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) |
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.
Specialty: Gastroenterology, Infectious Diseases
Objective: severity, prognosis, stage, disease progression
ICD-10: K74, B18.2,