidometric AssayDescription 

Reference Range

Alpha 2 Macroglobulin
Sex Age From Age To Type Range Range Unit
Alpha 2 MacroglobulinMaleSex   Age From   Age ToNormalType80-290Rangemg/dL
Alpha 2 MacroglobulinFemaleSex   Age From   Age ToNormalType110-270Rangemg/dL
ALT
Sex Age From Age To Type Range Range Unit
Alpha 2 MacroglobulinMaleSex   Age From   Age ToNormalType10-50RangeU/L
Alpha 2 MacroglobulinFemaleSex   Age From   Age ToNormalType10-35RangeU/L
Apolipoprotein A1
Sex Age From Age To Type Range Range Unit
Alpha 2 Macroglobulin Sex2 YearsAge From17 YearsAge ToNormalType>120Rangemg/dL
Alpha 2 MacroglobulinMaleSex18 YearsAge From99 YearsAge ToNormalType>114Rangemg/dL
Alpha 2 MacroglobulinFemaleSex18 YearsAge From99 YearsAge ToNormalType>124Rangemg/dL
Bilirubin, Total
Sex Age From Age To Type Range Range Unit
Alpha 2 Macroglobulin Sex   Age From   Age ToNormalType0.2-1.3Rangemg/dL
Fibrosis Interpretation
Sex Age From Age To Type Range Range Unit
Alpha 2 Macroglobulin Sex   Age From   Age ToType FibroTest Score: >=0 and <=0.21 - Metavir Score: F0 no fibrosisRange 
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeFibroTest Score: >0.21 and <=0.27 - Metavir Score: F0-F1 no fibrosisRange 
Alpha 2 Macroglobulin Sex   Age From   Age ToType FibroTest Score: >0.27 and <=0.31 - Metavir Score: F1 minimal fibrosisRange 
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeFibroTest Score: >0.31 and <=0.48 - Metavir Score: F1-F2 minimal fibrosisRange 
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeFibroTest Score: >0.48 and <=0.58- Metavir Score: F2 moderate fibrosisRange 
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeFibroTest Score: >0.58 and <=0.72 - Metavir Score: F3 advanced fibrosisRange 
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeFibroTest Score: >0.72 and <=0.74 - Metavir Score: F3-F4 advanced fibrosisRange 
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeFibroTest Score: >0.74 and <=1.00- Metavir Score: F4 severe fibrosisRange 
Fibrosis Score
Sex Age From Age To Type Range Range Unit
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeNo reference range availableRange 
Fibrosis Stage
Sex Age From Age To Type Range Range Unit
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeNo reference range availableRange 
GGT
Sex Age From Age To Type Range Range Unit
Alpha 2 MacroglobulinMaleSex   Age From   Age ToNormalType10-71RangeU/L
Alpha 2 MacroglobulinFemaleSex   Age From   Age ToNormalType6-42RangeU/L
Haptoglobin
Sex Age From Age To Type Range Range Unit
Alpha 2 Macroglobulin Sex   Age From   Age ToNormalType31-238Rangemg/dL
Necroinflammatory Activity Grade
Sex Age From Age To Type Range Range Unit
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeNo reference range availableRange 
Necroinflammatory Activity Interpretation
Sex Age From Age To Type Range Range Unit
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeActiTest Score: >=0 and <=0.17 - Metavir Score: A0 no activityRange 
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeActiTest Score: >0.17 and <=0.29 - Metavir Score: A0-A1 no activityRange 
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeActiTest Score: >0.29 and <=0.36 - Metavir Score: A1 minimal activityRange 
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeActiTest Score: >0.36 and <=0.52 - Metavir Score: A1-A2 minimal activityRange 
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeActiTest Score: >0.52 and <=0.60 - Metavir Score: A2 significant activityRange 
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeActiTest Score: >0.60 and <=0.62 - Metavir Score: A2-A3 significant activityRange 
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeActiTest Score: >0.62 and <=1.00 - Metavir Score: A3 severe activityRange 
Necroinflammatory Activity Score
Sex Age From Age To Type Range Range Unit
Alpha 2 Macroglobulin Sex   Age From   Age ToTypeNo reference range availableRange 

Special Info

Protect from light. Avoid freeze/thaw cycles of specimen. Overnight fasting is preferred. Grossly hemolyzed and grossly lipemic specimens will be rejected. Specimens from patients less than 2 years old are unacceptable. Additionally, specimens QNS for one or more analytes will not be accepted.

Clinical Info

The FibroTest-ActiTest interpretation is a proprietary algorithm owned by BioPredictive. FibroTest and ActiTest permit the non-invasive evaluation of Hepatitis B or C individuals for the presence of liver fibrosis and liver inflammation, respectively. The FibroTest and ActiTest scores are calculated based on patient age, gender and concentrations of serum of y-glutamyl transferase (GGT), total bilirubin (TB), a-2 macroglobulin, haptoglobin, apolipoprotein A1 and alanine aminotransferase (ActiTest). Fibrotest and ActiTest Scores, on a scale of 0.0 to 1.0, are assigned a Metavir scale indicating the level of fibrosis or inflammation present.

Clinical Limitation

Specimens from patients less than 2 years of age are unacceptable.