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Summary   Background  Although the FibroTest has been validated as a biomarker to determine the stage of fibrosis in non‐alcoholic fatty liver disease ( NAFLD ) with results similar to those in chronic hepatitis C ( CHC ), B ( CHB ), and alcoholic liver disease ( ALD ), it has not yet been confirmed for the prediction of liver‐related death.    Aim  To validate the 10‐year prognostic value of FibroTest in  NAFLD  for the prediction of liver‐related death.    Method  Patients in the prospective FibroFrance cohort who underwent a FibroTest between 1997 and 2012 were pre‐included. Mortality status was obtained from physicians, hospitals or the national register. Survival analyses were based on univariate (Kaplan‐Meier, log rank, AUROC) and multivariate Cox risk ratio taking into account age, sex and response to anti‐viral treatment as covariates. The comparator was the performance of the FibroTest in  CHC , the most validated population.    Results  7082 patients were included; 1079, 3449, 2051, and 503 with  NAFLD ,  CHC ,  CHB , and  ALD , respectively. Median (range) follow‐up was 6.0 years (0.1‐19.3). Ten year survival (95%  CI ) without liver‐related death in patients with  NAFLD  was 0.956 (0.940‐0.971; 38 events) and 0.832 (0.818‐0.847; 226 events;  P  = 0.004) in  CHC . The prognostic value (AUROC / Cox risk ratio) of FibroTest in patients with  NAFLD  was 0.941 (0.905‐0.978)/1638 (342‐7839) and even higher than in patients with  CHC  0.875 (0.849‐0.901;  P  = 0.01)/2657 (993‐6586).    Conclusions  The FibroTest has a high prognostic value in NAFLD for the prediction of liver‐related death. (ClinicalTrials.gov number, NCT01927133).

alimentary pharmacology and therapeutics

Long‐term prognostic value of the FibroTest in patients with non‐alcoholic fatty liver disease, compared to chronic hepatitis C, B, and alcoholic liver disease