Table 1 Ishak modification for hepatic activity index (HAI) for scoring of necroinflammatory activity in chronic hepatitis
From: Liver biopsy assessment in chronic viral hepatitis: a personal, practical approach
(A) Periportal or periseptal interface hepatitis (piecemeal necrosis) | |
Absent | 0 |
Mild (focal, few portal areas) | 1 |
Mild/moderate (focal, most portal areas) | 2 |
Moderate (continuous around <50% of tracts or septa) | 3 |
Severe (continuous around >50% of tracts or septa) | 4 |
(B) Confluent necrosis | |
Absent | 0 |
Focal confluent necrosis | 1 |
Zone 3 necrosis in some areas | 2 |
Zone 3 necrosis in most areas | 3 |
Zone 3 necrosis+occasional portal-central (P-C) bridging | 4 |
Zone 3 necrosis+multiple P-C bridging | 5 |
Panacinar or multiacinar necrosis | 6 |
(C) Focal (spotty) lytic necrosis, apoptosis and focal inflammation | |
Absent | 0 |
One focus or less per × 10 objective | 1 |
Two to four foci per × 10 objective | 2 |
Five to ten foci per × 10 objective | 3 |
More than ten foci per × 10 objective | 4 |
(D) Portal inflammation | |
Absent | 0 |
Mild, some or all portal areas | 1 |
Moderate, some or all portal areas | 2 |
Moderate/marked, all portal areas | 3 |
Marked, all portal areas | 4 |
