A simple bedside blood test (Fibrofast; FIB-5) is superior to FIB-4 index for the differentiation between non-severe and severe fibrosis in patients with chronic Hepatitis C

Document Type : Original article

Authors

1 Gastrohepatology Unit, Internal Medicine dept., Faculty of Medicine, Mansoura Univ., Egypt.

2 Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt

3 Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt.

4 Community Medicine Department, National Research Center, Cairo, Egypt

5 Pathology Department, Faculty of Medicine, Mansoura University, Egypt.

Abstract

A simple noninvasive score (Fibrofast, FIB-5) was developed using five routine laboratory tests (ALT, AST, Alkaline phosphatase, Albumin and Platelets count) for the detection of severe hepatic fibrosis in patients with chronic hepatitis C. The FIB-4 index is a noninvasive test for the assessment of liver fibrosis, and a score of ≤3.35 enables the correct identification of patients who have nonsevere (F0-2) from severe fibrosis (F3 4), and could avoid liver biopsy. The aim of this study was to compare the performance characteristics of FIB-5 and FIB-4 to differentiate between nonsevere
from severe fibrosis. A cross-sectional study included 604 chronic HCV patients. All liver biopsies were scored using
METAVIR system. Both FIB-5 and FIB-4 scores were measured and the performance characteristics were calculated using the ROC curve. The performance characteristics of Fibro-Fast at ≥ - 2.1 and FIB-4 at ≤ 3.25 for the differentiation between non-severe fibrosis and severe fibrosis were; sensitivity 39.6%, NPV 88.7% and sensitivity 29.7%, NPV 87.4% respectively. Conclusion: FIB-5 score at the new cutoff is more superior to FIB-4 index for the differentiation between non- severe and severe fibrosis. 

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