Histopathology of chronic viral hepatitis: guidelines for a revised classification

Over the last few years a need for reassessment of the classification of chronic hepatitis has emerged in both clinicians who diagnose and treat liver patients and histopathologists who evaluate liver biopsies. The introduction of an aetiologic terminology, the evaluation of inflammatory activity and necrosis (grading) as well as of fibrosis as the equivalents of a stage in the disease appear to be major requirements. Due to the present satisfactory knowledge of the natural history of hepatitis B, there is also a discussion on the advisability of a personalized classification of chronic hepatitis B, i.e. a classification based upon consideration of profiles (or phases) rather than rigid morphological categories. This paper is intended as a guideline with a view to a revised classification of chronic hepatitis.