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Algorithm of Bedossa and Poynard (METAVIR CSG) for Grading the Activity of Chronic Hepatitis C in a Liver Biopsy

Purpose: To grade the histologic activity in a liver biopsy taken from a patient with chronic hepatitis C using the algorithm from the METAVIR Cooperative Study Group.

Description

Bedossa et al developed a simple algorithm for determining the activity of viral hepatitis C seen in a liver biopsy. The histologic activity of the hepatitis reflects the basic necroinflammatory lesions present. The METAVIR Cooperative Study Group consists of physicians from multiple hospitals across France.


Parameters:

(1) piecemeal necrosis

(2) lobular necrosis

(3) portal inflammation

(4) bridging necrosis

 

Parameter

Finding

Score

piecemeal necrosis

none

0

 

mild

1

 

moderate

2

 

severe

3

lobular necrosis

none

0

 

mild

0

 

moderate

1

 

severe

2

portal inflammation

none

0

 

mild

1

 

moderate

2

 

severe

3

bridging necrosis

none

0

 

present

1

 

where:

• The points for bridging necrosis are given on page 290.

 

Piecemeal Necrosis

Lobular Necrosis

Activity

0

0

none (A0)

0

1

mild (A1)

0

2

moderate (A2)

1

0

mild (A1)

1

1

mild (A1)

1

2

moderate (A2)

2

0

moderate (A2)

2

1

moderate (A2)

2

2

severe (A3)

3

0

severe (A3)

3

1

severe (A3)

3

2

severe (A3)

 


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Specialty

Objective

ICD-10