正常血清ALT水平
Some patients with chronic hepatitis C have normal serum alanine aminotransferase (ALT) levels, even when tested on multiple occasions. 一些慢性丙型肝炎患者有正常的血清丙氨酸轉氨酶（ ALT ）水平，即使在多次測試。 In this and other situations in which the diagnosis of chronic hepatitis C may be questioned, the diagnosis should be confirmed by testing for HCV RNA. 在這個和其他情況下 ， 診斷慢性丙型肝炎可能有疑問的，應當診斷測試證實了丙型肝炎病毒RNA 。 The presence of HCV RNA indicates that the patient has ongoing viral infection despite normal ALT levels. 在場的情況表明 ， 丙型肝炎病毒RNA的病人正在進行的病毒感染 ， 儘管ALT正常水平。

Liver Biopsy 肝活檢
Liver biopsy is not necessary for diagnosis but is helpful for grading the severity of disease and staging the degree of fibrosis and permanent architectural damage. Hematoxylin and eosin stains and Masson's trichrome stain are used to grade the amount of necrosis and inflammation and to stage the degree of fibrosis. Specific immunohistochemical stains for HCV have not been developed for routine use. 肝臟活組織切片檢查是沒有必要的診斷 ， 但有利於分級疾病的嚴重程度和分期程度的纖維化和永久性建築的破壞。蘇木精伊紅染色和Masson的三色染色用於高檔的數額壞死和炎症和程度階段纖維化。特異性免疫組化的丙型肝炎病毒尚未開發的日常使用。 Liver biopsy is also helpful in ruling out other causes of liver disease, such as alcoholic liver injury or iron overload. 肝活檢也有助於排除其他原因的肝臟疾病，如酒精性肝損傷或鐵負荷。

HCV causes the following changes in liver tissue: 丙型肝炎病毒的原因有下列變動肝組織：
Necrosis and inflammation around the portal areas, so-called "piecemeal necrosis" or "interface hepatitis." 壞死和炎症的門戶地區，所謂的“零打碎敲壞死”或“界面肝炎。 ”

Necrosis of hepatocytes and focal inflammation in the liver parenchyma. 壞死的肝細胞和炎症的協調肝實質。

Inflammatory cells in the portal areas ("portal inflammation"). 炎性細胞在門戶領域（ “門戶炎症” ） 。

Fibrosis, with early stages being confined to the portal tracts, intermediate stages being expansion of the portal tracts and bridging between portal areas or to the central area, and late stages being frank cirrhosis characterized by architectural disruption of the liver with fibrosis and regeneration. 纖維化與早期階段被局限於門戶大片，中間階段正在擴大門戶傳單和縮小地區之間的門戶網站或向中心區，晚期肝硬化的特點是坦率的建築破壞了肝纖維化和再生。

Grading and staging of hepatitis by assigning scores for severity are helpful in managing patients with chronic hepatitis. 分級 ， 分期的肝炎指定分數嚴重性 ， 有利於在管理慢性肝炎患者。 The degree of inflammation and necrosis can be assessed as none, minimal, mild, moderate, or severe. 程度的炎症及壞死可以被評估為0票，最低限度，輕度，中度，重度。 The degree of fibrosis can be similarly assessed. 纖維化的程度可同樣評估。 Scoring systems are particularly helpful in clinical studies on chronic hepatitis. 積分制度是特別有用的臨床研究慢性肝炎。