A histologic comparison of hepatitis B with non-A, non-B chronic active hepatitis

The histopathologic aspects of 62 cases of chronic active hepatitis (CAH) were examined to compare hepatitis B surface antigen (HBsAg)-positive with HBsAg-negative (non-A, non-B) cases. Epidemiologically, the two groups were distinct. Homosexuals and young, male users of intravenous drugs accounted for most of the cases of hepatitis B CAH, whereas older men and women with a history of blood transfusions represented a large percentage of the HBsAg-negative cases. However, there were no pathologic differences between the two diseases, in severity of inflammatory activity, degree of architectural damage, appearance of the bile ducts, or prevalence of cirrhosis. In a population of hospitalized patients, these two diseases cannot be distinguished microscopically unless hepatocytes that contain HBsAg are demonstrated. Although our current understanding of non-A, non-B CAH is limited, the disease not necessarily remit spontaneously, and progression to cirrhosis can be expected in some cases.