Fib-4 and fibroscan in assessment of liver fibrosis in alcoholic liver disease

Background: Alcohol-associated liver disease (ALD) is a leading cause of cirrhosis worldwide. Although liver biopsy is the gold standard for staging fibrosis, its invasiveness and limitations have prompted use of non-invasive tools. This study aimed to assess the role of FIB-4 in staging fibrosis in ALD and compare its diagnostic accuracy with Fibro Scan. Methods: This prospective cross-sectional study included 100 ALD patients at RNT Medical College, Udaipur. Patients >18 years with documented alcohol intake were enrolled after informed consent. Exclusions included HIV infection and other liver diseases (NAFLD, HBV, HCV). FIB-4 was calculated using age, AST, ALT, and platelet count (cut-off: >3.25 for cirrhosis). Liver stiffness was assessed using FibroScan. Data were analyzed using descriptive statistics and chi-square test. Results: The mean age of patients was 52.7 years; 82% were male. Based on FIB-4, 33 patients had scores <1.45, 25 had intermediate scores (1.45–3.25), and 42 had scores >3.25. All patients with FIB-4 >3.25 were diagnosed with cirrhosis on FibroScan, while those with low scores (<1.45) had no cirrhosis. Mean FibroScan values increased across fibrosis stages (4.88 kPa in F0–F1, 8.9 kPa in F2, 10.6 kPa in F3, and 45.83 kPa in F4), showing strong correlation with FIB-4 scores (p < 0.001). Interpretation & conclusions: FIB-4 and FibroScan both demonstrated significant correlation with fibrosis stage in ALD patients. FIB-4 offers a simple, cost-effective screening tool, while FibroScan provides more precise staging. Combined use of these methods can reduce reliance on liver biopsy and enable early identification of patients with advanced fibrosis or cirrhosis.