Common Pathological Changes in Viral Hepatitis

Viral hepatitis can lead to a range of liver damage, with several key pathological features commonly observed. These changes in liver tissue help doctors understand the progression and severity of the disease.

Liver Cell Necrosis

One of the primary signs of viral hepatitis is the death of liver cells, known as necrosis. This can vary in severity from minor to extensive damage. In mild cases, small areas of liver cells may die, referred to as focal necrosis or spotty necrosis. In more severe cases, large sections of liver tissue can be affected, leading to massive necrosis. The extent of necrosis directly correlates with the level of liver dysfunction, with more widespread damage resulting in more serious health consequences.

Inflammatory Cell Infiltration

When liver cells begin to die, the body responds by sending inflammatory cells to the affected area. This leads to what is known as inflammatory cell infiltration. In early stages, this inflammation may be limited to the portal regions of the liver. However, as the condition progresses, inflammation can spread into the liver lobules, forming what is called interface hepatitis. This occurs when inflammatory cells break through the limiting plate of the liver cells. Depending on the pattern of inflammation, this can also lead to bridging necrosis, where bands of dead tissue connect different areas of the liver.

Fibrous Tissue Proliferation

Another major change seen in chronic viral hepatitis is the development of fibrosis, or the buildup of fibrous tissue. This is caused by the activation of hepatic stellate cells, which release collagen and other extracellular matrix proteins. Fibrosis typically begins around areas of necrosis and can gradually expand, eventually leading to cirrhosis if left untreated. The progression of fibrous tissue can disrupt the normal architecture of the liver and impair its function over time.

These pathological changes—necrosis, inflammation, and fibrosis—are crucial indicators in diagnosing and managing viral hepatitis. Monitoring their development helps guide treatment decisions and assess disease progression.