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Liver and intrahepatic bile ducts-nontumor

Viral hepatitis

Hepatitis delta agent (Hepatitis D)


Reviewers: Komal Arora, M.D. (see Reviewers page)
Revised: 12 May 2012, last major update May 2012
Copyright: (c) 2004-2012, PathologyOutlines.com, Inc.

General
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● Only occurs with hepatitis B virus because delta agent is a defective RNA virus that requires hepatitis B infection for its own replication
● May cause any clinical syndromes or histologic patterns of hepatitis B
● May also cause an acute hepatitis with atypical biphasic pattern or a chronic hepatitis that progresses rapidly to cirrhosis in 15% of patients
● Consider delta virus infection if (a) recurrent acute hepatitis or (b) sudden fulminant hepatitis in chronic hepatitis B carrier
Diagnosis: serology

Micro description
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● Typical histology of hepatitis B infection
● May also show morule cell (multivesicular change due to vacuoles in infected hepatocytes) and more pronounced necrosis and inflammatory activity

Micro images
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Lobular and portal inflammation with fatty macrovacuoles


Acidophil bodies


Immunostains for HBV surface antigen


Immunostain for HDV antigen (nuclear localization)

Additional references
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Curr Infect Dis Rep 2012 ;14:9, Lancet 2011;378(9785):73

End of Liver and intrahepatic bile ducts-nontumor > Viral hepatitis > Hepatitis delta agent (Hepatitis D)


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