FIB-4 Score Calculator

Calculate the FIB-4 (Fibrosis-4) index to estimate liver fibrosis risk using age, AST, ALT, and platelet count. A non-invasive screening tool used in hepatology. Educational reference only.

🫁 Clinical Reference📐 FIB-4 = (Age × AST) / (Platelets × √ALT)🏥 Health
Age (years)
AST (U/L)
ALT (U/L)
Platelet count (×10⁹/L)
Please enter valid values.

Formula & Reference

VariableSymbolFormulaUnits
FIB-4 Score CalculatorFIB-4 = (Age × AST) / (Platelets × √ALT)index value

Step-by-Step Examples

Example 1
Low Risk Profile

Age=35, AST=25, ALT=22, Platelets=250.

  • FIB-4 = (35×25)/(250×√22) = 875/(250×4.69) = 875/1172.5 = 0.75
  • Below the 1.3 threshold — low fibrosis risk
✓ FIB-4 = 0.75 (low risk)
Example 2
Indeterminate Range

Age=55, AST=50, ALT=45, Platelets=180.

  • FIB-4 = (55×50)/(180×√45) = 2750/(180×6.71) = 2750/1207.6 = 2.28
  • Falls in the indeterminate range — may warrant additional evaluation
✓ FIB-4 = 2.28 (indeterminate)
Example 3
High Risk Profile

Age=65, AST=80, ALT=55, Platelets=120.

  • FIB-4 = (65×80)/(120×√55) = 5200/(120×7.42) = 5200/890 = 5.84
  • Well above 2.67 threshold — suggests high risk of advanced fibrosis
✓ FIB-4 = 5.84 (high risk)

Real-World Applications

Common Mistakes to Avoid

⚠️
Using FIB-4 as a definitive fibrosis diagnosis

FIB-4 is a screening risk stratification tool, not a diagnostic test. Indeterminate or high-risk results typically warrant further evaluation (imaging, specialist referral, sometimes biopsy).

⚠️
Applying the same cutoffs to all age groups uniformly

Some research suggests age-specific cutoffs may improve accuracy, particularly distinguishing younger vs older patients, though the standard cutoffs remain widely used.

⚠️
Forgetting that FIB-4 was validated mainly for specific conditions

FIB-4 was originally developed and validated primarily for hepatitis C and HIV-coinfected patients, though it's now used more broadly across liver disease etiologies with reasonable performance.

Frequently Asked Questions

What does FIB-4 score predict?
It estimates the probability of advanced liver fibrosis (scarring) using readily available clinical data, helping identify patients who may need further specialist evaluation.
What do the FIB-4 score ranges mean?
Below 1.3: low probability of advanced fibrosis. 1.3-2.67: indeterminate, may need further testing. Above 2.67: higher probability of advanced fibrosis, often prompting specialist referral.
How accurate is FIB-4 compared to biopsy?
FIB-4 has good but imperfect accuracy for ruling out advanced fibrosis at low scores and identifying likely advanced fibrosis at high scores, but the indeterminate range requires additional testing for clarity.
What conditions is FIB-4 used for?
Originally developed for hepatitis C/HIV co-infection, now used broadly for NAFLD/NASH, hepatitis B, alcohol-related liver disease, and other chronic liver conditions.
What happens if my FIB-4 score is high?
A high score typically prompts further evaluation such as liver elastography (FibroScan), specialized blood tests, or hepatology specialist referral — it does not by itself confirm a fibrosis diagnosis.

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