Chronic hepatitis diagnosis

Chronic hepatitis diagnosis is clinic, biological, but mostly histological. Chronic hepatitis can often be asymptomatic, or the clinical features are completely nonspecific, and therefore they are sometimes discovered by routine bilogical investigations.
Almost a half of patients suffering from acute hepatitis are discovered by periodical analyses or by a routine ultrasonography, which will show splenomegaly. When presuming the existence of chronic hepatitis, one should start with an exact etiological history, a correct clinical examination, a biological evaluation of the hepatic disease (the four biological syndromes: cytolytic, hepatoprive, inflammatory and billiar), an abdominal ultrasonography to evaluate the spleen dimension and the possible signs of portal hypertension.

The staging of chronic hepatitis is made compulsory by a hepatic biopsy (HBP). The biopsy will allow the correct histological framing, and also a quite exact prognosis, and sometimes will bring important etiological data, and it will allow in the same time a therapeutical decision. Non invasive markers which measures fibrosis were recently introduced. They use biological tests or hepatic elastography.

The histological staging of chronic hepatitis requires a compulsory hepatic puncture. This is a technique with low invasivity and a minimal risk. Lately HPB has been done by ultrasonographic control. THe bioptic fragment, after fixing and coloration with HE or special colorations, will be interpretated by an experimented pathologist. Whis will describe the lesions, a histological classification in chronic persistent hepatitis, in chronic active hepatitis, and the chronic lobular hepatitis, and then will use a quantifying score of lesions. At this moment, there are more histological framing scores.