55Hepatitis Overview: Acute and Chronic

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Questions and Answers

What type of transmission is associated with Hepatitis A infection?

Airborne transmission

Vector-borne transmission

Parenteral transmission

Faecal-oral transmission (correct)

Which statement is true regarding Hepatitis B and Hepatitis C?

Both are primarily transmitted via contaminated food.

Both have a high rate of becoming chronic infections. (correct)

Hepatitis B commonly leads to silent infections in children.

Both are classified as infective hepatitis.

What is the histological appearance associated with hepatitis A?

Periportal inflammation with plasma cells (correct)

Massive necrosis with fibrous tissue

Congestion of central veins

Lymphoid aggregates predominantly in the portal areas

What is a key feature of Hepatitis A regarding chronic infections?

It has a very rare chronic state. Signup and view all the answers

Which type of antibody indicates a recent Hepatitis A infection?

IgM anti-HAV Signup and view all the answers

What characterizes acute hepatitis?

Abnormality resolved within 6 months Signup and view all the answers

Which viruses are primarily associated with acute hepatitis?

HAV, HBV, HCV, and HEV Signup and view all the answers

What is a key histological feature of hepatitis regardless of its duration?

Presence of lymphocytes Signup and view all the answers

Which of the following can cause chronic hepatitis?

Hepatitis B virus in certain age groups Signup and view all the answers

What is the characteristic feature of autoimmune hepatitis?

May have both acute flares and chronic aspects Signup and view all the answers

What distinguishes non-alcoholic fatty liver disease from conventional chronic hepatitis?

It is associated with metabolic syndrome Signup and view all the answers

Which molecule's presence is significant in HBV serology?

HBe antigen Signup and view all the answers

Which of the following is NOT considered under conventional 'chronic hepatitis'?

Alcohol-related liver disease Signup and view all the answers

What is a key laboratory finding associated with high AST/ALT levels in children with chronic hepatitis?

Normal albumin levels Signup and view all the answers

Which symptom is commonly associated with chronic hepatitis during its presentation?

Vague symptoms like anorexia/malaise Signup and view all the answers

What is one of the rare causes of chronic hepatitis mentioned?

Alpha-1-antitrypsin deficiency Signup and view all the answers

In assessing chronic hepatitis, what is a non-invasive method used to evaluate fibrosis?

FibroScan Signup and view all the answers

Which of the following is NOT categorized as chronic hepatitis?

Primary biliary cholangitis (PBC) Signup and view all the answers

What is the primary aim in the management of chronic hepatitis?

Reduce risk of progression to cirrhosis and hepatocellular carcinoma (HCC) Signup and view all the answers

What is typically preserved in chronic hepatitis despite the presence of elevated liver enzymes?

Albumin levels Signup and view all the answers

What type of inflammation is characteristic of chronic hepatitis?

Piecemeal necrosis/interface inflammation Signup and view all the answers

What is the primary risk factor for higher severity of Hepatitis E infection?

Pregnant women Signup and view all the answers

Which hepatitis virus requires the presence of Hepatitis B virus for its replication?

Hepatitis D Signup and view all the answers

What is the primary cause of chronic hepatitis, cirrhosis, and liver cancer worldwide?

Hepatitis B Signup and view all the answers

Which group has a childhood infection rate of 20-30% for chronic Hepatitis B?

Children Signup and view all the answers

What method confirms ongoing Hepatitis C infection?

HCV RNA in blood Signup and view all the answers

Which of the following is NOT associated with chronic Hepatitis C infection?

100% chance of resolution Signup and view all the answers

What is the approximate number of deaths annually attributed to chronic Hepatitis B?

1 million Signup and view all the answers

What is the commonest cause of acute liver failure (ALF) in South Asia?

Hepatitis E Signup and view all the answers

What is the most common genotype of Hepatitis C found in the US?

Type 1a Signup and view all the answers

Which factor does NOT contribute to the risk of progression in chronic Hepatitis C?

Exercise frequency Signup and view all the answers

What extrahepatic manifestation is associated with Hepatitis C?

