Albumin-bilirubin score: Monitoring hepatic function in patients with chronic hepatitis C virus infection

Table 1 Diagnostic performance of the albumin-bilirubin score across liver diseases

Liver disease	Study type	Country	Sample size	Key findings
Chronic HCV fibrosis staging	Retrospective diagnostic accuracy	Japan	382	Cutoff of 2.125; sensitivity of 73.2%; specificity of 87.1%. ALBI differentiated fibrosis stages (F0-F4). Lower scores associated with improved HCC-free and overall survival
Chronic HCV advanced fibrosis/cirrhosis	Cross-sectional diagnostic study	Egypt	781	Area under the receiver operating characteristic of 0.73-0.74; cutoff of 2.95; sensitivity approximately 79%; specificity approximately 53%. Moderate diagnostic performance for F3-F4
HCV cirrhosis portal hypertension and encephalopathy	Retrospective correlation study	United States	61	ALBI score correlated with portal hypertension (P = 0.023) and encephalopathy (P = 0.038)
Nonviral HCC in MASLD/metabolic dysfunction-associated steatohepatitis fibrosis risk assessment	Observational study	Japan	190	Cutoff of 2.60. ALBI showed high omission rates (35.8%-62.6%). Fibrosis-4 and MASLD fibrosis score performed better for high-risk group identification

ALBI: Albumin-bilirubin; HCC: Hepatocellular carcinoma; HCV: Hepatitis C virus; MASLD: Metabolic dysfunction-associated steatotic liver disease.

Table 2 Prognostic prediction using the albumin-bilirubin score across liver diseases

Liver disease	Study type	Country	Sample size	Key findings
HBV-related cirrhosis long-term prognosis	Prognostic comparison study	China	322	ALBI correlated with fibrosis stage and hepatocellular carcinoma-free survival. Higher scores predicted mortality, outperforming MELD and Child-Pugh in some analyses
HBV AoCLF	Prognostic study (3-month mortality)	China	84 AoCLF + 56 chronic hepatitis B	AUROC ALBI of 0.784; ALBI + MELD of 0.912. Combination improved mortality prediction
Primary biliary cholangitis	Long-term prognostic cohort	Japan	409	ALBI outperformed Child-Pugh for 3-year, 5-year, and 10-year survival (AUROC of 0.90-0.94)
Metabolic dysfunction-associated steatotic liver disease	Longitudinal cohort study	United States	5666	AUROC mortality: 1-year of 0.715, 2-year of 0.646, 3-year of 0.652. ALBI ≥ -2.69 increased mortality risk (hazard ratio = 4.86)

ALBI: Albumin-bilirubin; AoCLF: Acute-on-chronic liver failure; AUROC: Area under the receiver operating characteristic; HBV: Hepatitis B virus; MELD: Model for end-stage liver disease.