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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.


● 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

● 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

Lobular and portal inflammation with fatty macrovacuoles

Acidophil bodies

Immunostains for HBV surface antigen

Immunostain for HDV antigen (nuclear localization)

Additional references

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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