Application of liver fibrosis index for chronic hepatitis B

What is it about?

FIB-4 is a practical index for staging hepatic fibrosis. An accurate assessment of liver fibrosis in patients with hepatitis virus B infection is essential not only in determining whether and when to initiate antiviral therapy, but also in predicting long-term clinical prognosis. For example, with regard to antiviral therapy, it is known that maintenance of viral suppression can reduce liver-related complications in chronic hepatitis B patients. Furthermore, assessing prognosis in patients with cirrhosis is required to closely follow the potential development of hepatocellular carcinoma and other complications.

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Why is it important?

Liver fibrosis stage is an important factor in determining prognosis and need for treatment in patients infected with hepatitis B virus. Liver biopsies are typically used to assess liver fibrosis; however, noninvasive alternatives such as the FIB-4 index have also been developed.To date, liver biopsy remains the gold standard for assessing liver fibrosis; however, it does have some limitations. The invasive nature of the biopsy is associated with patient discomfort, and can cause rare but important complications. Furthermore, its accuracy is affected by sampling error and variability in pathological interpretation, and the dynamic process of liver fibrosis related to disease progression and regression cannot be easily quantified. An ideal diagnostic index should be accurate, noninvasive, inexpensive, convenient and readily available. The limitations of the liver biopsy have lead many clinicians to develop noninvasive indexes, and most attention has been focused on whether noninvasive indexes can detect the presence or absence of fibrosis.

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