Non invasive fibrosis biomarkers reduce but not substitute the need for liver biopsy

Table 1 METAVIR scoring system for liver fibrosis

Stage	Description
F0	No fibrosis
F1	Portal fibrosis without septa
F2	Portal fibrosis with few septa
F3	Septal fibrosis without cirrhosis
F4	Cirrhosis

Portal fibrosis is a stellate enlargement of portal tracts without any bridging fibrosis on the biopsy sample. Few septa mean at least one fibrous septa on the core biopsy. Theoretically, a fibrous septa is a bridge of connective tissue between two portal tracts, a portal tract and a centrolobular vein, or between two centrolobular veins. Septal fibrosis means that the liver biopsy is crossed by several septa; the transition between F2 and F3 begins when there is more fibrous septa than portal tracts without septa on the biopsy. Cirrhosis means that liver tissue is mutilated by nodular fibrosis that delineates hepatocytes nodules.