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“+1”>Modified Staging: architectural changes, fibrosis and cirrhosis*
Change Score
No fibrosis 0
Fibrous expansion of some
portal areas, with or without short fibrous septa
Fibrous expansion of most
portal areas, with or without short fibrous septa
Fibrous expansion of most
portal areas with occasional portal to portal (P-P) bridging
Fibrous expansion of portal
areas with marked bridging [portal to portal (P-P) as well as portal to
central (P-C)]
Marked bridging (P-P and/or
P-C) with occasional nodules (incomplete cirrhosis)
Cirrhosis, probable or definite 6

  1. Ishak K, et al. Histological grading and staging
    of chronic hepatitis.
    J Hepatol 1995;22:696-699.
  2. Knodell RG, et al. Formulation and application
    of a numerical scoring system for assessing histological activity in
    asymptomatic chronic active hepatitis. <ahref=
    “https://www.hepatitiscentral.com/hepatitis-c/liver/histology/”> Hepatology1981;1(5):431-5
*Additional features which should be noted but not scored: Intra-acinar fibrosis, perivenular (‘chicken
wire’ fibrosis) and phlebosclerosis of terminal hepatic venules.