ArticleHepatic medicine : evidence and research2025
Performance of APRI and FIB-4 Scores Compared to FibroScan: A Cross-Sectional Study in a Black Sub-Saharan African Population.
Article in Hepatic medicine : evidence and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Liver disease diagnostics and access barriers in African settings: a narrative review.Journal of clinical pathology · 2026Review
- LiverPRO: a new screening test for fibrosis in steatotic liver disease.Translational gastroenterology and hepatology · 2026Article
- Metabolic-associated steatotic liver disease in children and adolescents: a scoping review and narrative synthesis of epidemiology, risk factors, and screening approaches with emerging implications for sub-Saharan Africa.Frontiers in endocrinology · 2026Article
- Evaluating the Role of Ultrasonography in Diagnosing Alcohol-associated Liver Disease in Low-resource Settings: A Critical Review of Current Evidence.Journal of medical ultrasoundReview
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Abstract
Background and Aim: Several non-invasive tests are used to assess liver fibrosis and cirrhosis in patients with liver disease. However, most validation studies have not included populations in sub-Saharan Africa. This study aimed to evaluate the diagnostic performance of the APRI and FIB-4 scores in a Congolese cohort. Patients and Methods: A cohort of patients in Kinshasa underwent FibroScan and laboratory testing to calculate APRI and FIB-4 scores. Pearson correlation, sensitivity, specificity, and ROC curve analyses were used to evaluate the performance of these non-invasive scores against FibroScan. Cirrhosis was defined as liver stiffness ≥14 kPa by FibroScan. Thresholds for APRI and FIB-4 scores predicting cirrhosis were set at ≥ 1.5 and ≥ 2.67, respectively. Results: The study included 316 patients (mean ± SD age: 48.1 ± 14.1 years; 60.8% male; 10.1% with diabetes; 37.1% obese; 14.2% with hepatitis B; 6.7% with hepatitis C; 25.6% with a history of alcohol use). The Pearson correlation between APRI and FibroScan was r = 0.210 (p < 0.001), while the correlation between FIB-4 and FibroScan was better (r = 0.478, p < 0.001). In subgroup analyses, FIB-4 correlated with FibroScan only among patients with alcohol use or hepatitis B or C, APRI only correlated with FibroScan in alcohol dependent patients. The sensitivity and specificity of APRI were 29.7% and 97.9% respectively, compared to 60.0% and 93.3% for FibroScan. The areas under the ROC curve were 0.8462 for APRI and 0.8312 for FIB-4, with thresholds lower than those reported in the literature: 0.422 for APRI and 1.285 for FIB-4, but these varied according to the subgroup. Conclusion: APRI and FIB-4 scores demonstrate high specificity but low sensitivity for diagnosing cirrhosis in this population. Their diagnostic performance is notably better in patients with alcohol-related liver disease or viral hepatitis, but poor among those with diabetes or obesity.
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