Viral hepatitis types

Cirrhosis has many causes (Table 21-1). In the United States, excessive alcohol intake and chronic viral hepatitis (types B and C) are the most common causes. 

Chronic alcohol consumption Chronic viral hepatitis (types B, C, and D)... 

Francioni S, M Pastore, Alpha-fetoprotein and acute viral hepatitis type B, J. 

Schiraldi, O., Modngno, A., Miglietta, A., Fera, G. Prolonged viral hepatitis type A with cholestasis case report. Ital. J. Gastroenterol. 1991 23 364-366... 

Dienstag, XL., Rhodes, A.R., Bhan, A.K., Dvorak, A.M., Mihm, M.C.jr., Wands, XR. Urticaria associated with acute viral hepatitis type B. Studies of pathogenesis. Ann. Intern. Med. 1978 89 34-40... 

Seeff, L.B. Natural history of viral hepatitis, type C. Semin. Gastro-intest. Dis. 1995 6 20-27... 

While cirrhosis has many causes (Table 37-1), in the United States excessive alcohol intake and chronic viral hepatitis (types B and C) are the most common causes. A breakdown of the indications for liver transplantation (Table 37-2) provides an estimate of the clinical frequency for each of the potential causes of cirrhosis, as transplant represents the deflnitive therapeutic strategy for cirrhosis. These data underestimate alcoholic liver disease, as these patients are often not considered suitable transplant candidates. 

Serologic testing for viral hepatitis type B, C, and D were nonreactive, but fecal studies showed shedding of hepatitis virus type A. Tests for antibodies to antigens of the hepatitis A virus (anti-HAV) in the serum were positive for the immunoglobulin M type. 

A diagnosis of acute viral hepatitis type A was made, probably contracted from virus-contaminated food Percy had eaten while on his cruise. His physician explained that there was no specific treatment for type A viral hepatitis but recommended symptomatic and supportive care and prevention of transmission to others by the fecal-oral route. Percy took acetaminophen 3 to 4 times a day for fever and arthralgias throughout his illness. 

The two most serious complications of acute viral hepatitis found in J patients such as Percy Veere are massive hepatic necrosis leading to ful- minant liver failure and the eventual development of chronic hepatitis. Both complications are rare in acute viral hepatitis type A, however, suggesting that acetaminophen toxicity may have contributed to Percy s otherwise unexpectedly severe hepatocellular dysfunction and early hepatic encephalopathy. 

Guidelines for the prevention of the transmission of viral hepatitis. Type A, in the food service area. Minneapolis Minnesota Department of Health, 1990. 

Centers for Disease Control. 1976. Perspective on the control of viral hepatitis. Type B. Morbid. Mortal. Weekly Rep. 25 3-10 (Suppl.). 

Yellow phosphorus was the first identified liver toxin. It causes accumulation of lipids in the liver. Several liver toxins such as chloroform, carbon tetrachloride, and bromobenzene have since been identified. I he forms of acute liver toxicity are accumulation of lipids in the liver, hepartxiellular necrosis, iii-trahepatic cholestasis, and a disease state that resembles viral hepatitis. The types of chrome hepatotoxicity are cirrhosis and liver cancer. 

Table 4 Treatment of viral infections other than chronic viral hepatitis and HIV with type I IFNs...

Identify modes of transmission and risk factors among the major types of viral hepatitis. 

There are five types of viral hepatitis hepatitis A (HAV), B... 

Viral hepatitis can occur at any age and is the most common cause of liver disease in the world. The true prevalence and incidence may be underreported because most patients are asymptomatic. The epidemiology, etiology, and pathogenesis vary depending on the type of hepatitis and will be considered separately below. 

Most patients infected with any type of viral hepatitis have no symptoms. 

Diagnosing viral hepatitis may be difficult because most infected individuals are asymptomatic. Because symptoms cannot identify the specific type of hepatitis, laboratory serologies must be obtained (Table 21-2). In addition, liver function tests may be obtained to assess the extent of cholestatic and hepatocellular injury. However, the definitive test to determine the amount of damage and inflammation of hepatic cells is a liver biopsy. 

Primary liver cancer, or HCC, is a rare type of cancer in Western countries, but occurs frequently in Africa and Asia. HCC is often the sequel to chronic viral hepatitis, cirrhosis, nutritional deficiencies, or specitic toxins. More common types of cancer occurring in the liver are metastatic diseases, which originate mainly from primary gastrointestinal tumors. For the growth of these and other solid tumors, sprouting of the vascular system, called angiogenesis, is essential to provide an adequate blood supply to the tumor cells. Nutrients and oxygen are needed for the proliferation of tumor cells [134-136],... 

Gastrointestinal Decrease in appetite, nausea and vomiting, pancreatitis, hepatomegaly, relapsing type B viral hepatitis... 

If the patient had acute viral hepatitis with significantly raised transaminases and a raised PT, an increase in the dosage interval of paracetamol should be considered as the clearance of paracetamol has been shown to be reduced by approximately 50% in these types of patients. 

Virus infections Acute viral hepatitis (HAV, HEV, HCV) is accompanied by cholestasis in 5-20% of cases. (63) The frequency differs from country to country. It is most prevalent in those with a severe form of the disease, elderly people and women. Cholestasis is also common in viral infections with concomitant hepatitis, especially due to CMV, Coxsackie virus, rubella virus, HSV (types I, II, IV), HIV, REO virus (type III), parvovirus (type B 19), and ECHO virus (types 9, 11, 14, 19). 

Lemon, S.M. Type A viral hepatitis epidemiology, diagnosis and prevention. Clin. Chemist. 1997 43 1494-1499... 

Griffiths, P.D., Elils, D.S., Znckerman, A.J. Other common types of viral hepatitis and exotic infections. Brit. Med. Bull. 1990 46 512—532... 

Predisposition The additional liver damage caused by the accumulation of urocarboxyporphyrins (UCP) and heptacarboxyporphyrins (HCP) in hepatic tissue is a prerequisite for clinically manifest PCT. Several forms of liver disease increase susceptibility to PCT, e. g. viral hepatitis B, and more particularly type C (286, 287, 302, 309), fibrosis, siderosis, cirrhosis, alcohol-induced liver... 

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