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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(unpublished) Scheuer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

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