Chronic liver disease (CLD) and cirrhosis account for 2% of the deaths worldwide. One in 5 deaths in world due to liver disease (18.3%) is contributed by India.

Liver disease remains silent for decades. First presentation is often due to complication of advanced liver disease (e.g. Jaundice, water in abdomen, altered consciousness, bleeding or cancer). These are potentially life threatening.

Early diagnosis of liver disease provides an opportunity for treatment. Antiviral drugs (for hepatitis B and C), de-addiction ( Alcohol associated liver disease), lifestyle modification (in fatty liver disease) can reduce morbidity, mortality and need for transplantation.

Routine set of liver function tests (LFTs) can be nearly normal in chronic or advanced liver disease and are poor in accuracy in diagnosis of CLD.

Non-invasive tests (NIT) e.g. FIB-4, elastography, are simple and offer an opportunity to early identification and risk stratification of liver disease. They help identify presence or absence of fibrosis (scarring in the liver).

Presence of fibrosis (scarring) is the strongest predictor of development of future advanced liver disease and its complications.

Population based screening has shown increased identification of silent liver disease with NITs.