Hepatitis C virus: Morphogenesis, infection and therapy

Figure 8 Natural history of hepatitis C virus infection and start to treat. The recommendation to treat chronic hepatitis is usually a “significant” fibrosis as defined by a Child–Pugh score (A to C) and a fibrosis grade (F) greater than 1 by the Metavir scoring system, with usually a significant necrotic-inflammation as defined by an activity stage greater than 1 by the Metavir scoring system[288,289]. The Child–Pugh score employs five clinical measures of liver disease: Total bilirubin, Serum albumin, Prothrombin time, Ascites, Hepatic encephalopathy. The letter F refers to the scars of the liver caused by the aggression. It is classified from F0 to F4: F1, F2 are minimal to moderate fibrosis, F3 corresponds to a pre-cirrhotic stage and F4 corresponds to cirrhosis. Red arrows indicated the time to start treatment[290].