FIB-4 index
Non-invasive estimate of the risk of advanced liver fibrosis.
FIB-4: enter all values
FIB-4 = (age × AST) ÷ (platelets × √ALT)
Interpretation in MASLD
| FIB-4 | Risk of advanced fibrosis |
|---|---|
| Below 1.30 (below 2.0 if aged 65 or over) | Low |
| 1.30 to 2.67 (2.0 to 2.67 if aged 65 or over) | Indeterminate |
| Above 2.67 | High |
FIB-4 is less reliable under 35 years of age. In chronic hepatitis C the original cut-offs of 1.45 and 3.25 apply.
References
Sterling RK, Lissen E, Clumeck N, et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology. 2006;43(6):1317-1325.
Shah AG, Lydecker A, Murray K, et al. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2009;7(10):1104-1112.
McPherson S, Hardy T, Dufour JF, et al. Age as a confounding factor for the accurate non-invasive diagnosis of advanced NAFLD fibrosis. Am J Gastroenterol. 2017;112(5):740-751.