Cytopathic Liver Injury in Acute Delta Virus Hepatitis

Hepatitis δ-virus (the δ-agent) is now recognized as a cause of acute hepatitis, fulminant hepatitis, chronic hepatitis, and cirrhosis in hepatitis B surface antigen-positive hosts. This report describes the clinical course and liver biopsy histopathology of acute δ-hepatitis in a young American woman with presumed chronic hepatitis B infection. The liver biopsy specimen features included severe cytotoxic and cytopathic hepatocellular damage, small droplet vacuolar liver cell degeneration, and few parenchymal inflammatory cells, lesions resembling epidemic δ-hepatitis in Venezuelan Indians and experimental chimpanzee b-superinfection. This case suggests that this form of cytopathic liver injury is an important morphologic expression of δ-virus hepatitis that deserves wider diagnostic recognition.