IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 16, Issue 8 Ver. III (Aug. 2017), PP 66-70 www.iosrjournals.org DOI: 10.9790/0853-1608036670 www.iosrjournals.org 66 | Page Fib-04 Score At the End of Treatment in Chronic Hepatitis C Patients Treated with Pegylated Interferon And Ribavirin: An Observational Study *1 Dr. Muhammad Imran, 2 Prof Dr. Karim Kammeruddin, 3 Dr. Nida Sajid, 4 Dr. Amjad Iqbal, 5 Dr. Syeda Zufiesha zehra, 6 Mahboob Ali 1 Department of Medicine, Baqai Medical University 2 Professor of Department of medicine, Baqai Medical University 3 Assistant professor Department of Medicine, Baqai Medical University 4 Department of Medicine, Baqai Medical University 5 House officer, DIKIOHS, DUHS Karachi 6 Dow University of Health Sciences, Institute of Nursing (MSN) Corresponding Author : * Dr. Muhammad Imran Abstract Background: FIB-4 Score is a simple formula to predict liver fibrosis based on the standard biochemical / hematological values i.e. AST, ALT, Platelet count and age. The Score lower than 1.45 has a Negative Predictive Value (NPV) of 95% for significant fibrosis i.e. F3-F4 while, a Score of greater than 3.25 has a PPV of 80% for advance fibrosis i.e. F3-F4. So an improvement of FIB-4 Score is a possible indicator of change in liver fibrosis. Objective: To observe the disparity in paired FIB-04 Score in hepatitis C patients treated with pegylated interferon and ribavirin at the beginning of the treatment and at the end of treatment evaluation (ETR). Method: An observational study was carried out in patients with mono-infected, compensated CHC patients ,treated with Pegylated Interferon & Ribavirin for 24weeks to 48 weeks (according to genotype)in a tertiary care hospital (i.e. Baqai Medical University Hospital Nazimabad) from Jan 2010 to March 2015 in a paired manner i.e. before (at beginning) and at the End of treatment evaluation (ETR). Responses were analyzed by using ‘Wilcoxon signed rank test. SPSS 23.00 version was used to analyze data. Results: Fifty eight patients diagnosed with hepatitis C took part in the study out of which 24 were males (41.4%) with mean age 38.8 (22y-60y) and 34 were females (58.6%) with mean age 43.6 (31y-60y). Out of 58 participants, 8 patients were type 1 genotype, 48 patients were type 3 genotype and 1 was type 4. Genotype of 1 participant was not recorded. According to result evaluated, there is a statically significant decrease in FIB04 score from beginning of treatment (M=2.52, SD=1.35) to ETR (M=1.74, SD=1.37) justifying that there is a definite positive change in FIB-04 score (i.e. improvement in fibrosis) Conclusion: Distinct positive change in FIB-4 Score was observed in Chronic Hepatitis C patients treated with pegylated interferon/ribavirin at the end of treatment. Keywords: FIB-04 Score, hepatitis C, ribavirin, pegylated interferon I. Introduction In chronic hepatitis C, it is essential to do clear-cut assessment of liver fibrosis to access therapeutic indication and complication [1]. These complications are primarily coupled with advance stage of the disease [2]. Liver biopsy is deemed to be gold standard in ruling out hepatic fibrosis [3, 4]. However, liver biopsy is constrained by its invasive character; deprived acceptance, esp. when constant measures are essential; expenditure and availability, predominantly in non-western countries; intra- and inter-observer variability [5, 6] and sampling errors which generate around 24% false negative response for cirrhosis [7, 8]. Therefore, non- invasive test has been introduced to appraise liver fibrosis i.e. AST-to-platelet ratio index (APRI) [9], Forns test [10] and FibroTest, which coalesce numerous biochemical parameters [11, 12, 13, 14, 15]. In recent times, an innovative morphological technique i.e. transient elastography (FibroScan, Echosens, and Paris, France) has been introduced that measures liver stiffness [16]. All the former mentioned non-invasive tools are the fine predictors in identifying nil, minimum and extended fibrosis [17, 18]. In spite of being a probable substitute to liver biopsy, standard use of these tools is restricted by its cost and errors [19, 20, 21, 22]. Recently Pegasys Ribavirin International Co infection Trial (Apricot study) executed a pivotal study that projected simple non- invasive test for liver fibrosis named FIB-04 [23]. It is an apricot database derived test that distinguish mild to