Abstract
Introduction. The Fibrosis-4 (FIB-4) index is a simple, inexpensive, and validated non-invasive tool that may improve liver fibrosis risk stratification, although its clinical utility remains poorly documented in Mali. The objective of our study is to to evaluate the usefulness of the FIB-4 index for identifying patients at increased risk of advanced liver fibrosis. Methods. A descriptive and analytical multicenter cross-sectional study was conducted from December 2024 to September 2025 in the Hepato-Gastroenterology Department of Gabriel Touré University Hospital and the Internal Medicine Department of Mali University Hospital in Bamako on hospitalized patients with ascites, classified according to their HBsAg status. Results. Of the 120 patients included, 60 (50.0%) were HBsAg-positive. The mean age was 47.0 ± 15.2 years, and the male-to-female ratio was 1.22. Patients aged 40–59 years were significantly more likely to be HBsAg-positive (p = 0.017). Moderate ALT elevation was significantly associated with HBsAg positivity (p = 0.032), whereas AST levels did not differ significantly between the two groups. According to the FIB-4 index, 30.0% of patients were classified as having a high risk of advanced liver fibrosis. Although high-risk FIB-4 scores were more frequent among HBsAg-positive patients, the difference was not statistically significant (p = 0.113). Conclusion. The FIB-4 index identified a substantial proportion of hospitalized patients at high risk of advanced liver fibrosis.