Clinical pathologic correlation in viral hepatitis. The effect of the virus on the liver.

In clinical pathologic correlations, including the potential effect of the virus on the liver, the morphologic features of the various stages of viral hepatitis are the firm information available today. With acute hepatitis being an inflammatory reaction to cell injury and necrosis, and chronic hepatitis being sustained inflammation, correlation with clinical features and functional defects is good in acute hepatitis and less so in the chronic stages. The pathogenesis of the diseases-including cell necrosis, inflammation, fibrosis, and cirrhosis formation-is reasonably well understood, and this knowledge assists both in prognosis and in monitoring of therapy. The localization of the components of the hepatitis B antigen and their effects, including the nature of the immune response, is the most exciting aspect of the clinical pathologic problem. Today's interpretations offer, at best, a working hypothesis promising further understanding of the evolution of the disease.