FIB-4 index

FIB-4 identifies patients with significant liver fibrosis from conditions like non-alcoholic fatty liver disease, chronic hepatitis, or alcohol-related liver disease before symptoms appear. Early detection through FIB-4 screening enables lifestyle modifications (weight loss, alcohol cessation), medication adjustments, and closer monitoring to prevent progression to cirrhosis, liver failure, or hepatocellular carcinoma.

Most adults benefit from checking FIB-4 yearly as part of a liver panel. With a known liver concern under active monitoring, retest every six months.

At baseline / for screening: Once every 12 months from age 30 as part of a comprehensive panel. More frequently, every 3 to 6 months, if you have known liver disease, regular alcohol intake, fatty liver (MASLD), or take hepatotoxic medication.

When monitoring an intervention or change: Retest 3 to 6 months when actively monitoring liver fibrosis risk, particularly with known MASLD or advanced fatty liver. After a sustained lifestyle intervention (significant weight loss, dietary improvement, alcohol reduction), expect 6 to 12 months for a meaningful shift in FIB-4.

Note: FIB-4 is age-adjusted (rises naturally over the years), so the trajectory matters more than crossing a fixed threshold. After meaningful weight loss or MASLD treatment, expect 6 to 12 months for a true shift; sooner retests reflect noise rather than progression.