Pathological changes in the liver include conspicuous focal activation of sinusoidal cells, accumulation of lymphocytes and histiocytes in the parenchyma, often replacing hepatocytes lost by cytolytic necrosis, mainly in the periportal areas, focal degeneration and occasional co-agulative necrosis. It has been reported that acute hepatitis B is characterised by more extensive parenchymal abnormalities and inflammatory changes than those found in hepatitis A, whereas portal inflammation and cholestasis are less prominent.

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