Hepatic fibrosis derives from the interplay of a number of cellular events, results in excessive buildup of connective tissues in the liver. There are strong clinical research interests as the burden of chronic liver disease is growing, threat of cirrhosis is increasing, and these patients are at high risk to develop hepatocellular carcinoma (HCC). Main causes of liver fibrosis in Vietnam include viral etiologies, alcohol consumption and non-alcoholic steatohepatitis (NASH) among others. It is critical to stage the disease accurately and facilitate early detection.

Why do we need to stage liver fibrosis?
1. Assess Stage and Prognosis of Disease
2. Treatment Decisions
3. Monitor and Assess Effectiveness of Treatment
4. Allows HCC early detection

The main challenge in chronic hepatitis detection is that this condition is usually asymptomatic at early stages. Methods used to evaluate liver fibrosis include biopsy, serum biomarkers and elastography. Although liver biopsy remains the gold standard, this is highly invasive and carries a small amount of risk for patients. Serum biomarkers are favored in many instances and have been extensively correlated to liver biopsy results [1]. There were conditional recommendations from the World Health Organization (WHO) [2] that provided guidance to use such measurements in resource limited settings. For elastography techniques, these are regularly coupled with clinical radiographic imaging to probe the stiffness of the liver [3]. It provides key measures to address detection and possible prognosis. Using a combination of different techniques based on different settings, early detection for liver disease is possible.