Diabetes Signup and view all the answers

What does sustained virological response (SVR) reduce the risk of in chronic Hepatitis C?

Cirrhosis Signup and view all the answers

Which histological feature is typically seen in mild chronic hepatitis?

Portal tract lymphoid aggregates Signup and view all the answers

Which of the following statements about the histology of mild chronic hepatitis is incorrect?

Fatty change is not associated with mild chronic hepatitis. Signup and view all the answers

What is the primary genotype of Hepatitis C found in Europe?

Type 1b Signup and view all the answers

Which factor is least likely to worsen the risk of progression in chronic Hepatitis C?

Regular exercise Signup and view all the answers

Which of the following extrahepatic manifestations is most closely associated with Hepatitis C?

Porphyria cutanea tarda (PCT) Signup and view all the answers

What outcome does a sustained virological response (SVR) NOT reduce the risk of?

Development of diabetes Signup and view all the answers

Which of the following statements about acute viral hepatitis is false?

Confluent necrosis is absent in necrotic areas. Signup and view all the answers

Which of the following features is NOT commonly associated with Hepatitis A?

Chronic disease has a significant prevalence. Signup and view all the answers

What type of transmission is primarily associated with Hepatitis A and Hepatitis E?

Faecal-oral transmission Signup and view all the answers

Which of the following statements correctly describes the immune response to Hepatitis A infection?

IgG anti-HAV indicates previous exposure to the virus. Signup and view all the answers

Which pathological feature is indicative of acute hepatitis?

Periportal inflammation with plasma cells Signup and view all the answers

What is a significant biochemical marker for chronic hepatitis?

Persistently high AST/ALT Signup and view all the answers

Which condition is NOT classified under chronic hepatitis?

Cirrhosis related to alcohol Signup and view all the answers

Which of the following is characteristic of the interface inflammation seen in chronic hepatitis?

Blurring of the boundary with liver parenchyma Signup and view all the answers

What is a common symptom encountered during the presentation of chronic hepatitis?

Jaundice without abdominal pain Signup and view all the answers

What is the role of scoring systems in the assessment of chronic hepatitis?

Guide prognosis and treatment decisions Signup and view all the answers

In assessing chronic hepatitis, which method is utilized to evaluate the extent of fibrosis non-invasively?

FibroScan Signup and view all the answers

What distinguishes autoimmune hepatitis from other causes of chronic hepatitis?

It has a distinct autoimmune pathogenesis. Signup and view all the answers

What does the chronicity of hepatitis denote?

Persisting abnormality beyond 6 months Signup and view all the answers

Which of the following is most likely to cause acute liver failure?

Severe acute hepatitis from HAV. Signup and view all the answers

What factor does NOT contribute to the risk of fibrosis progression in chronic hepatitis?

Increase in physical activity Signup and view all the answers

What is a possible outcome of chronic HBV infection depending on the age of the patient?

Can progress to chronicity in a higher proportion of infected individuals. Signup and view all the answers

Which symptom is least likely to be associated with acute hepatitis?

Severe weight gain. Signup and view all the answers

What type of cell is primarily involved in the inflammatory response in hepatitis?

Lymphocytes. Signup and view all the answers

Which condition is categorized distinctly from conventional chronic hepatitis?

Non-alcoholic fatty liver disease. Signup and view all the answers

Which characteristic is most associated with viruses that cause acute hepatitis?

They include both hepatotropic and non-hepatotropic viruses. Signup and view all the answers

What significant aspect of HBV serology is indicated by the presence of HBe antigen?

It indicates high levels of viral replication. Signup and view all the answers

What is the population at the highest risk of serious disease due to Hepatitis E?

Pregnant women Signup and view all the answers

Which hepatitis virus is known as a 'passenger' RNA virus that requires HBV for replication?

Hepatitis D Signup and view all the answers

What is the approximate global prevalence of chronic Hepatitis B virus infection?

300 million Signup and view all the answers

Which group is considered to have the highest prevalence of chronic Hepatitis B, above 8%?

Southeast Asia Signup and view all the answers

What is the typical progression rate from acute to chronic infection in Hepatitis C cases?

