| Key Histologic Features | Typical Causes | |
|---|---|---|
| Classic Viral Pattern | Diffuse hepatocyte injury and necrosis | Hepatitis viruses, Drugs |
| Mononucleosis Pattern | Lobular inflammation in sinusoidal distribution | Epstein-Barr virus, Hepatitis C virus, Cytomegalovirus, Drugs |
| Herpetic Pattern | Randomly scattered foci of necrosis | Herpes simplex virus,Adenovirus, Varicella-zoster virus, Enteroviruses |
| HEPATITIS A | HEPATITIS B | HEPATITIS C | HEPATITIS D | HEPATITIS E | |
|---|---|---|---|---|---|
| Route of Infection | Fecal-oral | Parenteral, Sexual, Perinatal | Parenteral, ? Sexual | Parenteral, ? Sexual | Fecal-oral |
| Fulminant Hepatitis | 0.2% | 0.2-1% | 0.2-1% | 1-10% (coinfection), 5-20% (superinfection) | 0.2-1% |
| Chronic Infection | No | 1-10% | 50-70% | 2-5% (coinfection), 40-70% (superinfection) | No |
| Serologic Diagnosis | IgM anti-HAV | HBsAg and IgM anti-HBc | Anti-HCV | Anti-HDV and HBsAg, (IgM anti-HBc in coinfection) | Not widely available |
| CMV MONONUCLEOSIS | OPPORTUNISTIC HEPATITIS | CONGENITAL INFECTION | |
|---|---|---|---|
| Clinical Setting | Normal hosts | Immunocompromised patients | Newborns |
| Histologic Background | Sinusoidal inflammatory pattern | Neutrophilic microabscesses, mild lobular hepatitis | Portal inflammation, variable hepatocyte injury |
| Viral Inclusions | No | Yes | Yes |
| Massive Necrosis | Rare | Rare | Rare |
| Chronic Liver Disease | No | Not reported | Uncommon |