fibrosis-4/5 index; fibrosis-4/5 score; FIB-4/5 index; FIB-4/5 score

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Indications

Procedure

Interpretation

  • patients with a score of < 1.3 are unlikely to have fibrosis & should be periodically reassessed[5]
  • further evaluation by transient elastography for patients with a score of > 1.3[5]
  • patients with FIB-4 scores of 1.3-2.67 should have transient elastography with FibroScan[6]
    • 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[6]

More general terms

Additional terms

References

  1. Sterling RK, Lissen E, Clumeck N et al Development of a simple noninvasive index to predict significant fibrosis patients with HIV/HCV co-infection. Hepatology 2006;43:1317-1325. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16729309
  2. 2.0 2.1 Fibrosis-4 (FIB-4) Index for Liver Fibrosis Noninvasive estimate of liver scarring in HCV & HBV patients, to assess need for biopsy. https://www.mdcalc.com/calc/2200/fibrosis-4-fib-4-index-liver-fibrosis
  3. 3.0 3.1 Fibrosis-4 (FIB-4) Calculator University of Washington https://www.hepatitisc.uw.edu/page/clinical-calculators/fib-4
  4. 4.0 4.1 FIB-4 Calculator https://www.omnicalculator.com/health/fib-4
  5. 5.0 5.1 5.2 Rinella ME et al. AASLD practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology 2023 May; 77:1797. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36727674 https://journals.lww.com/hep/Fulltext/2023/05000/AASLD_Practice_Guidance_on_the_clinical_assessment.31.aspx
  6. 6.0 6.1 6.2 Kanwal F, Shubrook JH, Adams LA et al. Clinical care pathway for the risk stratification and management of patients with nonalcoholic fatty liver disease. Gastroenterology 2021 Nov; 161:1657. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34602251 https://www.gastrojournal.org/article/S0016-5085(21)03384-9/fulltext
  7. 7.0 7.1 van Kleef LA, Francque SM, Prieto-Ortiz JE, et al. Metabolic Dysfunction-Associated Fibrosis 5 (MAF-5) Score Predicts Liver Fibrosis Risk and Outcome in the General Population With Metabolic Dysfunction. Gastroenterology. 2024 Mar 19:S0016-5085(24)00300-7 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38513745 https://www.gastrojournal.org/article/S0016-5085(24)00300-7/fulltext?