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Scoring Systems for Staging of Chronic Hepatitis
Various scoring systems are used to evaluate the amount of fibrosis in chronic hepatitis.

HAI (histological activity index) by Knodell

I. Periportal +/- Bridging Necrosis [Score]
A. none [ 0]
B. mild piecemeal necrosis [1]
C. moderate piecemeal necrosis (involve less than 50% of the circumference of most portal tracts) [3]
D. marked piecemeal necrosis (involve more athan 50% of the circumference of most portal tracts) [4]
E. moderate piecemeal necrosis plus bridging necrosis plus bridging necrosis [5]
F. marked piecemeal necrosis plus bridging necrosis plus bridging necrosis [6]
G. multilobular necrosis [10]
II. Intralobular Degeneration and Focal Necrosis
A. none [0]
B. mild (acidoplhilic bodies, balooning degeneration and/or scattered foci of hepatocellular necrosis in < 1/3 of lobules or nodules) [1]
C. moderate (involvement of 1/3 ~ 2/3 of lobules or nodules) [3]
D. marked (involvement of > 2/3 of lobules or nodules) [4]
III. Portal Inflammation
A. no portal inflammation [0]
B. mild (sprinkling of inflammatory cells in < 1/3 of portal tracts) [1]
C. moderate (increased inflammatory cells in 1/3 ~ 2/3 of portal tracts) [3]
D. marked (dense packing of inflammatory cells in > 2/3 of portal tracts) [4]
IV. Fibrosis
A. no fibrosis [0]
B. fibrous portal expansion [1]
C. bridging fibrosis (portal-portal or portal-central linkage) [3]
D. cirrhosis [4]





From Knodell RG et al.; Formulation and application of a numerical scoring system for assessing histological activity in asymtomatic chronic active hepatitis. Hepatology, (1981) 1:431






Grading system for cirrhosis: the Child-Pugh score



Score	Bilirubin (mg/dl)	Albumin (gm/dl)	PT (Sec)	Hepatic encephal	Ascites (grade)
1	< 2	> 3.5	1 - 4	None	None
2	2 - 3	2.8 - 3.5	4 - 6	1 - 2	Mild
3	> 3	< 2.8	> 6	3 - 4	Severe

Child class: A= 5 - 6, B= 7 - 9, C= > 9


Source: HepCnet