History of Chronic Hepatitis

by Jau-Shin WU, M.D

History:

1. First classification—1968 (De Grote:A classification of chronic hepatitis, Lancet 2:626)

•—– at that time, most cases: causes unknown (autoimmune)

•—– the proposed classification was aimed at distinguishing subgroups according to the degree of disease activity to provide prognostic information and criteria for the use of immunosuppressive therapy (prognosis, immunotherapy)

•a) chronic persistent hepatitis—milder activity

•b) chronic aggressive(active) hepatitis—more severe activity

•Histological basis:
•initially — emphasis on the presence of periportal piecemeal necrosis

•later —identify the importance of lobular parenchymal lesions esp. bridging hepatic necrosis which tends to progress to cirrhosis
2. Revised classification:(1994)