For Non-Alcoholic Steatohepatitis (NASH) a FIB-4 score 2.67 = F3 - F4
For Hepatitis C Virus (HCV) a FIB-4 score 3.25 = F3 - F4
Fib 4 calculator (Fibrosis-4 calculator) result can be used to evaluate how much wrinkling there is in the liver. To determine the FIB-4 score, input the appropriate parameters. Be cautious when using the calculator on persons under the age of 35 or over the age of 65, as the value is less dependable in these individuals.
Liver fibrosis is the result of long-term damage to the liver caused by a range of factors such as bacterial, drug-induced, immune deficiency, cholestatic, and metabolic illnesses. Fibrosis is a major contributor to liver disease and portal hypertension.
In contrast to cirrhosis, there is growing proof that fibrosis can be treated and reversed in its beginning phases. Individuals with moderate infection should be observed, while those with severe infection should be treated, so knowing the severity of fibrosis is critical for treatment planning.
Fibrosis-4 Calculator: Formula for determining the FIB-4 score
FIB-4 Score = (Age x AST) / (Platelets x √(ALT))
AST stands for Aspartate Aminotransferase, an enzyme discovered in a variety of tissues (liver, kidney, heart, brain). Rises in the range of 5 to 40 IU/L are most often indicative of tissue damage.
ALT stands for Alanine Aminotransferase, a liver enzyme that can cause harm when levels rise above 7-56 IU/L.
Note: Use caution in patients under the age of 35 or above the age of 65, as the score is less accurate in these age groups.
How to use the Fib 4 calculator in medical practice?
We’re addressing two issues, as with any indicator. Is an affected person free of fibrosis, in which case they may not require prompt intervention and can be monitored cautiously? Secondly, does an affected person have severe fibrosis that would necessitate extensive study, such as an ultrasound to look for hepatocellular cancer and an endoscopy to look for varices?
Medication is also prioritized for those with chronic fibrosis. As a starting point, we employ the FIB-4 tool. When paired with the aspartate aminotransferase platelet ratio index, it provides a strong negative predictive value for eliminating progressive fibrosis in severe hepatitis C virus.
The prognostic score for favorable outcomes is less evident. Those with Fibrosis-4 greater than 1.5 and/or a platelet ratio index of aspartate aminotransferase greater than 0.5 are frequently referred to for liver elastography.
There’s no evidence that fibrosis-4 is effective in those who have already been medicated with a direct-acting antiviral and have had a substantial virologic recovery. I wouldn’t predict fibrosis-4 or the aspartate aminotransferase platelet ratio index to be raised except if the patient had low platelets since aspartate aminotransferase and alanine aminotransferase commonly regulate with the prolonged virologic response.
This is also true for liver elastography, where the majority of benefits are due to decreased inflammation rather than fibrosis.
Reasons behind the use of the Fibrosis-4 or Fib 4 calculator
- Since a liver biopsy is a fundamental basis for diagnosing liver fibrosis, it is not without flaws. Because a biopsy only examines a small part of the liver, uncertainties are possible. A liver biopsy is also associated with a high level of complication.
- Because liver fibrosis frequently proceeds in a non-linear fashion, it’s critical to be able to track fibrosis patterns in clinical practice over time.
- Cirrhosis sufferers must be screened for hepatocellular carcinoma (HCC) and gastroesophageal varices, likewise, assessments to detect the ailment must be extremely efficient.
- In individuals with non-alcoholic fatty liver disease, the FIB-4 index outperformed seven other noninvasive fibrosis indicators, such as the Non-alcoholic Fatty Liver Disease Fibrosis Score.
Fibrosis-4 or Fib 4 calculator’s limitations
While FIB-4 provides a simple and relatively cheap way to diagnose liver fibrosis, it is not above flaws. Assuming that age is in the numerator, it may not function as well in those demographics as it was designed in a group of participants that did not comprise the very young or very old.
Moreover, because age is included, it is less trustworthy when used longitudinally. Because Aspartate Aminotransferase is also included in the numerator, it may exaggerate fibrosis in people who drink.
- Because liver fibrosis sometimes proceeds non-linearly, it’s essential to effectively track fibrosis patterns in patient characteristics over time, and invasive re-assessments put people in danger. fibrosis-4 enables for non-invasive evaluation of liver fibrosis.
- fibrosis-4 was created in people who had co-infection with the human immunodeficiency virus and the hepatitis C virus.
- fibrosis-4 was created to link with Ishak fibrosis rates (by biopsy) and has three levels:
- 0 – 2 (slight fibrosis)
- 3 – 4 (normal fibrosis)
- 5 – 6 (intense fibrosis/cirrhosis)
When to use Fib 4 calculator
- Severe hepatitis, alcoholic liver disorder, non-alcoholic fatty liver infections, and cholestatic and metabolic liver illnesses are all known health risks for liver problems.
- Sick people who have been diagnosed with liver fibrosis should have their fibrosis monitored throughout time to see if it is progressing or stabilizing.
Sources of Liver Fibrosis
Scarring of the liver tissue is a direct consequence of inflammation, whether from illness or accident. This is the process of tissue regeneration in which new collagen is deposited.
Sadly, normal liver units pay a price for this, and total hepatic function is reduced to varying degrees. Cirrhosis develops as fibrosis progresses, and this can lead to liver failure.
Severe viral hepatitis B and alcoholic liver cirrhosis are the two most common causes of liver injury. Nonalcoholic fatty liver disease and chronic hepatitis C are two other diseases.
Nonalcoholic steatohepatitis, or NASH, has been the highest chronic form of non-alcoholic fatty liver disease, and it happens when fat buildup, irritation, and fibrosis limit liver performance.
If FIB-4 values remain low, patients with low fibrosis values may be eligible for medicinal care rather than a liver biopsy. Unless there are other medical or diagnostic symptoms of progression to end-stage liver infection, chronic fibrosis/cirrhosis values may necessitate a liver biopsy for cirrhosis proof. The fibrosis-4 or Fib 4 calculator can be used by your healthcare professional to determine your fibrosis score.
What does a fibrosis score of four mean?
A fibrosis phase of 2 or above indicates that your liver has a bunch of fibrosis. If your fibrosis stage is 3 or 4, you have advanced fibrosis. If your fibrosis stage is 4, you have liver problems. Your medical provider can calculate your fibrosis score using the findings of your FibroScan test alone or in combination with the results of other tests.
How accurate is fibrosis-4?
In 92.1 percent and 76 percent of the occurrences, a FIB-4 value less than 1.45 or larger than 3.25 (64.6 percent of the cases) was concordant with FibroTest scores. Conclusion: The FIB-4 score is a straightforward, reliable, and economical approach for measuring liver fibrosis for values outside of 1.45-3.25, and it was found to be concordant with FibroTest outcomes.
Can Alanine Aminotransferase levels return to normal?
Health and fitness adjustments, such as frequent workouts and a nutritious diet, can help people reduce their Alanine Aminotransferase levels. Higher fiber consumption, limiting vegetable oils and processed foods, and eating a variety of nutrients from fruits and vegetables may all assist to decrease levels.
When does fibrosis become cirrhosis and how long does it take?
Cirrhosis usually develops after 15 to 20 years in the percentage of cases. Cirrhosis can cause ascites, kidney damage, hepatic encephalopathy, and variceal hemorrhage, among other symptoms.