Acute viral hepatitis with bridging hepatic necrosis. An overview

Bridging hepatic necrosis in the setting of acute viral hepatitis (BHN/AVH) represents an enigmatic syndrome inasmuch as its incidence, significance, course, and therapeutic response have not been clearly defined. It has been thought that this histologic finding carries a high risk of early mortality or evolution to chronic active hepatitis and/or cirrhosis. The data are sparse, and largely based on retrospective studies in selected populations. Steroids have not proved to be effective thus far, while drugs used in other forms of serious liver disease (eg, penicillamine, colchicine) have not been tried. A recent prospective study indicates that BHN/AVN may be a far more benign entity than was previously suspected. Further prospective studies are needed to clarify the significance of this lesion as well as the need for and response to medical therapy.