80-90% Signup and view all the answers

What factors influence the risk of chronic disease progression associated with Hepatitis B infection?

All of the above Signup and view all the answers

Which Serological test confirms ongoing Hepatitis C infection?

HCV RNA in blood Signup and view all the answers

Which hepatitis virus becomes a common cause of acute liver failure in South Asia?

Hepatitis E Signup and view all the answers

What factor is considered a significant predictor of response in type 1 Hepatitis C infection?

Polymorphism in IFNL3/IL28B gene Signup and view all the answers

Which extrahepatic manifestation is commonly associated with Hepatitis C?

Cryoglobulinaemia plus glomerulonephritis Signup and view all the answers

What is the typical estimate of cirrhosis development over two decades in chronic Hepatitis C?

20% Signup and view all the answers

Which of the following is NOT typically considered when assessing the clinical course of chronic Hepatitis C?

Previous viral loads Signup and view all the answers

What aspect of chronic Hepatitis C increases the risk of progression to cirrhosis?

Alcohol consumption Signup and view all the answers

Which of the following accurately describes the connection between faecal-oral transmission and the types of viral hepatitis involved?

Both Hepatitis A and Hepatitis E can be transmitted through contaminated water. Signup and view all the answers

Which statement best describes the chronic nature of Hepatitis A and Hepatitis E?

Neither Hepatitis A nor E results in a chronic infection. Signup and view all the answers

What is a distinguishing feature of acute viral hepatitis regarding necrosis?

Spotty focal necrosis can occur individually in hepatocytes. Signup and view all the answers

Which histological feature is unique to Hepatitis A compared to other types?

Presence of acidophil bodies. Signup and view all the answers

Which immune response is triggered by a recent Hepatitis A infection?

Production of IgM anti-HAV. Signup and view all the answers

What is the typical outcome of acute hepatitis within six months?

Complete resolution of abnormality Signup and view all the answers

Which factor is most likely to contribute to the transition of acute hepatitis to chronic hepatitis?

Age at infection Signup and view all the answers

Which type of hepatitis is known to cause only chronic infections?

Hepatitis B Signup and view all the answers

Inflammatory cells found in typical cases of hepatitis are primarily comprised of what type?

Lymphocytes Signup and view all the answers

Which virus is least likely to be associated with acute diffuse liver damage?

Hepatitis G virus (HGV) Signup and view all the answers

What condition is an established cause of chronic liver disease but is not categorized under conventional chronic hepatitis?

Chronic inflammatory biliary tract diseases Signup and view all the answers

Which of the following symptoms is most commonly presented with acute hepatitis?

Nausea and malaise Signup and view all the answers

What is the significance of recognizing flares of chronic hepatitis in clinical practice?

May mimic acute hepatitis episodes Signup and view all the answers

What is a typical laboratory finding associated with chronic hepatitis in children?

Elevated bilirubin with normal albumin Signup and view all the answers

Which of the following conditions is considered to have always chronic characteristics?

Auto-immune hepatitis Signup and view all the answers

What is the significance of scoring systems in the assessment of chronic hepatitis?

They guide treatment options and prognosis. Signup and view all the answers

Which feature distinguishes chronic hepatitis from acute hepatitis?

Duration of symptoms lasting over six months Signup and view all the answers

In chronic hepatitis assessment, what does a FibroScan evaluate?

Fibrosis stage of the liver Signup and view all the answers

Which of the following conditions shares a risk of fibrosis and progression to cirrhosis but is not categorized as chronic hepatitis?

Alcohol-related liver disease Signup and view all the answers

What is an example of a symptom that can present alongside chronic hepatitis?

Vague symptoms like malaise Signup and view all the answers

Which biochemical change is a common indicator of prolonged liver injury in chronic hepatitis?

Persistently high ALT/AST levels Signup and view all the answers

Which population is at higher risk for severe disease related to Hepatitis E infection?

Pregnant women Signup and view all the answers

What is the implication of a positive Anti-HCV antibody test?

Indicates past exposure but not necessarily current infection Signup and view all the answers

What is the estimated global prevalence of chronic Hepatitis B infection?

