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An early identification of rapid fibrosers, however, is essential to decide whom to treat first with the novel but expensive antiviral drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Liver stiffness, biopsy\u2010proven fibrosis stages F0\u2013F4 (<jats:styled-content style=\"fixed-case\">METAVIR<\/jats:styled-content> or Kleiner score) and routine laboratory parameters were studied in 2068 patients with <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a01391) and <jats:styled-content style=\"fixed-case\">ALD<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a0677).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the routine parameters for liver damage, <jats:styled-content style=\"fixed-case\">AST<\/jats:styled-content> correlated best with <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content>:<jats:italic> r<\/jats:italic>\u00a0=\u00a00.54, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.0001 and <jats:styled-content style=\"fixed-case\">ALD<\/jats:styled-content>:<jats:italic> r<\/jats:italic>\u00a0=\u00a00.34, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.0001). In the absence of elevated transaminases, cut\u2010off values were almost identical between <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ALD<\/jats:styled-content> for F1\u20132, F3 and F4 (<jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content>: 5.1, 9.0 and 11.9\u00a0kPa vs ALD: 4.9, 8.1 and 10.5\u00a0kPa). These cut\u2010off values increased exponentially as a function of median <jats:styled-content style=\"fixed-case\">AST<\/jats:styled-content> level. The impact of <jats:styled-content style=\"fixed-case\">AST<\/jats:styled-content> on <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content> was higher in lobular\u2010pronounced <jats:styled-content style=\"fixed-case\">ALD<\/jats:styled-content> as compared to portal tract\u2010localized <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content>. Most notably, Cohen's weighted Kappa displayed an improved agreement of the novel <jats:styled-content style=\"fixed-case\">AST<\/jats:styled-content>\u2010dependent cut\u2010off values with histological fibrosis stage both for <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> (0.68 vs 0.65) and <jats:styled-content style=\"fixed-case\">ALD<\/jats:styled-content> (0.80 vs 0.76).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The novel <jats:styled-content style=\"fixed-case\">AST<\/jats:styled-content>\u2010adapted cut\u2010off values improve non\u2010invasive fibrosis staging in <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ALD<\/jats:styled-content> and may be also applied to other liver diseases. Especially in\u00a0<jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content>, they could help to decide whom to treat first with the novel but expensive antiviral drugs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.12904","type":"journal-article","created":{"date-parts":[[2015,6,30]],"date-time":"2015-06-30T08:03:23Z","timestamp":1435651403000},"page":"2514-2521","source":"Crossref","is-referenced-by-count":97,"title":["Inflammation\u2010adapted liver stiffness values for improved fibrosis staging in patients with hepatitis C virus and alcoholic liver disease"],"prefix":"10.1111","volume":"35","author":[{"given":"Sebastian","family":"Mueller","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Salem Medical Center Heidelberg Germany"},{"name":"Center for Alcohol Research University of Heidelberg Heidelberg 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