{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T05:46:33Z","timestamp":1782279993394,"version":"3.54.5"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early detection of hepatic involvement in common variable immunodeficiency (CVID) and agammaglobulinemia (AGA) remains hampered by the absence of validated non-invasive biomarkers. Although the Enhanced Liver Fibrosis (ELF) score is well established across different liver diseases, its role in CVID\/AGA remains undefined. We aimed to assess hepatic involvement using ELF and shearwave elastography (SWE), and to evaluate their correlation and agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 22 patients with CVID and 9 with AGA without previously known\/documented liver fibrosis. The ELF score was calculated from serum hyaluronic acid (HA), tissue inhibitor of metalloproteinases-1, and N-terminal propeptide of type III collagen. Liver stiffness (LS) was measured using SWE. False discovery rate was controlled using the Benjamini\u2013Hochberg method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>According to SWE, 64.5% of patients had elevated LS, whereas increased ELF values corresponding to intermediate and severe\/advanced fibrosis were present in 58% and 35.5%, respectively. There was a statistically significant agreement (weighted Cohen\u2019s \u03ba=0.324; p=0.002) along with a significant correlation between ELF and LS (p=0.01\/pbh=0.05). In addition, ELF values were also positively associated with AST (p&amp;lt;0.001\/pbh&amp;lt;0.001) and ALP (p=0.003\/pbh=0.03). Among individual ELF components, HA showed consistent associations with LS and liver enzymes, including ALT, AST, and \u03b3GT (p=0.01\/pbh=0.05; p&amp;lt;0.001\/pbh&amp;lt;0.001; p=0.004\/pbh=0.04, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our exploratory findings suggest that combining ELF and SWE may provide a promising non-invasive approach for liver assessment, potentially reflecting different but complementary aspects of hepatic involvement in CVID and AGA; however, their clinical utility requires validation in larger, prospective, multicenter studies with histopathological correlation to define disease-specific thresholds.<\/jats:p>\n                  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