FibroTest (FibroSure in USA) & ActiTest

FibroTest (known as FibroSure in the USA) is a non-invasive test measuring liver scarring in hepatitis C (or B), resulting in scores which correspond to the 0-4 point METAVIR Fibrosis (scarring) scale. FibroTest is the most frequently used serum fibrosis marker and consists of an algorithm of five fibrosis markers (alfa2-macroglobulin [g/l], apolipoproteinA1 [g/l], total bilirubin [micromoles/l], haptoglobin [g/l], Gamma GT [IU/l]). Below left, see how it compares to the METAVIR scarring scale.

ActiTest, another non-invasive test, measuring liver inflammation in chronic viral hepatitis C (or B),  resulting in scores which correspond to the 0-3 point METAVIR Activity (inflammation/necrosis) scale. It requires the FibroTest scores from tests above, plus it requires an ALT score. Below right, see how it compares to the METAVIR Activity (inflammation/necrosis) scale.

For great interactive patient information on FibroTest and ActiTest and a letter to request testing from your doctor, see this webpage (

Information for doctors about FibroTest and ActiTest is found on this webpage (

Correlation with Metavir Scales: FibroTest (Fibrosis) and ActiTest (Inflammation):

14_Fibrotest_Metavir_Correlation 15ActiTest_CorrelationWith


NOTE: The above graphs resulted from this data:
Sample date=22/04/2007 (subject therefore is 35.3 yrs)
alfa2-macroglobulin [g/l]= 2.44
apolipoproteinA1 [g/l]=1.71
bilirubin [micromoles/l]=16.70 (also called total bilirubin)
haptoglobin [g/l]=0.74
GammaGT [IU/l]=66 (also called GGT)
ALT [IU/l]=211

How to Get Tested:

With referrals from a physician, you may be able to get the tests paid by your insurance. However, incorporating the test results into the algorithm of this test, done by BioPredictive company,  is at present seldom covered by medical insurance, so you would have to pay for this part yourself.
Wikipedia provides the following equation for calculating the FibroTest score regression coefficient:

z=4.467\times \log_{10} [\alpha2 macroglobulin (g/L)]-1.357\times\log_{10} [Haptoglobin (g/L)] + 1.017 \times \log_{10} [GGT (IU/L)] + 0.0281 \times [Age (years)]

+ 1.737 \times \log_{10} [Bilirubin (\mu mol/L)] - 1.184 \times [Apo A1 (g/L)] + 0.301 \times Sex (female=0, male=1)-5.54

Wikipedia says: “Due to variability of components assays and analyzers, FibroTest assays can only be performed in validated laboratories. FibroTest cannot be used without algorithms that detects false positives and false negatives; the equation alone is not a diagnosis tool.”  Wikipedia does not provide any equations for calculating ActiTest. This information is readily available on the Internet (top of Google search for Fibrotest).  However, HepCBC recommends that patients and doctors use the services of BioPredictive, as this algorithm is copyrighted.