This is a new guideline from NICE on cirrhosis. The most important bit for us is knowing who should be tested as we may need to be referring these patients on.
Higher risk patients
- Hepatitis B
- Hepatitis C
- Misuse of alcohol
- BMI of 30 or more
- Type 2 diabetes
Who should be tested for cirrhosis?
It is important not to just rely on normal LFTs to rule out cirrhosis. A significant proportion of patients with cirrhosis will have normal LFTs. Therefore the following patients need referral for testing:
- Hepatitis B
- Hepatitis C
- Alcohol Misuse (several months of heavy drinking eg men drinking over 50u a week and women over 35u a week).
- People diagnosed with alcohol-related liver disease.
- NAFLD (non-alcoholic fatty liver disease) with advanced liver fibrosis (see my recent summary of the NICE guideline on NAFLD and how to diagnose advanced liver fibrosis).
NB – patients with a high BMI or T2DM only need testing if they also meet the NAFLD criteria above.