Skip to main content
Calcimator

Liver Fibrosis Score (FIB-4) Calculator

Calculate the FIB-4 index for non-invasive liver fibrosis assessment using age, AST, ALT, and platelet count. Includes APRI score and NAFLD-specific cutoffs.

Inputs

Results

FIB-4 Index

1.37

Risk Category (0–2)

0

NAFLD Risk (0–2)1
AST/ALT Ratio (De Ritis)1
APRI Score0.38
APRI Risk (0–2)0
Next Step (0–2)1
How to Use This Calculator
  1. Enter the patient's Age in years, AST in U/L, and ALT in U/L from current laboratory results.
  2. Enter Platelet Count in ×10⁹/L to complete the FIB-4 formula.
  3. Review the FIB-4 Index — values below 1.30 suggest low fibrosis risk, above 2.67 suggests advanced fibrosis.
  4. Check the APRI Score and AST/ALT Ratio (De Ritis) for additional non-invasive fibrosis markers.
  5. Use the risk category to guide decisions about liver biopsy or specialist referral.

How the result changes with Age (years)

Age (years)FIB-4 IndexRisk Category (0–2)
260.710
471.290
711.941
922.521

What each input means

Age (years)
Patient age in years. FIB-4 is validated for adults 35–65 years.
AST (U/L)
Aspartate aminotransferase (SGOT) in units per liter.
ALT (U/L)
Alanine aminotransferase (SGPT) in units per liter.
Platelet Count (×10⁹/L)
Platelet count in 10⁹/L (e.g., 200 = 200,000/μL).

What each result means

FIB-4 Index
FIB-4 score. <1.45 = low risk, 1.45–3.25 = indeterminate, >3.25 = high risk.
Risk Category (0–2)
0 = low risk (F0–F1), 1 = indeterminate (need further testing), 2 = high risk (F3–F4).
NAFLD Risk (0–2)
NAFLD-specific cutoffs: 0 = low (<1.30), 1 = indeterminate (1.30–2.67), 2 = high (>2.67).
AST/ALT Ratio (De Ritis)
De Ritis ratio. >1.0 may suggest cirrhosis or alcoholic liver disease.
APRI Score
AST to Platelet Ratio Index. <0.5 = low risk, 0.5–1.5 = indeterminate, >1.5 = high risk.
APRI Risk (0–2)
APRI-based fibrosis risk: 0 = low, 1 = indeterminate, 2 = high.
Next Step (0–2)
0 = routine monitoring, 1 = consider elastography/further testing, 2 = elastography + hepatology referral.

How this is calculated

Worked example, using the default values

  1. Identify Input Parameters
    4 parameters
    Age (years) = 50, AST (U/L) = 30, ALT (U/L) = 30, Platelet Count (×10⁹/L) = 200 = 4 input(s) provided
  2. Calculate FIB-4 Index
    FIB-4 Index = round(fib4 * 100) / 100
    1.37 = 1.37
  3. Calculate Risk Category
    0 = 0
  4. Calculate NAFLD Risk
    1 = 1
  5. Calculate AST/ALT Ratio
    AST/ALT Ratio
    1 = 1

The questions that sit next to this one — chosen by subject, including calculators filed under a different category.

More in Medical & Clinical.