In this single-center cross-sectional study, several serological biomarkers (AST, ALT, TBIL, ALB, PLT, INR, GGT, CD5L, and TGFβ1) and non-serological indices (AST/ALT ratio, ALBI score, GPR, APRI, FIB-4, INPR, and FibroQ) exhibit moderate-to-high discriminative performance for ≥F3 fibrosis across four etiologies, including CHB, CHC, ALC, and NALC. The gene discussed is ALB; the disease is cryohydrocytosis.