Doctors don’t often diagnose liver fibrosis in its mild to moderate stages. This is because liver fibrosis doesn’t usually cause symptoms until more of the liver is damaged.

When a person does progress in their liver disease, they may experience symptoms that include:

• Appetite loss
• Difficulty thinking clearly
• Fluid buildup in the legs or stomach
• Jaundice (where the skin and eyes appear yellow)
• Nausea
• Unexplained weight loss
• Weakness

There are several different scales of liver fibrosis staging, where a doctor determines the degree of liver damage. Since staging can be subjective, each scale has its own limitations. One doctor may think a liver is slightly more scarred than another. However, doctors will usually assign a stage to liver fibrosis because it helps the patient and other doctors understand the degree to which a person’s liver is affected.

One of the more popular scoring systems is the METAVIR scoring system. This system assigns a score for “activity” or the prediction of how fibrosis is progressing, and for the fibrosis level itself. Doctors can usually assign this score only after taking a biopsy or tissue sample of a piece of the liver. The activity grades range from A0 to A3:

• A0: no activity
• A1: mild activity
• A2: moderate activity
• A3: severe activity

The fibrosis stages range from F0 to F4 as per liver fibrosis scan testing:

• F0: no fibrosis
• F1: portal fibrosis without septa
• F2: portal fibrosis with few septa
• F3: numerous septa without cirrhosis
• F4: cirrhosis