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Liver Fibrosis, Fibrosis-4 (FIB-4) Index Panel

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.

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