CLINICAL QUESTION

Can the Fibrosis-4 (FIB-4) score and/or Forns index accurately predict significant or severe liver fibrosis in adults with chronic hepatitis C virus (HCV) infection?

EVIDENCE-BASED ANSWER

Using low cutoffs with the FIB-4 score (ie, 1.45 or greater for detecting at least severe fibrosis [F3 or higher]) or Forns index (ie, 4.2 or greater for detecting at least significant fibrosis [F2 or higher]) yields relatively accurate results for predicting fibrosis with a sensitivity of 81.1% and 84.7%, respectively, in patients with HCV infection. Both measures may be used for initial fibrosis staging in adults with chronic HCV infection.¹ (Strength of Recommendation: C, disease-oriented evidence.)

PRACTICE POINTERS

In the United States, more than 2 million people are living with HCV infection, which causes more than 12,000 deaths each year.^2,3 The availability of direct-acting antiviral drugs has simplified treatment; primary care clinicians can manage much of the treatment of HCV infection.^4,5