Version August 2025
| Grade | Portal/periportal activity | Lobular activity | Grade | Fibrosis |
| 0 | None | None | 0 | None |
| 1 | Minimal portal inflammation | Inflammation but no necrosis | 1 | Enlarged fibrotic portal tracts |
| 2 | Mild piecemeal necrosis | Focal necrosis or acidophil bodies | 2 | Periportal or portal-portal septa but intact architecture |
| 3 | Moderate piecemeal necrosis | Severe focal cell damage | 3 | Fibrosis with architectural distortion but no obvious cirrhosis |
| 4 | Severe piecemeal necrosis | Damage includes bridging necrosis | 4 | Probable or definite cirrhosis |
