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12. Acute viral hepatitis (aetiology, pathomorphology, complicated forms): Difference between revisions

12. Acute viral hepatitis (aetiology, pathomorphology, complicated forms) (view source)

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Let’s take a closer look at all of them.
Let’s take a closer look at all of them.


=== Hepatitis A and E ===
== Hepatitis A and E ==
Hepatitis caused by hep A or hep E is usually a benign and self-limiting disease with an incubation time of 2 to 6 weeks. It cannot progress into chronic hepatitis or a carrier state either. They’re both spread by the faecal-oral route by ingestion of contaminated water or foods (like shellfish from contaminated water) and is mostly sporadic in developed countries. It may occur as waterborne epidemics in developing countries where people live in overcrowded, unsanitary conditions.
Hepatitis caused by hep A or hep E is usually a benign and self-limiting disease with an incubation time of 2 to 6 weeks. It cannot progress into chronic hepatitis or a carrier state either. They’re both spread by the faecal-oral route by ingestion of contaminated water or foods (like shellfish from contaminated water) and is mostly sporadic in developed countries. It may occur as waterborne epidemics in developing countries where people live in overcrowded, unsanitary conditions.


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Hepatitis E infection is only dangerous for pregnant women. Pregnant women with HEV infection can develop fulminant hepatitis, where the whole liver becomes necrotic and dies. This liver in this case will be called ''atrophia hepatis flava'', or ''yellow liver atrophy''. This can only be cured by liver transplant.
Hepatitis E infection is only dangerous for pregnant women. Pregnant women with HEV infection can develop fulminant hepatitis, where the whole liver becomes necrotic and dies. This liver in this case will be called ''atrophia hepatis flava'', or ''yellow liver atrophy''. This can only be cured by liver transplant.


=== Hepatitis B ===
== Hepatitis B ==
The HBV is a common viral infection worldwide which spreads via sex, blood, body fluids or vertically (mother-foetus transmission). The virus is tough and can withstand extreme temperatures and humidity. The HBV is a member of the Hepadnaviridae.
The HBV is a common viral infection worldwide which spreads via sex, blood, body fluids or vertically (mother-foetus transmission). The virus is tough and can withstand extreme temperatures and humidity. The HBV is a member of the Hepadnaviridae.


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=== Hepatitis C ===
== Hepatitis C ==
Hepatitis C is also a major cause of liver disease, and the major route for transmission is through blood. Intravenous drug use with a previously used needle is the biggest sinner of hepatitis C transmission. This type of hepatitis can resolve by itself after an acute inflammation, but it progresses into chronic hepatitis in most cases. We will discuss the acute changes done by HCV.
Hepatitis C is also a major cause of liver disease, and the major route for transmission is through blood. Intravenous drug use with a previously used needle is the biggest sinner of hepatitis C transmission. This type of hepatitis can resolve by itself after an acute inflammation, but it progresses into chronic hepatitis in most cases. We will discuss the acute changes done by HCV.


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Little is known about acute hepatitis C. The incubation time takes usually 6-12 weeks, and the onset of acute hepatitis C can be asymptomatic and easily missed. The RNA from the virus can be detected in the blood within days or weeks from infection, and elevations of serum aminotransferase can be seen as well. Although strong immune responses involving <abbr>CD4</abbr>+ and <abbr>CD8</abbr>+ cells, which is enough to make the infection self-limiting, only a minority of patients are capable of clearing the HCV infection after the acute hepatitis incidence.
Little is known about acute hepatitis C. The incubation time takes usually 6-12 weeks, and the onset of acute hepatitis C can be asymptomatic and easily missed. The RNA from the virus can be detected in the blood within days or weeks from infection, and elevations of serum aminotransferase can be seen as well. Although strong immune responses involving <abbr>CD4</abbr>+ and <abbr>CD8</abbr>+ cells, which is enough to make the infection self-limiting, only a minority of patients are capable of clearing the HCV infection after the acute hepatitis incidence.


=== Hepatitis D ===
== Hepatitis D ==
The HDV is a unique virus because it can’t cause any infection without being capsulated by HBsAg. So even if the HDV is different from HBV, it can only cause infection during a HBV coinfection. You can get infected from HDV in two settings:
The HDV is a unique virus because it can’t cause any infection without being capsulated by HBsAg. So even if the HDV is different from HBV, it can only cause infection during a HBV coinfection. You can get infected from HDV in two settings: