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HelpTest ID BLOD1457 FibroTest-ActiTest, Serum
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 non-interferon treatment for hepatitis
Evaluating fibrosis in patients suffering from metabolic conditions (nonalcoholic fatty liver disease) and patients who consume excess alcohol
Specimen Type
SerumNecessary Information
Age and sex are required.
Specimen Required
Supplies: Amber Frosted Tube, 5 mL (T915)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Amber vial
Specimen Volume: 3 mL
Collection Instructions:
1. Centrifuge and aliquot serum into an amber vial within 2 hours of collection.
2. Centrifuged serum must be light protected within 4 hours of collection. It is acceptable to draw the blood and then protect it from light after centrifugation as long as it is within 4 hours of collection.
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
| Patients <2 years of age | Reject |
Specimen Minimum Volume
1.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 7 days | LIGHT PROTECTED |
| Frozen | 14 days | LIGHT PROTECTED | |
| Ambient | 24 hours | LIGHT PROTECTED |
Day(s) Performed
HAPTF, A2MF: Monday through Saturday
ALTF, GGTF, TBILF: Monday through Sunday
APOAF: Monday through Saturday
Report Available
2 to 5 daysMethod Name
INTF: Algorithm and Interpretation Provided through BioPredictive
APOAF: Automated Turbidimetric Immunoassay
A2MF, HAPTF: Nephelometry
ALTF: Photometric Rate, L-Alanine with Pyridoxal-5-Phosphate
GGTF: Photometric Rate
TBILF: Photometric, Diazonium Salt
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
81596
Reporting Name
FibroTest-ActiTest, SReference Values
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
≤18 years: 178-495 mg/dL
>18 years: 100-280 mg/dL
ALANINE AMINOTRANSFERASE (ALT)
Males
<12 months: Not established
≥1 year: 7-55 U/L
Females
<12 months: Not established
≥1 year: 7-45 U/L
APOLIPOPROTEIN A1
Males
<24 months: Not established
2-17 years
Low: <115 mg/dL
Borderline low: 115-120 mg/dL
Acceptable: >120 mg/dL
≥18 years: ≥120 mg/dL
Females
<24 months: Not established
2-17 years
Low: <115 mg/dL
Borderline low: 115-120 mg/dL
Acceptable: >120 mg/dL
≥18 years: ≥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
≥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
≥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: 0.0-14.9 mg/dL
15 days-17 years: 0.0-1.0mg/dL
≥18 years: 0.0-1.2 mg/dL
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.Forms
If not ordering electronically, complete, print, and send Gastroenterology and Hepatology Test Request (T728) with the specimen
Secondary ID
38292Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| INTF | FibroTest-ActiTest, Interpretation | No | Yes |
| APOAF | Apolipoprotein A1, S | No | Yes |
| A2MF | Alpha-2-Macroglobulin, S | Yes, (Order A2M) | Yes |
| HAPTF | Haptoglobin, S | Yes, (Order HAPT) | Yes |
| ALTF | Alanine Aminotransferase (ALT), S | Yes, (Order ALT) | Yes |
| GGTF | Gamma Glutamyltransferase (GGT), S | Yes, (Order GGT) | Yes |
| TBILF | Bilirubin, Total, S | Yes, (Order BILIT) | Yes |
Testing Algorithm
This test is a patented test algorithm developed by BioPredictive. FibroTest combines 5 standard biomarkers (gamma-glutamyltransferase, total bilirubin, alpha-2-macroglobulin, apolipoprotein A1, and haptoglobin). The ActiTest adds a marker for inflammatory activity (alanine aminotransferase: ALT). These markers are weighted depending on the patient's age and gender.
Testing is compliant with BioPredictive's technical recommendations and approvals.
SANFORD LABORATORY INTERFACE BUILD INFORMATION
| Result Code | Result Code Description |
|---|---|
| 22994 | Fibrotest Score |
| 22995 | Fibrotest Stage |
| 22996 | Fibrotest Interpretation |
| 22997 | Actitest Score |
| 22998 | Actitest Grade |
| 22999 | Actitest Interpretation |
| 23003 | Fibrotest-Actitest Comment |
| 23001 | Biopredictive Serial Number |
| 23002 | Apolipoprotein A1, S |
| 20166 | Alpha-2-Macroglobulin |
| 20167 | Haptoglobin |
| 20171 | ALT |
| 20170 | GGT |
| 20169 | Total Bilirubin |