Chronic Non-A, Non-B Hepatitis: The Pathologist’s Perspective

  • Zachary D. Goodman


A clinical diagnosis of chronic hepatitis is made when a patient has an elevation of serum aminotransferase activity that persists for 6 months or longer.1 This may follow an otherwise typical acute viral hepatitis; it may be discovered incidentally in a patient being evaluated for some other reason; or the patient may present with symptoms of chronic liver disease. Frequently in this situation, the clinician is prompted to obtain a liver biopsy to confirm the diagnosis of chronic hepatitis and to gather information about the cause, the stage of the disease, and the prognosis. This raises the question of the value of the liver biopsy in providing that information.


Chronic Hepatitis Liver Biopsy Primary Biliary Cirrhosis Bile Duct Injury Chronic Active Hepatitis 
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  1. 1.
    Boyer JL, Miller DJ: Chronic hepatitis, in Schiff L, Schiff ER (eds): Diseases of the Liver. JB Lippincott, Philadelphia, 1987, pp. 687–723.Google Scholar
  2. 2.
    Bianchi L, De Groote J, Desmet VJ, et al: Acute and chronic hepatitis revisited. Lancet 2:914–919, 1977.Google Scholar
  3. 3.
    Poulsen H, Christoffersen S: Abnormal bile duct epithelium in chronic aggressive hepatitis and cirrhosis. A review of morphology and clinical, biochemical, and immunologic features. Hum Pathol 3:217–225, 1972.PubMedCrossRefGoogle Scholar
  4. 4.
    Bianchi L: Liver biopsy interpretation in hepatitis. Part II. Histopathology and classification of acute and chronic viral hepatitis/differential diagnosis. Pathol Res Pract 178:180–213, 1983.PubMedCrossRefGoogle Scholar
  5. 5.
    Alter HJ. Acute and chronic consequences of post-transfusion hepatitis, in Ostrow JD, Groszmann RJ, Hoofhagle JH (eds): Hepatology UpdatePortal Hypertension; Viral Hepatitis. American Association for the Study of Liver Diseases, Chicago, 1986, pp. 219–228.Google Scholar
  6. 6.
    Thome CHM, Higgins GR, Ulich TR, et al: A histologic comparison of hepatitis S with non-S, non-B chronic active hepatitis. Arch Pathol Lab Med 106:433–436, 1982.Google Scholar
  7. 7.
    Peters RL. Viral inflammatory diseases, in Peters RL, Craig JR (eds): Liver Pathology. Churchill Livingstone, New York, 1986, pp. 73–123.Google Scholar
  8. 8.
    Knodell RG, Ishak KG, Black WC, et al: Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology 1:431–435, 1981.PubMedCrossRefGoogle Scholar
  9. 9.
    Baggenstoss AH, Soloway RD, Summerskill WHJ, et al: Chronic active liver disease. The range of histologic lesions, their response to treatment, and evolution. Hum Pathol 3:183–198, 1972.PubMedCrossRefGoogle Scholar
  10. 10.
    Schalm SW, Korman MG, Summerskill WHJ, et al: Severe chronic active liver disease. Prognostic significance of initial morphologic patterns. Dig Dis 22:973–980, 1977.CrossRefGoogle Scholar
  11. 11.
    Cooksley WGE, Bradbear RA, Robinson W, et al: The prognosis of chronic active hepatitis without cirrhosis in relation to bridging necrosis. Hepatology 6:345–348, 1986.PubMedCrossRefGoogle Scholar
  12. 12.
    De Groote J, Fevery J, Lepoutre L: Long-term follow-up of chronic active hepatitis of moderate severity. Gut 19:510–513, 1978.PubMedCrossRefGoogle Scholar
  13. 13.
    Davis GL, Czaja AJ, Ludwig J: Development and prognosis of histologic cirrhosis in corticosteroid-treated hepatitis S surface antigen-negative chronic active hepatitis. Gastroenterology 87:1222–1227, 1984.PubMedGoogle Scholar
  14. 14.
    Combes B: The initial morphologic lesion in chronic active hepatitis, important or unimportantS Hepatology 6:518–522, 1986.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1989

Authors and Affiliations

  • Zachary D. Goodman
    • 1
  1. 1.Department of Hepatic PathologyArmed Forces Institute of PathologyUSA

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