Liver Fibrosis, FibroTest - Actitest
Label Mnemonic: FIBRO
Epic Lab Code: LAB8382
Downtime Form: A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery
Commercial Mail-out Laboratory
5231 RCP
356-8593
Specimen(s):
Serum
Specimen Instructions:
1. Protect specimen from light.
2. Centrifuge and aliquot within 2 hours of collection.
Collection Medium:
and
Red top tube 5 mL (Clot Activator) Red top tube 5 mL (Clot Activator)
Minimum:
Draw TWO red top tubes.

Preferred Minimum: 3 mL serum
Absolute Minimum: 1.5 mL serum
Delivery Instructions:
Wrap specimen in aluminum foil to protect from light. Deliver to laboratory immediately after collection.
Testing Schedule:
HAPTF, A2MF: Monday through Saturday; 3 p.m.
ALTF, GGTF, TBILF: Monday through Sunday; Continuously
APOAF: Monday through Saturday; Continuously
Turn Around Time:
1 day upon receipt at reference laboratory
Reference Range:
FibroTest-ActiTest, Interpretation

FibroTest Score     Stage     Interpretation
0.00-0.21*          F0        No fibrosis
0.21-0.27*          F0-F1     No fibrosis
0.27-0.31*          F1        Minimal fibrosis
0.31-0.48*          F1-F2     Minimal fibrosis
0.48-0.58*          F2        Moderate fibrosis
0.58-0.72*          F3        Advanced fibrosis
0.72-0.74*          F3-F4     Advanced fibrosis
0.74-1.00           F4        Severe fibrosis (Cirrhosis)
*Boundary values can apply to 2 stages based on rounding. For example, 
a FibroTest score of 0.305 will round up to 0.31 and be staged F1. A 
FibroTest score of 0.314 will round down to 0.31 and be staged F1-F2.

ActiTest Score      Grade     Interpretation
0.00-0.17*          A0        No activity
0.17-0.29*          A0-A1     No activity
0.29-0.36*          A1        Minimal activity
0.36-0.52*          A1-A2     Minimal activity
0.52-0.60*          A2        Significant activity
0.60-0.62*          A2-A3     Significant activity
0.62-0.100          A3        Severe activity
*Boundary values can apply to 2 grades based on rounding. For example, an ActiTest score of 0.285 will round up to 0.29 and be graded A0-A1. An ActiTest score of 0.294 will round down to 0.29 be graded A1.

ALPHA-2-MACROGLOBULIN
100-280 mg/dL

ALANINEAMINOTRANSFERASE (ALT)
Males:
<12 months: No established reference values
> or =1 year: 7-55 U/L

Females:
<12 months: No established reference values
> or =1 year: 7-45 U/L

APOLIPOPROTEIN A1
Males:
<24 months: No established reference values
2-17 years:
Low: <115 mg/dL
Borderline low: 115-120 mg/dL
Acceptable: >120 mg/dL
> or =18 years: > or =120 mg/dL

Females:
<24 months: No established reference values
2-17 years:
Low: <115 mg/dL
Borderline low: 115-120 mg/dL
Acceptable: >120 mg/dL
> or =18 years: > or =140 mg/dL

GAMMA-GLUTAMYLTRANSFERASE (GGT)
Males:
0-11 months: <178 U/L
12 months-6 years: <21 U/L
7-12 years: <24 U/L
13-17 years: <43 U/L
> or =18 years: 8-61 U/L

Females:
0-11 months: <178 U/L
12 months-6 years: <21 U/L
7-12 years: <24 U/L
13-17 years: <26 U/L
> or =18 years: 5-36 U/L

HAPTOGLOBIN
30-200 mg/dL

BILIRUBIN, TOTAL
0-6 days: Refer to www.bilitool.org for information on age-specific (postnatal hour of life) serum bilirubin values.
7-14 days: <15.0 mg/dL
15 days to 17 years: < or =1.0 mg/dL
> or =18 years: < or =1.2 mg/dL
Interpretive Data:
FibroTest-ActiTest provides a score that assesses hepatic fibrosis (F0- F4) and a score that assesses hepatic inflammatory activity (A0-A3). Interpretation of the score is provided in the report. Individual results from the 6 component tests are also provided with institution- specific reference intervals.

Fibrosis is reported relative to a scale ranging from F0-F4 (F0=no fibrosis, F1=minimal fibrosis, F2=moderate fibrosis, F3=advanced fibrosis, F4=severe fibrosis). Fibrosis scores may overlap (eg, F0/F1, F1/F2).

Activity is reported relative to a scale ranging from A0-A3 (A0=no activity, A1=minimal activity, A2=significant activity, A3=severe activity). Activity scores may overlap (eg, A0/A1, A1/A2).
Comments:
Useful For:
Evaluating hepatic fibrosis in chronic hepatitis C patients

Diagnosing fibrosis in carriers of chronic hepatitis B virus

Evaluating hepatic fibrosis in co-infected HIV carriers

Providing access to new-generation noninterferon treatment for hepatitis

Evaluating fibrosis in patients suffering from metabolic conditions (nonalcoholic fatty liver disease) and patients who consume excess alcohol
Methodology:
INTF: Algorithm and interpretation provided through BioPredictive.
APOAF: Automated Turbidimetric Immunoassay
A2MF: Nephelometry
HAPTF: Nephelometry
ALTF: Photometric Rate, L-Alanine with Pyridoxal-5-Phosphate
GGTF: Photometric Rate
TBILF: Photometric, Diazonium Salt (DPD)
CPT Code:
82172 Apolipoproteinz
82247 Bilirubin, total
82977 GGT
83010 Haptoglobin
83883 Alpha2macroglobulins, quantitative
84460 ALT