For professionals:

History:

1. Original 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)
   • International Working Party, Working Congress of Gastroenterology
     • -----Diagnosis is primarily based on etiology