In hepatitis B major, the hepatitis B virus is highly active and the virus enters the hepatocytes, causing degeneration (e.g., enlarged or shrunken hepatocytes), necrosis (single-cell, multi-cell necrosis), and a distribution of inflammatory cells around the hepatocytes, indicating the presence of hepatocellular damage. The chronic infection can cause fibroblasts to proliferate and liver tissue to become fibrotic and structurally disturbed, which in time can lead to cirrhosis and even liver cancer.
In major hepatitis B, that is, when the hepatitis B virus surface antigen, hepatitis B virus e antigen, and core antibody are positive, it indicates that the hepatitis B virus is present in the body and is in a relatively active replication phase. The hepatitis B virus attacks the hepatocytes, causing degeneration of the hepatocytes, such as swelling of the hepatocytes, reduction in the size of the hepatocytes, causing a decrease in the function of the hepatocytes, and also causing single cell necrosis, peripheral necrosis of the hepatocytes, causing a decrease in the function of the liver, as well as infiltrating inflammatory cells around the hepatocytes, indicating the presence of damage to the hepatocytes.
In addition, if chronic infection is present for a long time, the reticular scaffold of the liver will be damaged, which, together with the continuous regeneration of hepatocytes, will cause disruption of the internal structure of the liver into dense masses, i.e., cirrhosis, which severely affects liver function and can also cause clinical manifestations such as jaundice and ascites. In the long run, cirrhosis may also lead to liver cancer. Therefore, it is recommended that patients with major triplets should be treated early to improve their prognosis.