Hepatitis || DR. Fatima Allaith :
1.hepatitis is inflammation of liver leading to cell injury and necrosis.
2. causes : Hepatitis can be either acute or chronic
A. acute is the most common causes are viruses ( hepatitis A , C,B,D,E) and drugs (alcohol, acetaminophen,methyldopa)
B. Fulminant: also known as acute liver failure , sever liver injury with INR > 1.5 and hepatic encephalopathy in a patient without underlying chronic liver disease .
C. chronic : the most common causes are chronic viral infection ( hepatitis c most common in united states , HBV worldwide) , alcohol , autoimmune hepatitis , and metabolic syndrome (Wilson disease . hemochromatosis , alfa 1 antitrypsin deficiency ). 3.history (symptoms )/PE
Acute Hepatitis : often begins with nonspecific viral prodrome ( malaise , fever , joint pain , fatigue , URI symptoms , nausea , vomiting , change in bowel habits ) followed by jaundice , scleral icterus and tender hepatomegaly.
chronic Hepatitis : may be asymptomatic , but may cause fatigue and joint and muscle pain , jaundice and complications of portal hypertension (hepatic encephalopathy , ascites , esophageal varies )typically occur only when progresses to cirrhosis .At least 80% of those infected with hepatitis c and 10% of those with HBV in adulthood will develop persistent infection with chronic active hepatitis .
1. Hepatitis A : transmitted is fecal-oral and presentation typically self limited hepatitis , may lead to fulminant hepatic failure. Most common cause of acute viral hepatitis worldwide.
2.hepattis B : transmitted by body fluids , may be asymptomatic but may present as viral prodrome or jaundice . may lead to fulminant hepatic failure and require treatment with antivirals or liver transplant in sever cases . less than 10% in dults become chronic and transmitted vertically . extremely high transmission rate .
3.Hepatitis C :asymptomatic or viral prodrome and or jaundice , 80% become chronic , less likely to be sexual transmitted than HBV , very rare leads to acute liver failure .