MASLD, hepatitis B, and hepatitis C are liver diseases that can result in abnormal development of fibrosis.
MASLD is considered a manifestation of metabolic syndrome within the liver and is associated with type 2 diabetes and cardiovascular disease, whereas hepatitis B and C are caused by infection with the hepatitis B (HBV) and C (HCV) viruses, respectively.
Many patients with these liver diseases have a mild clinical presentation.
However, chronic disease progression can lead to the development of fibrosis, cirrhosis, and associated complications such as hepatocellular carcinoma.
Management of MASLD, hepatitis B, and hepatitis C depends, in part, on liver disease severity that is characterized by the presence of inflammation and/or advanced fibrosis.
There is a strong association of fibrosis stage with mortality in NAFLD and management implications for hepatitis B and hepatitis C.
A biopsy is the gold standard for assessing liver disease severity, but the procedure is highly invasive and involves safety risks.
The FIB-4 index, uses a combination of routine blood tests to indicate whether a patient has a high or low probability of advanced fibrosis.
The FIB-4 index formula yields a single score by combining patient age with measurements of 3 biomarkers: aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count.
The FIB-4 index has clinical utility for management of NAFLD, hepatitis B, and hepatitis C.
The FIB-4 index as an option for noninvasive testing to identify patients with high likelihood of advanced fibrosis.
The FIB-4 index has a high negative predictive value (≥90%) in patients with NAFLD.
This test particularly useful for ruling out advanced fibrosis and thereby avoiding unnecessary biopsies.
For hepatitis B, MASLD guidance includes the FIB-4 index as an alternative to biopsy for assessing disease severity; this assessment helps guide treatment decisions for patients with chronic HBV infection, including identification of appropriate candidates for antiviral therapy and determination of therapy duration.
FIB-4 index as an option for noninvasive testing to evaluate individuals with HCV infection for advanced fibrosis.
Fibrosis-4 (FIB-4) Index Panel includes tests for AST, ALT, and platelet count, plus calculation of the FIB-4 index.