SynthesisPloS one2014
The diagnostic value of the FIB-4 index for staging hepatitis B-related fibrosis: a meta-analysis.
Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
57 citing papers in PubMed, 1 synthesis or guideline pooled it.
- KASL clinical practice guidelines for management of chronic hepatitis B.Clinical and molecular hepatology · 2019Guideline
- Association of Subclinical Liver Fibrosis With Death in Patients With Coronary Artery Disease: A Post Hoc Analysis of the ISCHEMIA Trial.Journal of the American Heart Association · 2025Trial
- Cut or Count? Evaluating Advanced Fibrosis Assessment Tools in MASH and Chronic Viral Hepatitis.Biomedicines · 2026Article
- Circulating let-7 Predicts Hepatic Fibrogenesis of 12-Month Post-Nucleos(t)ide Analog Treatment in Patients With Hepatitis B Virus.The Kaohsiung journal of medical sciences · 2025Article
- Association Between Visceral Adiposity and the Prediction of Hepatic Steatosis and Fibrosis in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Journal of clinical medicine · 2025Article
- Radiologic correlation with fatty liver and adrenal adenoma using dual echo chemical shift magnetic resonance imaging.Abdominal radiology (New York) · 2025Article
- Diagnostic performance of FibroTest-ActiTest, transient elastography, and the fibrosis-4 index in patients with autoimmune hepatitis using histological reference.World journal of hepatology · 2025Article
- Fontan-Associated Liver Disease.Seminars in liver disease · 2025Review
- Liver histology pattern of young patients with inactive chronic hepatitis b virus infection from a hospital in South West Nigeria.BMC gastroenterology · 2024Article
- Fibrosis evaluation in chronic hepatitis B: FIB-6 score.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2024Article
- Validation of FIB-6 score in assessment of liver fibrosis in chronic hepatitis B.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2024Observational
- Hepatitis B relapse after entecavir or tenofovir alafenamide cessation under anti-viral prophylaxis for cancer chemotherapy.Virology journal · 2024Article
- Non-Invasive Assessment of Liver Fibrosis in Hepatitis B Patients.Journal of clinical medicine · 2024Review
- FIB-4 index is associated with mortality in critically ill patients with alcohol use disorder: Analysis from the MIMIC-IV database.Addiction biology · 2024Article
- Clinical correlates of CT imaging-derived phenotypes among lean and overweight patients with hepatic steatosis.Scientific reports · 2024Article
- Non-invasive assessment of hepatic fibrosis among patients with chronic hepatitis B virus infection in three tertiary hospitals in Nigeria.SAGE open medicine · 2024Article
- On-treatment risks of cirrhosis and hepatocellular carcinoma among a large cohort of predominantly non-Asian patients with non-cirrhotic chronic hepatitis B.JHEP reports : innovation in hepatology · 2023Article
- Improved on-treatment fibrosis-4 during antiviral therapy and lower hepatocellular carcinoma risk in cirrhotic patients with hepatitis B.Scientific reports · 2023Article
- Current Helicobacter pylori Infection Is Associated with Early Liver Injury: A Cross-Sectional Study in the General Population.The American journal of tropical medicine and hygiene · 2023Article
- Platelet-to-Monocyte Ratio as a Novel Promising Agent for the Prognosis of Hepatitis B Virus-Associated Decompensated Cirrhosis.Canadian journal of gastroenterology & hepatology · 2023Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLiver fibrosis stage is an important factor in determining prognosis and need for treatment in patients infected with hepatitis B virus (HBV). Liver biopsies are typically used to assess liver fibrosis; however, noninvasive alternatives such as the FIB-4 index have also been developed.
aimsTo quantify the accuracy of the FIB-4 index in the diagnosis of HBV related fibrosis and cirrhosis.
methodsA meta-analysis of studies comparing the diagnostic accuracy of the FIB-4 index vs. liver biopsy in HBV-infected patients was performed using studies retrieved from the following databases: PubMed, Ovid, EMBASE, the Cochrane Library, the Chinese National Knowledge Infrastructure and the Chinese Biology Medicine disc. A hierarchical summary receiver operating curves model and bivariate model were used to produce summary receiver operating characteristic curves and pooled estimates of sensitivity and specificity. The heterogeneity was explored with meta-regression analysis. Publication bias was detected using Egger's test and the trim and fill method.
results12 studies (N = 1,908) and 10 studies (N = 2,105) were included in the meta-analysis for significant fibrosis and cirrhosis, respectively. For significant fibrosis, the area under the hierarchical summary receiver operating curve (AUHSROC) was 0.78 (95% CI = 0.74-0.81). The recommended cutoff value was between 1.45 and 1.62, and the AUHSROC, summary sensitivity and specificity were 0.78 (95% CI = 0.74-0.81), 0.65 (95% CI = 0.56-0.73) and 0.77 (95% CI = 0.7-0.83), respectively. For cirrhosis, the AUHSROC was 0.89 (95% CI = 0.85-0.91). The recommended cutoff value was between 2.9 and 3.6, and the AUHSROC, summary sensitivity and specificity were 0.96 (95% CI = 0.92-1.00), 0.42 (95% CI = 0.36-0.48) and 0.96 (95% CI = 0.95-0.97), respectively. No publication bias was detected.
conclusionsThe FIB-4 index is valuable for detecting significant fibrosis and cirrhosis in HBV-infected patients, but has suboptimal accuracy in excluding fibrosis and cirrhosis.
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