In Chronic Viral Hepatitis -

Ans. is 'd' i.e., Grading refers to the extent of necrosis and inflammationClassification of hepatitis o In the new classification system of Hepatitis, Grading refers to the assessment of necroinflammatory activity.o Chronic hepatitis represents a series of liver disorders of varying causes and severity in which hepatic inflammation and necrosis continue for at least 6 months.o Earlier chronic hepatitis was categorized into three types depending upon histopathological features. These are(a) Chronic persistent hepatitis(b) Chronic lobular hepatitis(c) Chronic active hepatitiso Now, this categorization has been replaced by more informative classification based upon a combination of clinical serological and histological variables.o Now the classification is based upon(a) Its cause(b) Its histologic activity or grade(c) Its degree of progression or stage(a) Classification by causeIn this the hepatitis is classified according to the cause - such as viral hepatitis, autoimmune hepatitis, drug - associated hepatitis.(b) Classification by Grade -o This classification is based upon assessment of necroinflammatory activity.o An assessment of following histological features is made on liver biopsy -Peripoal necrosis Piecemeal necrosis Bridging necrosis Poal inflammation(c) Classification by stageThis classification is based upon the degree of fibrosis.It reflects the levels of progression of disease.Staging is based upon the degree of fibrosis as follows0 = No fibrosis1= Mild fibrosis (limited to poal tract)2 = Moderate fibrosis (Poal and peripoal fibrosis)3 = Severe fibrosis including bridging fibrosis4 = Cirrhosis