Fib-4 better than AST/ALT ratio!

[ToughToes]

Thanks very much to everyone who replied to my query about the accuracy of the AST/ALT ratio as an indicator of degree of fibrosis. The overwhelming consensus was that it was not of much predictive/prognosis value if the AST & ALT were within the normal range. However, nobody really spoke to the value of the Fib-4 equation score as a valid indicator of the extent of fibrosis, about which I was curious. What are your opinions on Fib-4?

[ToughToes]

Thanks. You mean that you can't get blood tests to check your AST level in the UK? I'm in Canada, and my blood test done on August 9 showed AST -13, ALT -9. My AST/ALT ratio, then, is 1.4. I also used an online calculator to get my Fib-4 score and it was really low at 0.42.

[l1thium]

Its been dropped from the standard LFT in UK but if you ask the GP, they will add it on aswell as GGT if requested and with good reason, such as excess alcohol use and concern of your Liver health, from my experience.

[l1thium]

Also it’s correct that the ratio is irrelevant if both numbers are in range and especially the lower end of normal.

FIB4 is a good indicator of current inflammation/damage however once the attack on the liver is removed (for example alcohol) you could have an extremely low FIB4 but the previous damage may still remain, only Fibroscan, imaging or Biopsy can determine any previous damage that remains at that point.