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Abstract OBJECTIVE: 1 Assessment of hepatic fibrosis in different systems. 2 Comparison between METAVIR, and Ishak modification of HAI systems. 3 Assessment of iron deposition in the liver in cases of chronic hepatitis C. METHODS: This study was carried out on 50 cases of chronic hepatitis C, referred to pathology department in Gastroenterology center, faculty of medicine, Mansoura University. Sections were prepared from paraffin blocks and subjected to the following: 1 conventional Hematoxylin and Eosin for routine histopathological examination. 2 Massons trichrome staining for detection of collagen type I. 3 PAS befor and after diastase . 4 Prussian blue staining for detection of hemosedrin deposition. 5 Orcien staining. 6 Siros red and reticulin staining of selected cases. 7 Immunohistochemical staining by anti gassmooth muscle actin antibodies. RESULTS: There was good correlation between Modified HAI system and METAVIR system regarding assessment of necroinflammatory injury and fibrosis, however the METVIR system revealed more sensitivity for severe of necroinflammatory activity. Immunohistochemical staining by anti gassmooth muscle actin antibodies revealed increased number of activated stellate cells which may contribute to the deposition of collagen and permanent scarring associated with progressive course of chronic hepatitis. Mild hemosedrosis was identified in small percent of patients and this may contribute to the environmental and dietary habits of our community. CONCLUSIONS: Both METAVIR and Ishak modification of HAI show good correlation in a assessment of necroinflammatory injury and fibrosis. METAVIR system is more sensitive for severe necroinflammatory activity. While Ishak modification of HAI is more sensitive for small changes in the necroinflammatory grade and fibrosis stage. Hepatic iron concentration is not significantly increased in cases of chronic hepatitis C. |