Staging and grading chronic viral hepatitis: A teaching hospital experience using an objective histological activity index in a tropical population

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Background: Chronic viral hepatitis (CVH) is the leading cause of chronic liver diseases (CLD) and exhibit diffuse parenchymal damage requiring a systematic assessment of disease extent and progression. Aims: The aim of this study is to determine the epidemiological pattern and grade/stage all cases of CVH using Ishaq Modified Histologic Activity Index (HAI); then share and to compare our experience with similar works elsewhere. Methods: Ten years (2006–2015) liver biopsies received in the Department of Pathology, Ahmadu Bello University Teaching Hospital Zaria, were fixed in formalin, embedded in paraffin and stained with routine and special stains were reviewed, graded and staged using Ishaq HAI. Data were analysed and presented in statistical frequency distribution tables and figures. Results: CVH formed 55.2% was the most common of liver diseases. There were119 male and 47 female with male-to-female ratio of 2.5: 1 and peaked in the third decade of life. Nearly 42.2% had modified Ishaq HAI score of 4–8, while 28.3% and 27.1% had score 1–3 and score 9–12, respectively. Only 2.4% had score of 13–18. Nearly 70.5% of cases were between Stages 0 and 2, 25.9% of cases were Stage 3and 4 while only 6% were in Stage 5. Hepatitis B virus (HBV) was the most common aetiology and found in 77.7% of cases, 13.3% were associated with hepatitis C virus (HCV) and HBV/HCV co infection in 9.0%. Conclusions: CVH was the most common form of CLD, peaked in the third decade of life. Nearly 42.2% were in mild grade disease while 70.5% had Stage 2 and below disease. HBV infection was the most common aetiology.