Comparison between FIB-4 Index and Fibroscan as Marker of Fibrosis in Chronic HCV Infection in Egyptian Patients

Noha A. El Nakeeb¹, Amir Helmy¹, Shereen A. Saleh¹, Heba M. Abdellah², Mostafa H. Abdel Aleem², Dina Elshennawy³

¹Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
²Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
³Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

DOI: 10.4236/ojgas.2014.412052                

Abstract

The FIB-4 index is a simple and noninvasive algorithm consisting to evaluate liver fibrosis in chronic HCV infection. Aim: To evaluate the utility of FIB-4 index as a noninvasive marker to assess liver fibrosis in chronic HCV infection in comparison to transient elastography. Patients and Methods: We studied 30 patients having chronic HCV infection based on clinical features, laboratory tests, diagnostics images, Fibroscan and FIB-4 score. According to the results of Fibroscan, the 30 patients were classified into two groups in order to obtain a cutoff value to exclude patient with significant fibrosis: group Ia: 7 patients with no or mild liver fibrosis (F0-F1) and group Ib: 23 pa-tients with significant fibrosis or cirrhosis (F2-F3-F4). Group IIa: 17 patients with no or significant fibrosis (F0-F1-F2-F3) and group IIb (F4): 13 patients with cirrhosis (F4). Results: The mean of FIB-4 index increased with the increase of the fibrosis score. FIB-4 index proved to be sensitive and specific in differentiation between patients with no or mild fibrosis (F0-F1) and patients with significant fibrosis or cirrhosis (F2-F3-F4) with the best cutoff value at 1.61. It also proved to be sensitive and specific in differentiation between patients with no or significant fibrosis (F0-F1-F2-F3) and patients with cirrhosis (F4) with cutoff value at 1.88. Conclusion: The FIB-4 index enabled the correct identification of extreme types of fibrosis. Using these cutoffs (1.61 - 1.88), 87% of patients fell outside these ranges and could thus avoid liverbiopsy with an overall accuracy of 70%.

Keywords

Chronic HCV Infection, Transient Elastography, FIB-4, Liver Fibrosis, Liver Cirrhosis

Conflicts of Interest

The authors declare no conflicts of interest.

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