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FibroSure Fibrosis Stage (METAVIR F0-F4)

The liver scarring stage, from F0 (none) to F4 (cirrhosis), estimated from the FibroSure blood score. It is not a biopsy result.

AI-verified against cited sources. Awaiting expert reviewAlso called METAVIR, F0-F4LOINC 48794-2

What it is

The METAVIR scale rates liver scarring (fibrosis) from F0 to F4. In a FibroSure report, the stage is looked up from the fibrosis score, which is calculated from blood tests. In-between stages such as F1–F2 or F3–F4 are printed when a score falls near a boundary. The stage is an estimate from blood, not a biopsy.

Why it matters

Scarring usually causes no symptoms until it is advanced, and the stage helps your clinician decide on follow-up for a long-term liver condition such as hepatitis B or C, fatty liver disease or alcohol-related liver disease. A stage should be read together with the score, your history and other tests.

If it’s low

Stage F0 or F0–F1 means the score falls in the range linked to little or no scarring. It is an estimate and cannot rule out scarring completely.

Common causes

  • No or minimal scarring in the liver

What can help

  • Ask how often your clinician would like to repeat it, based on your liver condition

If it’s high

Stage F2 or higher means the score falls in the range linked to moderate, advanced or severe scarring. Stage F4 is cirrhosis. A stage from a blood score is an estimate, so your clinician may suggest another test to confirm it.

Common causes

  • Conditions that distort the blood tests the score uses, such as Gilbert syndrome, hemolysis or a blocked bile duct
  • Scarring from chronic hepatitis B or C
  • Scarring from fatty liver disease
  • Scarring from long-term alcohol-related liver disease

What can help

  • Ask whether another test, such as elastography or the ELF blood test, would help confirm the stage
  • Talk with your clinician about managing the underlying liver condition, including weight, physical activity and alcohol

What can affect your result

  • The FibroSure score it comes from, which depends on age, sex and several blood markers
  • Gilbert syndrome, hemolysis, acute hepatitis and bile duct blockage
  • Kidney problems and liver transplant
  • Rounding of scores near a boundary, which decides whether a single stage or an in-between stage is printed
  • The stage comes from the FibroSure score, so anything that distorts the score distorts the stage. Labcorp says the test is not recommended in people with Gilbert syndrome, acute hemolysis, acute hepatitis, bile duct blockage, a liver transplant or kidney insufficiency.
  • Mayo asks for the serum to be separated within 2 hours and protected from light within 4 hours.
  • Mayo requires a 12-hour fast for its NASH-FibroTest and lists no fasting rule for the standard FibroTest-ActiTest, so follow your lab's instructions.

The stage follows scarring that builds over years, so it is not meant for frequent rechecks.

When to talk to a clinician

There is no urgent stage value. Talk with a clinician about stage F2 or higher so they can decide on follow-up. Get prompt care for yellow skin or eyes, vomiting blood, black or tarry stools, a swollen belly, or new confusion or drowsiness, and call 911 or your local emergency number if these are severe.

Questions you could ask

  • Which result matters most for me, the stage or the score?
  • Would an elastography scan or the ELF blood test help confirm this stage?
  • Could Gilbert syndrome, hemolysis or another condition be distorting the score?
  • What follow-up do you suggest for my liver condition?
  • How often should this be repeated, given my liver condition?

Questions people ask

Why does my stage say F1–F2 and not just F1 or F2?

In-between stages are printed when the score falls near a boundary between two stages. It means the score cannot say which of the two applies.

Is a FibroSure stage the same as a biopsy stage?

No. It uses the same F0 to F4 scale, but it is an estimate made from blood tests, and it can differ from what a biopsy would show.

Show the science and sources

For clinicians and researchers

The stage is a lookup on the FibroTest score: 0.00 to 0.21 is F0, 0.21 to 0.27 F0–F1, 0.27 to 0.31 F1, 0.31 to 0.48 F1–F2, 0.48 to 0.58 F2, 0.58 to 0.72 F3, 0.72 to 0.74 F3–F4, and 0.74 to 1.00 F4, as printed by Labcorp and Mayo Clinic Laboratories. Mayo notes that boundary scores can belong to two stages depending on rounding (for example 0.305 rounds to 0.31 and is staged F1, while 0.314 rounds to 0.31 and is staged F1–F2). The stage is a surrogate for the METAVIR biopsy stage, not a histological finding. Labcorp's report limits its use in Gilbert syndrome, acute hemolysis, acute hepatitis, extra-hepatic cholestasis, transplant recipients and renal insufficiency. Both labs state the test is not FDA-cleared.

LOINC 48794-2 (primary). Specimen: calculated.

Sources

  1. HCV FibroSure (test 550123) sample report, Labcorp (2023)
  2. FibroTest-ActiTest, Serum (Test ID FIBRO), Mayo Clinic Laboratories
  3. LOINC 48794-2 (NLM Clinical Tables), National Library of Medicine

AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.

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