FIB-4 Index - Evidencio

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The FIB-4 Index was developed in 2006 in order to accurately predict liver fibrosis in patients coinfected with HIV and Chronic Hepatitis C Virus and to distinguish between patients with mild to moderate fibrosis and those with advanced fibrosis.

The FIB-4 Index combines age, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels and platelet count to provide a score that can be used to estimate the probability of advanced liver fibrosis in patients at risk of/with liver disease.

Research authors: Richard K. Sterling, Eduardo Lissen, Nathan Clumeck, Ricard Sola, Mendes Cassia Correa, Julio Montaner, Mark S. Sulkowski, Francesca J. Torriani, Doug T. Dieterich, David L. Thomas, Diethelm Messinger, Mark Nelson

Version: 1.0.{{ model.microversion }}

Public
Hepatology
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V-1.0-10277.26.02.20

(01)08720938015113(8012)v1.0(4326)260220(240)10277

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Additional information

Details

Algorithm author

Evidencio

Algorithm ID

10277

Version

1.0.{{ model.microversion }}

Revision date

2026-02-20

Specialty

Hepatology

Algorithm type

Custom calculation ^{(Calculation)}

MeSH terms

Fibrosis, Liver

Hepatitis C

HIV

Status

Public

Formula

Study characteristics

Additional information

The FIB-4 Index was developed in a population of patients from the APRICOT trial, infected with both HIV and HCV, with elevated serum alanine amino-transferase at least twice or more within the 12 previous month, as well as compensated liver disease, and liver biopsy with histology consistent with chronic HCV. The algorithm was initially derived with 555 patients, and internally validated in 277 patients.

The FIB-4 index has been validated as a measure for liver fibrosis beyond the combination of HIV and HCV, such as in both Hepatitis B and C alone, as well as in NAFLD/MASLD.

Study Population

Total population size: 555

Continuous characteristics

Name	Mean	SD	Unit
Age	40	7	Years
Weight	73	14	kg
BMI (body mass index)	25	4	kg/(m²)
AST (aspartate aminotransferase)	56	39	U/L
ALT (alanine aminotransferase)	83	62	U/L
AST/ALT Ratio	0.75	0.31	-
AP (alkaline phosphatase)	80	34	U/L
Albumin	42	5	g/L
Glucose	5.3	1.6	mmol/L
HCV RNA	6.4	0.8	log IU/mL
PLT (platelet count)	194	66	(10⁹)/L
INR (international normalized ratio)	1.04	0.15	-
PTT (partial thromboplastin time)	33	7	sec
CD4	529	255	cells/μL
CD8	970	425	cells/μL
HIV RNA	9031	44590	copies/mL
HAI (hepatitis activity index)	8.1	3.8	-

Categorical characteristics

Name	Subset / Group	Nr. of patients
Gender	Male	444
Gender	Female	111
Race	Caucasian	427
Race	Other	128
HCV genotype	HCV Genotype 1	339
HCV genotype	HCV Genotype other	216
NRTI use	NRTI Use	461
NRTI use	No NRTI Use	94
NNRTI use	NNRTI Use	189
NNRTI use	No NNRTI Use	366
PI use	PI Use	244
PI use	No PI Use	311
Fibrosis level	Mild Fibrosis (Ishak 0-1)	198
Fibrosis level	Moderate Fibrosis (Ishak 2-3)	242
Fibrosis level	Advanced Fibrosis (Ishak 4-6)	115

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	Evidencio B.V., Irenesingel 19, 7481 GJ Haaksbergen, The Netherlands
	V-1.0-10277.26.02.20
	(01)08720938015113(8012)v1.0(4326)260220(240)10277
	Download the User manual
	Medical device In vitro diagnostic medical device

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V-1.0-10277.26.02.20

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