The METAVIR System

Algorithm for Evaluation of Histological Activity* Piecemeal Necrosis + Lobular Necrosis = Histological Activity Score

0 (none) 0 (none or mild) 0 (none)0 1 (moderate) 1 (mild)0 2 (severe) 2 (moderate)1 (mild) 0, 1 11 2 22 (moderate) 0, 1 22 2 3 (severe)3 (severe) 0, 1, 2 3

Fibrosis Scoring Score Description

0 No fibrosis1 Stellate enlargement of portal tract but without septa formation2 Enlargement of portal tract with rare septa formation3 Numerous septa without cirrhosis4 Cirrhosis

* Modified and reprinted with permission.4 Modified and reprinted with permission.3