Hepatitis: Causes, Symptoms, and Complications

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Questions and Answers

What is the primary mechanism behind inflammation of the liver and liver damage in Hepatitis?

Immune cells producing excessive cytokines

Immune cells attacking healthy hepatocytes

Virus causing infected hepatocytes to express abnormal protein on their surface, leading to immune cell destruction (correct)

Virus targeting and killing immune cells

Which of the following is NOT a common symptom of Hepatitis?

Jaundice and increased bilirubin

Fever and malaise

Atypical neutrophilia (correct)

Hepatomegaly and increased serum transaminases

What is the gold standard for diagnosing HCV infection?

HCV RNA testing using PCR (correct)

HCV IgG antibody testing

Liver biopsy

HCV IgM antibody testing

What is the significance of HAV IgG in Hepatitis A?

Indicates previous vaccination or recovery Signup and view all the answers

Which type of Hepatitis is often associated with Diabetes Mellitus and Metabolic Syndrome?

Non-alcoholic Fatty Liver Disease Signup and view all the answers

What is the significance of IgM anti-HBc in Acute Hepatitis B infection?

Indicates active infection Signup and view all the answers

What is the term for the scarring of the liver that can occur in Chronic Hepatitis?

Fibrosis Signup and view all the answers

What is the term for the inflammation of the liver characterized by giant cells?

Giant cell Hepatitis Signup and view all the answers

What is the term for the increased production of bilirubin in the blood, leading to yellowing of the skin and eyes?

Jaundice Signup and view all the answers

What is the term for the chronic liver failure that can occur in Chronic Hepatitis?

Cirrhosis Signup and view all the answers

What is the mechanism of action of Ribavirin?

Inhibits viral RNA synthesis Signup and view all the answers

What is the primary indication for Pegylated Interferon?

Treatment of hepatitis B and C Signup and view all the answers

What is the characteristic of Sofosbuvir that makes it a preferred treatment option?

High cure rate and fewer adverse effects Signup and view all the answers

What is the difference between Sofosbuvir and Ledipasvir?

Sofosbuvir is an anti-HCV RNA polymerase inhibitor, while Ledipasvir is an inhibitor of HCV NS5A protein Signup and view all the answers

What is the treatment approach for Hepatitis A?

Maintain appropriate nutrition and hydration, and watch personal hygiene Signup and view all the answers

What is the effectiveness of Sofosbuvir with Ribavirin and Interferon in treating HCV genotype 1?

90% Signup and view all the answers

What is the primary indication for Elbasvir + Grazoprevir (Zepatier)?

Treatment of genotype 1 or 4 in treatment-naive or treatment-experienced patients Signup and view all the answers

What is the contraindication for Ribavirin?

Pregnancy Signup and view all the answers

What is the characteristic of Pegylated Interferon?

Given via injection Signup and view all the answers

What is the cost of Sofosbuvir?

$84,000 to $168,000 for a course of treatment Signup and view all the answers

Study Notes

Hepatitis

Inflammation of the liver, characterized by inflammatory cells in liver tissue
Often asymptomatic, leading to jaundice, poor appetite, and malaise
Acute hepatitis lasts less than 6 months, while chronic hepatitis lasts more than 6 months

Chronic Hepatitis

May initially have no symptoms
Progresses to fibrosis (scarring) and cirrhosis (chronic liver failure)
Increases the risk of hepatocellular carcinoma

Causes of Hepatitis

Viral hepatitis (most common cause of liver inflammation worldwide)
Alcoholic hepatitis
Toxic/drug-induced hepatitis
Autoimmune hepatitis
Non-alcoholic fatty liver disease (often associated with diabetes and metabolic syndrome)
Ischemic hepatitis (often associated with heart failure)
Giant cell hepatitis (rare, affecting newborns and children)

Pathophysiology

Virus targets hepatocytes, causing them to express abnormal proteins on their surface
Immune cells destroy infected hepatocytes
Main mechanism behind liver inflammation and damage

Symptomatology

Fever, malaise, and nausea due to immune system response
Hepatomegaly and transaminase leakage into blood, causing increased serum transaminases (ALT > AST)
Atypical lymphocytosis common due to viral antigen stimulation
Jaundice, increased bilirubin (conjugated and unconjugated), and increased urobilinogenuria

HAV Serology

HAV IgM indicates active infection
HAV IgG indicates protective antibody, recovery, or previous vaccination

HCV Serology

HCV RNA testing using PCR is the gold standard
Detects virus early, even 1-2 weeks after infection
Detects levels of viral RNA in the blood
Decrease in levels indicates recovery, while no change indicates chronic HCV

Treatment of Hepatitis

Treating HAV

Maintain nutrition and hydration
Practice good personal hygiene to prevent spread
No antiviral medications indicated due to spontaneous resolution in almost all patients
Post-exposure prophylaxis with Hepatitis A vaccine or immunoglobulin for unvaccinated individuals

Treating HCV

Antiviral medication treatment recommended for all people with chronic HCV
Initial treatment depends on genotype of HCV identified

Effectiveness of Treatments

Sofosbuvir (Sovaldi) with ribavirin and interferon is 90% effective for genotypes 1, 4, 5, or 6
Sofosbuvir with ribavirin is 70-95% effective for genotypes 2 and 3
Ledipasvir (Harvoni) with sofosbuvir is 93-99% effective for genotype 1, but expensive
Ribavirin and peginterferon is 60-90% effective for genotype 6

Anti-HBV Drugs

Lamivudine (3TC)
Adefovir (Hepsera)
Entecavir (Baraclude)
Telbivudine (Tyzeka)
Tenofovir (Viread)
Peginterferon (first-line agents for treating HBV)

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Description

This quiz covers the definition, symptoms, and causes of Hepatitis, including chronic Hepatitis and its complications such as fibrosis, cirrhosis, and hepatocellular carcinoma.