fibrosis-4 index; FIB-4 index; FIB-4 score

Indications

• estimation of hepatic fibrosis in liver disease
  • non-alcoholic fatty liver
  • hepatitis B
  • hepatitis C

Procedure

• derived from age, serum AST, serum ALT & platelet count
  • can be obtained using online calculators

Interpretation

• patients with a score of < 1.3 are unlikely to have fibrosis & should be periodically reassessed
• further evaluation by transient elastography for patients with a score of > 1.3
• patients with FIB-4 scores of 1.3-2.67 should have transient elastography with FibroScan
  • patients with low liver stiffness < 8 kPa can be followed in primary care
  • patients with intermediate liver stiffness > 8 kPa or high > 12 kPa should be referred to a hepatologist
• patients with FIB-4 scores > 2.67 should be referred to a hepatologist

More general terms

• numerical rating scale (NRS)