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Histopathological study of chronic hepatitis B and C: a comparison of two scoring systems

Rekha Rozario1, Banumathi Ramakrishna

  • 1Department of Pathology, Christian Medical College and Hospital, Vellore 632004, India.

Journal of Hepatology
|January 28, 2003
PubMed

Insights

The Ishak and METAVIR scoring systems show good agreement for necroinflammation and excellent agreement for fibrosis in chronic viral hepatitis patients. This aids in consistent histological assessment for liver disease.

Area of Science:

  • Hepatology
  • Histopathology
  • Virology

Background:

  • Chronic viral hepatitis diagnosis relies on histological scoring systems.
  • The Ishak (modified histological activity index, HAI) and METAVIR systems are commonly used.
  • Evaluating concordance between these systems is crucial for consistent patient management.

Purpose of the Study:

  • To assess the correlation between the Ishak and METAVIR scoring systems.
  • To evaluate these systems in Indian patients with chronic viral hepatitis B or C.
  • To compare histological features between hepatitis B virus (HBV) and hepatitis C virus (HCV) infections.

Main Methods:

  • Liver biopsies from 127 patients were scored using both Ishak and METAVIR systems.
  • Weighted kappa analysis was employed to determine correlation.
  • Serum transaminase levels and specific histological features were analyzed.

Main Results:

  • Moderate correlation (weighted kappa 0.627) was observed for necroinflammatory activity between Ishak and METAVIR.
  • Excellent correlation (weighted kappa 0.998) was found for fibrosis.
  • HCV biopsies showed significantly more micronodular cirrhosis, lymphoid aggregates, bile duct damage, bile ductular proliferation, and steatosis compared to HBV.

Conclusions:

  • The Ishak and METAVIR scoring systems demonstrate good concordance for assessing necroinflammatory changes.
  • Excellent agreement exists between the two systems for evaluating fibrotic changes in chronic viral hepatitis.
  • These findings support the interchangeable use of Ishak and METAVIR for fibrosis staging.
Abstract

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