Reproducibility of the Ishak Modified Histologic Activity Index in the Evaluation of Chronic Viral Hepatitis

Abstract

Biopsies from 55 serologically confirmed chronic hepatitis B(30), C( 22) and, B and C (3) cases were independently evaluated by two pathologists and Ishak modified histologic activity indices were determined. Study was repeated two months later. Both interobserver and intraobserver reproducibility were assessed using kappa statistics. Interobserver reproducibility of the "periportal or periseptal interface hepatitis (piecemeal necrosis)" and "focal lytic necrosis, apoptosis and focal inflammation" parameters forming Ishak modified histologic activity index was found to be low. It is concluded that Ishak modified histologic activity index, especially these parameters, should be revised to increase reproducibility.