TIMP1 and Hepatic fibrosis: The Enhanced liver fibrosis (ELF) score, which combines metalloproteinase 1 (TIMP-1), serum hyaluronic acid (HA), and procollagen III N- terminal peptide (PIIINP), has been the only serological surrogate of liver fibrosis that has demonstrated good performance in detecting fibrosis staging according to two different histological classifications and identifying patients with poor prognosis; an ELF score of ≥10.0 predicts a higher incidence of clinical complications and worse survival [94].