FIB-4 Calculator

Calculate FIB-4 and APRI scores to assess liver fibrosis and disease progression risk

Calculate FIB-4 and APRI Scores

years

Patient's age in years (most accurate for ages 35-65)

U/L

Aspartate transaminase level (normal: 10-40 U/L)

U/L

Alanine transaminase level (normal: 7-56 U/L)

Platelet count (normal: 150,000-400,000/μL)

FIB-4 Score Results

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FIB-4 Score
Formula: (age × AST) / (platelets × √ALT)

APRI Score Results

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APRI Score
Formula: (AST/40) / (platelets×10⁻⁹)

⚠️ Medical Disclaimer

This calculator is for educational purposes only and should not replace clinical judgment. FIB-4 and APRI scores are screening tools and may require additional testing for confirmation. Always consult with healthcare providers for proper interpretation and clinical decision-making.

Score Analysis

Example Calculation

Patient with NAFLD Screening

Age: 55 years

AST: 45 U/L

ALT: 38 U/L

Platelet Count: 180,000/μL

Calculations

FIB-4: (55 × 45) / (180,000 × √38) = 2475 / (180,000 × 6.16) = 2.23

APRI: (45/40) / (180) = 1.125 / 180 = 0.63

Interpretation: Intermediate risk for advanced fibrosis - consider additional testing

FIB-4 Reference Ranges

Low Risk (< 1.45)

Excludes advanced fibrosis in 94.7% of patients

Intermediate (1.45-3.25)

Consider additional testing

High Risk (> 3.25)

Confirms advanced fibrosis in 82.1% of patients

APRI Reference Ranges

Low Risk (< 0.5)

Rules out progression in ~87% of cases

Intermediate (0.5-1.0)

Intermediate risk of progression

High Risk (>= 1.0)

High possibility of severe cirrhosis

Normal Lab Values

AST:10-40 U/L
ALT:7-56 U/L
Platelets:150-400K/μL
Optimal age range:35-65 years

Understanding FIB-4 and APRI Scores

What is FIB-4?

FIB-4 (Fibrosis-4) is a non-invasive scoring system used to assess the probability of liver fibrosis, particularly in patients with NAFLD (Non-Alcoholic Fatty Liver Disease), hepatitis C, B, or HIV co-infections.

Clinical Applications

  • Screen for advanced liver fibrosis
  • Monitor NAFLD progression
  • Guide referral decisions
  • Reduce need for liver biopsy

Formula Components

FIB-4 = (age × AST) / (platelets × √ALT)

APRI = (AST/40) / (platelets×10⁻⁹)

  • Age: Patient's age in years
  • AST: Aspartate transaminase (U/L)
  • ALT: Alanine transaminase (U/L)
  • Platelets: Platelet count (/μL)

Best Performance: FIB-4 is most accurate in patients aged 35-65 years. Results may be less reliable outside this age range.

NAFLD and Liver Fibrosis

Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common liver disease worldwide. It can progress to advanced fibrosis and cirrhosis, leading to permanent liver function loss.

Risk Factors for NAFLD

  • • Obesity and overweight
  • • Type 2 diabetes
  • • Metabolic syndrome
  • • Hypertension
  • • Dyslipidemia
  • • Insulin resistance

When to Use FIB-4

  • • Suspected NAFLD patients
  • • Elevated liver enzymes
  • • Metabolic risk factors
  • • Hepatitis C screening
  • • Pre-treatment assessment
  • • Regular monitoring