The diagnostic terms for chronic hepatitis were originted in 1950's and 1960's. Chronic active hepatitis, chronic persistent hepatitis, chronic lobular hepatitis were designed for categories of severity and extent of necroinflammatory proces, not as i...
The diagnostic terms for chronic hepatitis were originted in 1950's and 1960's. Chronic active hepatitis, chronic persistent hepatitis, chronic lobular hepatitis were designed for categories of severity and extent of necroinflammatory proces, not as indpendent disease entities but they have been used like separate diseases.
Since 1980's quite a few methods for quantitative assessment of chronic hepatitis were produced to meet the request of evaluation for therapeutic trials and prognosis, by distinguished pathologists. The Knodell's histologic activity index (HAI) has been most popular but its numerical score includes grading and staging together, as it was criticized by P. Scheuer. It is reasonable to divide the grading and staging as separate category because the grading represents the degree of necroinflammatory activity and the staging means degree of fibrosis and architectural distortion. The modified HAI, generated by International Association of the Study of the Liver(IASL) in 1994, is most comprehensive and useful system which has high objectivity and reproducibility. The grading and staging system by Batts and Ludwig has a advantage of combination of the descriptive diagnosis and quantitative scoring and it is simple and useful for reporting of liver biopsy.
Considering that most chronic hepatitis of Koreans are caused by hepatitis B virus. We'd better adopt the modified HAI of IASL and apply it to Korean chronic hepatitis. If we find any different histologic pattern from that of western people, we modify it and develop highly reproducible and useful scoring system to correspond the pattern of chronic hepatitis of Koreans.