Page 37 - The Flying Publisher Guide to Hepatitis C Treatment

Patients’ monitoring during and after treatment | 37

Table 2.4 – Scoring systems for histological stage*
Stage IASL Batts-Ludwig Metavir Ishak
(Desmet 1994 ) (Batts 1995) (Bedossa 1996) (Ishak 1995)
0 No fibrosis No fibrosis No fibrosis No fibrosis
1 Mild fibrosis Fibrous portal Periportal Fibrous expansion of
expansion fibrotic some portal areas
expansion with or without short
fibrous septa
2 Moderate Rare bridges or Periportal Fibrous expansion of
fibrosis septae septae most portal areas
with or without short
fibrous septa
3 Severe fibrosis Numerous Porto-central Fibrous expansion of
bridges or septae most portal areas
septae with occasional
portal to portal
bridging
4 Cirrhosis Cirrhosis Cirrhosis Fibrous expansion of
most portal areas
with marked
bridging
5 Marked bridging with
occasional nodules
6 Cirrhosis
* According to data from Ghany 2009.
Non invasive methods
Non-invasive assessment of liver fibrosis based on either
biochemical methods or imaging techniques have emerged over
the past ten years as an alternative to the systematic use of LB.
These methods are easy-to-do, reliable and can be repeated in
follow-up visits. However, these noninvasive tests are more
adequate for identifying patients with advanced
fibrosis/cirrhosis than in differentiating those with moderate
and mild fibrosis. According to the current recommendations,
these methods should not replace LB in routine clinical practice.
Transient elastography (FibroScan™) uses ultrasound and low
frequency elastic waves to measure liver elasticity/stiffness in
kilopascals (kPa).