Liver pathology of hepatitis C, beyond grading and staging of the disease

Table 2 Various staging systems for assessment of fibrosis in chronic hepatitis

Score	System
Ishak modification of Knodell staging system (1995)[53]
0	No fibrosis
1	Fibrous expansion of some portal areas with or without short fibrous septa
2	Fibrous expansion of most portal areas with or without short fibrous septa
3	Fibrous expansion of most portal areas with occasional portal to portal (P-P)
4	Fibrous expansion of portal areas with marked P-P and portal-central bridging
5	Marked bridging with occasional nodules (incomplete cirrhosis)
6	Cirrhosis, probable or definite (Bridging fibrosis with nodule formation)
METAVIR system (1996)[54]
F0	No fibrosis
F1	Portal fibrosis without septa
F2	Portal fibrosis with rare fibrous septa
F3	Numerous septae without cirrhosis
F4	Cirrhosis
Scheuer system (1991)[52]
0	No fibrosis
1	Enlarged, fibrotic portal tracts
2	Periportal or portal-portal septa but intact architecture
3	Fibrosis with architectural distortion but no obvious cirrhosis
4	Probable or definite cirrhosis
Batts and Ludwig (1995)[51]
0	No fibrosis (normal connective tissue)
1	Portal fibrosis (Fibrous portal expansion)
2	Periportal fibrosis (Periportal or rare portal-portal septa)
3	Septal fibrosis (Fibrous septa with architectural distortion; no obvious cirrhosis)
4	Cirrhosis