In short
FIB-4 is a free score calculated from your age and three routine blood results. It tells your doctor whether serious scarring is unlikely or needs a closer look.
It uses age, AST, ALT and platelet count. No extra test is needed if you already have these results.
A low score (below 1.3, or below 2.0 if you are 65 or older) means advanced scarring is unlikely. A higher score means the next step is a liver stiffness scan such as FibroScan.
FIB-4 is less reliable under age 35. It is a guide for your doctor, not a diagnosis.
Related questions
- What is a FibroScan, and how do I prepare?
- What are liver enzymes (ALT and AST)?
- Do I need a liver biopsy?
Sources
- EASL–EASD–EASO Clinical Practice Guidelines on the management of MASLD. J Hepatol 2024;81:492–542. Link
- Abaalkhail F, et al. MASLD management in Saudi Arabia: a modified Delphi-based adaptation of international standards. Saudi J Gastroenterol 2026;32(2):104–20. Link
- Younossi ZM, et al. Updated global consensus recommendations for risk stratification, treatment initiation, and response monitoring in MASLD. Clin Gastroenterol Hepatol 2026;24(9):2333–47. Link
Last updated 2026-10-03. Based on international and Saudi guidelines. Education only: it does not replace your doctor. Read the disclaimer.