Knodell et al reported the Histology Activity Index (HAI) to describe the range of histologic changes associated with chronic hepatitis.
Points |
Periportal/Bridging Necrosis |
0 |
none |
1 |
mild piecemeal necrosis |
3 |
moderate piecemeal necrosis (< 50% of circumference of most portal tracts) |
4 |
marked piecemeal necrosis |
5 |
moderate piecemeal necrosis plus bridging necrosis |
6 |
marked piecemeal necrosis plus bridging necrosis |
10 |
multilobular necrosis |
Points |
Intralobular Degeneration and Focal Necrosis |
0 |
none |
1 |
mild (acidophilic bodies, ballooning degeneration, necrosis) |
3 |
moderate |
4 |
marked |
Points |
Portal Inflammation |
0 |
none or minimal |
1 |
mild |
3 |
moderate |
4 |
marked with dense packing in more than two thirds of portal area |
Points |
Fibrosis |
0 |
no fibrosis (normal connective tissue) |
1 |
fibrosis confined to enlarged/expanded portal tracts |
3 |
bridging fibrosis |
4 |
cirrhosis |
total score =
= SUM(points for all 4 parameters)
necroinflammatory score =
= (points for periportal/bridging necrosis) + (points for intralobular degeneration) + (points for portal inflammation)
Interpretation:
• minimum total score: 0
• maximum total score: 22
• minimum necroinflammatory score: 0
• maximum necroinflammatory score: 18
Specialty: Gastroenterology, Infectious Diseases