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Hey JJ-
This is a chart, which you cant see but explains, stage four being cirrhosis and stage two only being moderate fibrosis, if this is clear as mud I can find more.
Neil ******************************************************* Scoring Systems for Staging of Chronic Hepatitis
Various scoring systems are used to evaluate the amount of fibrosis in chronic hepatitis.

Score Description Knodel Sciot and Desmet
(unpublished) Scheuer
0 No fibrosis No fibrosis None None
1 Mild fibrosis Fibrous portal
expansion Periportal fibrous
expansion Enlarged,fibrotic
portal tracts
2 Moderate fibrosis (blank) Porto-portal septa
(> 1 septum) Periportal or portal-portal septa,
but intact architecture
3 Severe fibrosis Bridging fibrosis
(portal-portal or
portal-central linkage Portocentral septa
(> 1 septum) Fibrosis with architectural
distortion, but no
obvious cirrhosis
4 Cirrhosis Cirrhosis Cirrhosis Probable or definite

From: Desmet: Hepatology 1994) 19:1513; Knodell: Hepatology 1981) 1:431; Scheuer: J Hepatology 1991) 13:372


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

--Get Outdoors-Enjoy Life----Neil
Hi JJ-
Ok let me explain it to you the way I understand it-

FIBROSIS- is the development of excessive fibrous tissue which may cause, and is caused by damage and scarring, caused by diease or alcohol, in HCV the scale is 1-4, one being minor stage, 4 meaning trouble, as the liver has reached Cirrhosis, fibrosis is the stages of your liver being damaged.

CIRRHOSIS - is the stage when the liver is permently damaged,injured and scarred, it gets inflammed and does not function properly, leading to liver transplant, I seen a liver with cirrhosis,it was swelled up twice its size, puffy, inflammed, bright pink, and looked more like lungs,nasty.

OSIS - Means the process or condition- ie- Fibro-osis Cirrho-osis

HCV - damages the liver in stages 1 - 4, by scarring and inflamation, by that nasty virus, when we reach stage 2, many have to make the decision on whether or not to treat with drugs,to prevent further damage, which YOU are doing, NOW, if, as we all hope, you kill the Dragon virus, the damage stops, at that stage.

Now some think, well if I cure this, I can drink alcohol again, well that damage is irreversable, you will still have to take care of yourself to prevent futher damage, a person whom, say, was stage two HCV, took the meds and was virus free, then went back drinking alcohol, may still develop Cirrhosis from damage done by the alcohol.- Nasty stuff on our livers that Dragons Blood, [Alcohol].

Clear as mud?

--Get Outdoors-Enjoy Life----Neil

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