TABLE 2.
The METAVIR scoring system taking into account inflammatory activity and fibrosis
| Activity | Grade | Fibrosis | Stage | ||||
|---|---|---|---|---|---|---|---|
| No activity | A0 | No fibrosis | F0 | ||||
| Minimal activity | A1 | Portal fibrosis without septa | F1 | ||||
| Moderate activity | A2 | Portal fibrosis and some septa | F2 | ||||
| Severe activity | A3 | Septal fibrosis without cirrhosis | F3 | ||||
| Cirrhosis
|
F4
|
||||||
| Histology activity index – Knodell scoring system* | |||||||
|
Periportal ± bridging necrosis |
Score |
Intralobular degeneration and focal necrosis |
Score |
Portal inflammation |
Score |
Fibrosis |
Score |
| None | 0 | None | 0 | No portal inflammation | 0 | No fibrosis | 0 |
| Mild piecemeal necrosis | 1 | Mild (acidophilic bodies, ballooning degeneration and/or scattered foci of hepatocellular necrosis in 1/3 of lobules or nodules) | 1 | Mild (sprinkling of inflammatory cells in <1/3 of portal tracts) | Fibrous portal expansion | 1 | |
| Moderate piecemeal necrosis (involves <50% of the circumference of most portal tracts | 3 | Moderate (involvement of 1/3–2/3 of lobules or nodules) | 3 | Moderate (increased inflammatory cells in 1/3–2/3 of portal tracts) | 3 | Bridging fibrosis (portal-portal or portal-central linkage) | 3 |
| Marked piecemeal necrosis (involves >50% of the circumferenceof most portal tracts) | 4 | Marked (involvement of >2/3 of lobules or nodules) | 4 | Marked (dense packing of inflammatory cells in >2/3 of portal tracts) | 4 | Cirrhosis | 4 |
| Moderate piecemeal necrosis plus bridging necrosis | 5 | ||||||
| Marked piecemeal necrosis plus bridging necrosis | 6 | ||||||
| Multilobular necrosis | 10 | ||||||