Muhammad Tahir Khadim, Muhammad Ashraf Qamar, Naseer Ahmed Khan, Saadat Parveen.
Light microscopic evaluation of grade and stage of chronic hepatitis B and C.
Pak J Pathol Jan ;15(2):69-73.

An observational retrospective study to evaluate histological features of sixty, serologically positive cases of chronic hepatitis B and C was conducted at Combined Military Hospital Multan from May 2002 to December 2003. Paraffin embedded sections were stained with haematoxylin, eosin and gomori`s reticulin stain. The grade of chronic hepatitis was assessed by the extent of portal/periportal necroinflammation, lobular changes and portal inflammatory cell infiltrate. The stage of disease process was evaluated by examining reticulin stained sections. Knodell histological activity index (HAI) score was assigned separately to both the grade and stage of hepatitis. Mild to moderate piecemeal necrosis was present in 50 %, marked piecemeal necrosis with bridging necrosis in 38.3%, multilobular necrosis in 8.3%, mild intra lobular degeneration with focal necrosis was seen in 33.3%, moderate to severe intra lobular degeneration was seen in 66.7% of the biopsies. All cases showed portal lymphocytic infiltrate. Cases of chronic hepatitis C showed mild steatosis and lymphoid aggregates also. Liver biopsy is important investigation for the diagnosis, assessment of grade and stage of chronic hepatitis and evaluation of therapeutic intervention.

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