More advanced panels, such as the Enhanced Liver Fibrosis (ELF) test, combine multiple circulating fibrosis markers, including hyaluronic acid, tissue inhibitor of metalloproteinase 1 (TIMP-1), and procollagen III N-terminal peptide (PIIINP), demonstrating strong correlation with biopsy-proven fibrosis and predicting outcomes [40]. This evidence concerns the gene TIMP1 and Hepatic fibrosis.