Nomenclature of Chronic Hepatitis: A Plea for Change

Abstract

The present nomenclature for pathologic classification of chronic hepatitis–that is, 'chronic persistent hepatitis' and 'chronic active hepatitis', as proposed by a European group of pathologists and hepatologists 26 years ago (1)–is not descriptive and does not indicate the location of the pathologic changes in the liver lobule. The word 'persistent' just means that the pathologic process is continuous and lasting and fails to indicate that the morphologic changes (inflammatory cell infiltration) in the liver are essentially limited to the portal tracts, well within the boundary of the so-called 'limiting plate'. It also fails to convey the notion that the pathologic process in the liver is more often than not stationary and generally does not evolve and progress to cirrhosis. Chronic active hepatitis (CAH) is, in its own right, even more persistent than chronic persistent hepatitis (CPH)