{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T15:12:00Z","timestamp":1783177920609,"version":"3.54.6"},"reference-count":5,"publisher":"BMJ","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1997,11]]},"abstract":"<jats:p>BACKGROUND: Chronic hepatitis C virus infection associated with contaminated anti-D immunoglobulin has become an issue of recent concern. The clinical course of chronic hepatitis C infection is unpredictable and histological assessment is felt to be the most reliable means of assessing disease status. Semiquantitative scoring systems have been devised, which assess degree of necroinflammatory disease activity (grade) and extent of disease progression with fibrosis (stage) in chronic hepatitis. Often, using these systems, biopsies of anti-D associated chronic hepatitis C cases show mild changes only, with low scores. The significance of these low scores is uncertain. AIMS: To evaluate the significance of low scores in chronic hepatitis. METHODS: Liver biopsies were assessed from two groups of patients in whom liver histology would be expected to be normal: 30 cases of Gilbert's syndrome and 13 necropsy cases of young people (&lt; 45 years) with no history or risk factors for liver disease. These biopsies were scored using the histological activity index of Knodell et al and its recent modification (separation of scores for grade and stage) by Ishak et al. RESULTS: Twenty of 30 cases of Gilbert's syndrome and 11 of the 13 necropsy cases had chronic hepatitis scores of 1 or 2, whereas only eight cases of Gilbert's and two necropsy cases had scores of 0. The remaining two Gilbert's cases had scores of 3 and 5. Similar results were found using both the histological activity index of Knodell et al and the method of Ishak et al. CONCLUSION: The finding of low but positive scores using these systems in people with normal liver histology questions the reliability and significance of finding such scores in patients with chronic hepatitis and is of particular concern in the evaluation of chronic hepatitis C infection.<\/jats:p>","DOI":"10.1136\/jcp.50.11.929","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"929-931","source":"Crossref","is-referenced-by-count":14,"title":["Mild abnormalities in liver histology associated with chronic hepatitis: distinction from normal liver histology."],"prefix":"10.1136","volume":"50","author":[{"given":"E W","family":"Kay","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"O'Dowd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Alyusuf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Sachithanandan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C B","family":"Walsh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J F","family":"Fielding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M B","family":"Leader","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1997,11,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1046\/j.1365-2559.1997.d01-588.x","article-title":"Chronic hepatitis: what is activity and how should it be assessed?","volume":"30","author":"Scheuer, P.J.","year":"1997","unstructured":"Scheuer PJ. Chronic hepatitis: what is activity and how should it be assessed? Histopathology 1997;30: 103-5.","journal-title":"Histopathology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1016\/S0168-8278(96)80234-0","article-title":"Intra-observer and inter-observer variation in the histopathological assessment of chronic viral hepatitis","volume":"25","author":"Goldin, R.D.; Goldin, J.G.; Burt, A.D.; Dhillon, P.A.; Hubschee, S.; Wyatt, J.","year":"1996","unstructured":"Goldin RD, Goldin JG, Burt AD, Dhillon PA, Hubschee S, Wyatt J, et al. Intra-observer and inter-observer variation in the histopathological assessment of chronic viral hepatitis. J Hepatol 1996;25:649-54.","journal-title":"J Hepatol"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1002\/hep.1840010511","article-title":"Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis","volume":"1","author":"Knodell, R.G.; Ishak, K.G.; Black, W.C.; Chen, T.S.; Craig, R.; Kaplowitz, N.","year":"1981","unstructured":"Knodell RG, Ishak KG, Black WC, Chen TS, Craig R, Kaplowitz N, et al. Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology 1981; 1:431-5.","journal-title":"Hepatology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/0168-8278(95)80226-6","article-title":"Histological grading and staging of chronic hepatitis","volume":"22","author":"Ishak, K.; Baptista, A.; Bianchi, L.; Callea, F.; DeGroote, J.; Gudat, F.","year":"1995","unstructured":"Ishak K, Baptista A, Bianchi L, Callea F, DeGroote J, Gudat F, et al. Histological grading and staging of chronic hepatitis. JHepatol 1995;22:696-9.","journal-title":"JHepatol"},{"key":"ref_5","article-title":"Pathology of the liver","author":"MacSween, R.N.M.","year":"1994","unstructured":"MacSween RNM, Anthony PP, Scheuer PJ, Burt AJ, Portmann BC, eds. Pathology of the liver, 3rd edn. Edinburgh: Churchill Livingstone, 1994.","edition":"3rd edn"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.50.11.929","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T16:49:41Z","timestamp":1758818981000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.50.11.929"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,11]]},"references-count":5,"journal-issue":{"issue":"11","published-online":{"date-parts":[[1997,11,1]]},"published-print":{"date-parts":[[1997,11]]}},"alternative-id":["10.1136\/jcp.50.11.929"],"URL":"https:\/\/doi.org\/10.1136\/jcp.50.11.929","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[1997,11]]}}}