FIB-4: An inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotest

Abstract

To optimize the management of patients with chronic hepatitis C virus (HCV) infection, noninvasive tests to determine the degree of hepatic fibrosis have been developed. The aims of this study were (1) to validate a simple, inexpensive, noninvasive test called FIB‐4, which combines standard biochemical values (platelets, ALT, AST) and age, in a series of 847 liver biopsies performed in HCV‐monoinfected patients; and (2) to compare the results of 780 FIB‐4 and FibroTests performed the same day in a series of 592 HCV‐infected patients. The FIB‐4 index enabled the correct identification of patients with severe fibrosis (F3‐F4) and cirrhosis with an area under the receiver operating characteristic curve of 0.85 (95% CI 0.82‐0.89) and 0.91 (95% CI 0.86‐0.93), respectively. An FIB‐4 index P < 0.01). A FIB‐4 value 3.25 (64.6% of the cases) was concordant with FibroTest results in 92.1% and 76%, respectively. Conclusion: For values outside 1.45‐3.25, the FIB‐4 index is a simple, accurate, and inexpensive method for assessing liver fibrosis and proved to be concordant with FibroTest results. (HEPATOLOGY 2007.)