Non-invasive fibrosis assessment using age, AST, ALT, and platelets for NAFLD and viral hepatitis
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Clinical background · Scoring criteria · Evidence-based pearls
The FIB-4 (Fibrosis-4) Index was originally developed in 2006 by Sterling and colleagues in HIV/HCV co-infected patients at the ACTG A5071 trial, using four simple variables: age, AST, ALT, and platelet count. It was subsequently validated in NAFLD and other chronic liver diseases. The FIB-4 index is the most widely recommended non-invasive test for advanced fibrosis assessment in NAFLD/MASLD, endorsed by the American Association for the Study of Liver Diseases (AASLD), EASL, and the National Lipid Association. It avoids the need for liver biopsy in the majority of patients and is practical in primary care settings.
Other evidence-based tools commonly used alongside this calculator
MELD Score
Model for End-Stage Liver Disease - predicts 3-month mortality and prioritizes liver transplant allocation
Glasgow-Blatchford Score (GBS)
Risk stratification for upper GI bleeding - identifies patients safe for outpatient management
Rome IV IBS Diagnostic Criteria
Diagnosis and subtyping of Irritable Bowel Syndrome using Rome IV criteria — and differential diagnosis guide
BISAP Score
Bedside Index for Severity in Acute Pancreatitis — predicts in-hospital mortality within 24 hours of admission
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