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Liver Scarring Risk Calculator

Uses the FIB-4 liver fibrosis score. Estimates liver scarring risk using age, AST, ALT and platelet count. Doctor-reviewed. Free tool.

🫀 What does this tool do?
This tool estimates the risk of significant liver scarring using simple blood test results.

Long-term liver injury from fatty liver, diabetes, alcohol, viral hepatitis or other causes may lead to scarring inside the liver. This is called liver fibrosis.

This calculator uses the FIB-4 score. It does not diagnose fatty liver, cirrhosis, hepatitis or liver cancer. It only helps identify whether further liver assessment may be needed.

You will need:
  • Your age
  • AST (also called SGOT) from your liver profile or LFT
  • ALT (also called SGPT) from your liver profile or LFT
  • Platelet count from your Full Blood Count (FBC/CBC)
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SuitabilityBlood ValuesYour Result
Can this tool be used reliably?
Please answer a few questions first to make sure this result is appropriate for you.
⚠️ Age note: under 35
This score is less reliable in people under 35 years. Medical interpretation or another fibrosis assessment may be needed.
⚠️ Age note: 65 or older
In people aged 65 years or older, FIB-4 may give higher results. A different lower-risk cutoff is often used. Please interpret the result carefully with medical advice.
Please enter a valid age.
These conditions can affect AST, ALT or platelet count and may make the result less reliable.
Enter your blood test values
Find these values in your most recent blood test reports. Enter the number only — do not include the unit.
Where to find AST
Found in your liver profile or LFT report. May be written as AST or SGOT. Enter the number only.
Example: if your report says AST 42 U/L, enter 42.
Please enter a valid AST value.
Where to find ALT
Found in your liver profile or LFT report. May be written as ALT or SGPT. Enter the number only.
Example: if your report says ALT 55 U/L, enter 55.
Please enter a valid ALT value.
Where to find Platelet count
Found in your Full Blood Count (FBC or CBC) report. May be written as Platelet count, Platelets, or PLT.
Enter the main number only. If your report says Platelets 250 ×10³/µL or 250 ×10⁹/L, enter 250. Do not enter 250000.
⚠️ Possible platelet entry error
Please enter the platelet count as the main number only. Example: enter 250, not 250000.
⚠️ Very low platelet count entered
A value below 10 is very low. Please confirm the value from your report.
Please enter a valid platelet count.
Your Liver Scarring Risk Result
Values You Entered
FIB-4 Liver Scarring Risk Score
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This tool is not for emergencies
If you have severe abdominal pain, yellowing of the skin or eyes (jaundice), vomiting blood or black stools — do not use this calculator. Seek emergency medical care immediately.
⚠️ Medical Disclaimer
This tool provides educational information only. It does not diagnose liver disease and does not replace medical advice. All results must be interpreted by a doctor.
Dr. Seneth Gajasinghe
Medically Reviewed By
Dr. Seneth Gajasinghe
MBBS (Col) · MD (Col) · SLMC No. 27329
This tool uses the FIB-4 liver fibrosis score. Results are for educational guidance only and do not replace clinical assessment.
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Understanding the FIB-4 Liver Fibrosis Score

The FIB-4 score is one of the most widely used non-invasive ways to assess the likelihood of significant liver scarring. Here is what the score means and when it is used.

What is liver fibrosis?

Liver fibrosis is the build-up of scar tissue inside the liver, usually as a response to long-term injury. Common causes include non-alcoholic fatty liver disease (NAFLD/MASLD), alcohol use, type 2 diabetes, obesity, and chronic viral hepatitis (hepatitis B or C). Advanced fibrosis can progress to cirrhosis, where large parts of the liver are replaced by scar tissue and liver function may be impaired.

What is the FIB-4 score?

FIB-4 is a simple formula using four values: age, AST, ALT and platelet count. It estimates the likelihood of significant liver scarring without requiring a liver biopsy. It is commonly used in primary care and liver clinics to decide whether further tests — such as FibroScan, ELF test or ultrasound — are needed.

FIB-4 score categories (age 35–64)

FIB-4 ScoreCategoryWhat it suggests
Less than 1.3Low riskAdvanced liver scarring is unlikely. Review risk factors and maintain healthy lifestyle.
1.3 to 2.67IntermediateResult is not clearly low or high. Further assessment may be needed.
Above 2.67High riskHigher chance of significant liver scarring. Medical review and further tests recommended.

FIB-4 score categories (age 65 or older)

FIB-4 ScoreCategoryWhat it suggests
Less than 2.0Low riskAdvanced liver scarring is less likely at this age threshold.
2.0 to 2.67IntermediateFurther assessment may be needed.
Above 2.67High riskHigher chance of significant liver scarring. Medical review recommended.

What happens if the result is high or intermediate?

A high or intermediate FIB-4 result does not mean you have cirrhosis. It means further assessment is recommended. This may include a FibroScan (liver stiffness test), the ELF blood test, an ultrasound of the liver, or review by a liver specialist (hepatologist or gastroenterologist). Your doctor will guide you on the most appropriate next step.

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Frequently Asked Questions

Common questions about the FIB-4 score and liver scarring, answered by Sineth Hospitals.

FIB-4 is a simple score calculated using age, AST, ALT and platelet count. It estimates the likelihood of significant liver scarring (advanced fibrosis) without the need for a liver biopsy. It is commonly used to decide whether further liver investigation is needed.
No. This tool estimates the probability of significant liver scarring. It does not diagnose fatty liver, cirrhosis, hepatitis or liver cancer. A doctor must review any abnormal result and arrange appropriate tests.
AST (also called SGOT) and ALT (also called SGPT) are found in your liver profile or LFT blood test report. Platelet count is found in your Full Blood Count (FBC or CBC) report. Enter the number only — do not include the unit.
Enter the main platelet number only. If your report says 250 ×10³/µL or 250 ×10⁹/L, enter 250. These two units are numerically the same for this calculator. Do not enter 250000 — the calculator will flag this as a likely unit error.
FIB-4 is less reliable in people under 35 years. In those aged 65 or older, the score tends to be higher, so a different lower-risk cutoff is recommended. The score may also be affected by acute liver infection, dengue, heavy exercise, recent chemotherapy, pregnancy and blood disorders. Always interpret the result with a doctor.
An intermediate FIB-4 result means the score is not clearly in the low or high range. It does not mean you definitely have liver scarring. Your doctor may recommend a repeat test after lifestyle changes, a FibroScan, the ELF blood test, or specialist review to get a clearer picture.
Mild elevation of AST and ALT can have many causes, including fatty liver, alcohol, strenuous exercise, certain medications, and other conditions. It does not always mean liver scarring. The FIB-4 score combines these values with age and platelet count to give a more complete picture. Always discuss elevated liver enzymes with your doctor.
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Medical Disclaimer
This tool is for general educational purposes only. It does not diagnose liver disease and does not replace professional medical advice, diagnosis, or treatment. The FIB-4 score is an estimate based on blood test values and may not accurately reflect liver health in all individuals or situations. Always consult your doctor for interpretation and personalised medical advice.