Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis

A Histology Activity Index has been developed which generates a numerical score for liver biopsy specimens obtained from patients with asymptomatic chronic active hepatitis. Biopsies are graded in four categories: periportal necrosis, intralobular necrosis, portal inflammation, and fibrosis. Under code, three pathologists and three hepatologists evaluated 14 liver biopsy specimens obtained from five patients with asymptomatic chronic active hepatitis. Good correlation was seen between severity of liver biopsy lesions as judged by conventional histological descriptions and Histology Activity Index scores. Significant differences in Histology Activity Index score occurred in only 2 of 28 duplicate scorings of biopsy specimens by two observers. This system provides definitive endpoints for statistical analysis of serial changes in liver histology and offers an alternative to the use of conventional pathological descriptions in following the natural history and treatment responses of asymptomatic chronic active hepatitis.

[1]  M. Kerstein,et al.  Analysis of survival after portal decompression , 1978 .

[2]  P. Scheuer.  Liver biopsy in chronic hepatitis: 1968-78. , 1978, Gut.

[3]  S. Phillips,et al.  Inhibition of colonic water and electrolyte absorption by fatty acids in man. , 1973, Gastroenterology.

[4]  C. Blackburn,et al.  Active chronic hepatitis. , 1970, The American journal of medicine.

[5]  I. Mackay.  Chronic hepatitis: effect of prolonged suppressive treatment and comparison of azathioprine with prednisolone. , 1968, The Quarterly journal of medicine.

[6]  J. de Groote,et al.  A classification of chronic hepatitis. , 1968, Lancet.

[7]  K. Ishak,et al.  Development of chronic liver disease after acute non-A, non-B post-transfusion hepatitis. Role of gamma-globulin prophylaxis in its prevention. , 1977, Gastroenterology.

[8]  L. Elveback,et al.  Clinical, biochemical, and histological remission of severe chronic active liver disease: a controlled study of treatments and early prognosis. , 1972, Gastroenterology.

[9]  W. Summerskill,et al.  Classification and treatment of chronic active liver disease. , 1968, Gastroenterology.

[10]  W. Kyner,et al.  Alterations in pentobarbital pharmacokinetics in response to parenteral and enteral alimentation in the rat , 1980 .

[11]  A. M. Skene,et al.  Observer variation in assessment of liver biopsies including analysis by kappa statistics , 1980 .

[12]  L. Elveback,et al.  Chronic active liver disease. The range of histologic lesions, their response to treatment, and evolution. , 1972, Human pathology.