Common Pathological Changes in Viral Hepatitis

Viral hepatitis can cause a range of structural and cellular changes in the liver, which are critical in determining the severity and progression of the disease. The most common types of liver damage associated with viral hepatitis include:

1. Hepatocyte Necrosis

One of the primary features of viral hepatitis is liver cell death, or necrosis. Depending on the extent of damage, this can manifest in several forms such as focal necrosis, spotty necrosis, or extensive necrosis. Mild cases typically show isolated cell death (spotty necrosis), while more severe cases involve larger areas of dead tissue (extensive necrosis). The degree of necrosis directly correlates with the severity of liver dysfunction.

2. Inflammatory Cell Infiltration

As liver cells die, they trigger an immune response that leads to the infiltration of inflammatory cells into the liver tissue. This inflammation can be limited to the portal areas or extend into the hepatic lobules, forming what is known as interface hepatitis. When the inflammation crosses the boundary of liver plates and spreads into the parenchyma, it can lead to bridging inflammation, which is a more severe pattern of liver injury.

3. Fibrous Tissue Proliferation

Chronic liver damage in viral hepatitis often leads to fibrosis. This occurs when hepatic stellate cells become activated and produce excessive amounts of extracellular matrix proteins, particularly collagen. Fibrosis typically develops around areas of necrosis and can progress over time, potentially leading to cirrhosis if the damage is persistent and untreated.

These pathological changes are key indicators used by medical professionals to assess the stage and severity of viral hepatitis, and they play a major role in guiding treatment decisions.