Background And Aim: The diagnostic value of serum markers of liver fibrosis has been investigated in numerous studies. This study aimed to investigate the value of PAPAS index for non-invasive assessment of liver fibrosis in Egyptian patients with chronic hepatitis C in comparison to FIB-4 and FibroQ. Methods: Forty naïve Egyptian patients with chronic hepatitis C virus prior to treatment with antiviral therapy were included. All were subjected to clinical evaluation, laboratory investigations, abdominal ultrasonography, transient elastography (Fibroscan) in addition to non-invasive indices (PAPAS index, FIB-4 and Fibro Q). Results: The mean stiffness score of studied patients by transient elastography was 11.3±7.6 kpascal where 9 cases (22.5%) were F1, 12 cases (30%) were F2, 9 cases (22.5%) were F3 and 10 cases (25%) were F4. PAPAS index was significantly higher in F3-F4 (advanced fibrosis) than F1- F2 (non advanced fibrosis) (P<0.001). PAPAS showed highly significant diagnostic performance in differentiating advanced from non-advanced fibrosis in comparison to FIB-4 and FibroQ. The AUC of ROC curve of PAPAS, FIB-4 and FibroQ was 0.987, 0.787 and 0.714 respectively. Using cutoff value of ≥ 2.05 PAPAS index could predict advanced fibrosis with PPV 95%, sensiti vity 100% and <2.05 could exclude advanced fibrosis with NPV 100%, and specificity 95.2%. Conclusion: PAPAS index was superior to FIB-4 and FibroQ in differentiating between advanced and non-advanced fibrosis
