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 1
1 2 2
2 (moderate) 0, 1 2
2 2 3 (severe)
3 (severe) 0, 1, 2 3

Fibrosis Scoring
Score Description

0 No fibrosis
1 Stellate enlargement of portal tract but without septa formation
2 Enlargement of portal tract with rare septa formation
3 Numerous septa without cirrhosis
4 Cirrhosis

* Modified and reprinted with permission.4

Modified and reprinted with permission.3