300 million Signup and view all the answers

Which situation is least likely to present with acute liver failure due to Hepatitis A?

Routine vaccinations received before age 1 Signup and view all the answers

In which demographic is the transmission of Hepatitis D most commonly observed?

Injecting drug users Signup and view all the answers

What is a characteristic feature of Hepatitis C infection?

It shows high mutation rates causing different genotypes Signup and view all the answers

Which statement reflects the relationship between hepatitis B and hepatitis D infection?

Hepatitis D only occurs as a superinfection of chronic Hepatitis B Signup and view all the answers

What is the role of serological tests for Hepatitis E in non-endemic countries?

To identify zoonotic sources of outbreaks Signup and view all the answers

Study Notes

Hepatitis

Acute Hepatitis: Liver abnormality resolves within 6 months.
Some diseases cause only acute hepatitis (HAV).
Some causes of acute hepatitis may become chronic (HBV, HCV).
Severe acute hepatitis may cause acute liver failure.
Lymphocytes are the inflammatory cells in prototypical cases of hepatitis.
Flares of chronic hepatitis may mimic acute hepatitis.

Chronic Hepatitis

Persisting abnormality >6 months
Represents ongoing effects of acute hepatitis.
Biochemical, histological, or clinical evidence of hepatocellular damage.
Various causes but shared histology.
Can be detected during routine testing or investigation of symptoms.
Cirrhosis and decompensation can occur later.

Causes of Acute Hepatitis

Viruses (HAV, HBV, HCV, HEV, EBV, CMV, rubella)
Drugs
Symptoms: Nausea, anorexia, malaise.
Signs: Enlarged tender liver, jaundice, no signs of chronic disease.
Blood: High AST/ALT, elevated bilirubin, normal albumin, lengthened PT.

Causes of Chronic Hepatitis

Chronic viral hepatitis (B, C, B+D)
Chronic drug hepatitis (rare)
Autoimmune hepatitis (always chronic)
Wilson's disease (very rare, always chronic)
Alpha-1-antitrypsin deficiency (very rare)
Other causes of chronic liver disease/damage (e.g., PBC/PSC, alcohol-related liver disease, NAFLD, haemochromatosis)
All these can cause increased risk of fibrosis, cirrhosis, and HCC.

Assessment of Chronic Hepatitis

Blood tests (ALT/AST)
Viral load/genotype testing
Biopsy: ‘Grade’ of necroinflammatory activity & ‘Stage’ of fibrosis.
Non-invasive assessments of fibrosis (e.g., FibroScan)
Treatment goals include eliminating or reducing progression to cirrhosis and HCC.

Viral Hepatitis

Hepatotropic viruses: HAV, HEV, HBV, HCV, Yellow fever virus.
Transmission: Fecal-oral (HAV, HEV), Parenteral (HBV, HCV), Monkey-mosquito-man (Yellow fever).
Coinfection/superinfection possible (HCV/HBV, HBV/HDV).

Hepatitis A

Fecal-oral transmission
Usually subclinical or mild illness
Symptomatic in adults (jaundice, fever)
Silent infection in childhood
Very rare cause of ALF, jaundice can be prolonged
No chronic disease/carrier state
Anti-HAV antibody provides lifelong immunity.
IgM anti-HAV indicates acute infection
Active immunisation is available.

Hepatitis A Histology

Periportal inflammation with plasma cells
Cholestasis
Acidophil bodies, apoptosis, “councilman body”

Hepatitis E

Similar illness/epidemiology to hepatitis A.
Mainly developing countries
Common cause of ALF in South Asia (genotype 1)
Sporadic cases in non-endemic countries (zoonotic, genotype 3)
Mostly subclinical/mild, rarely acute liver failure.
Higher risk in pregnant women
No chronic disease/carrier state, except in immunosuppression
Histology resembles Hepatitis A

Hepatitis B

300 million people worldwide with chronic HBV disease.
Leading cause of chronic hepatitis, cirrhosis, and liver cancer worldwide.
Up to 1 million deaths annually.
Prevalence varies by geography and risk factors.
High prevalence in Southeast Asia, China, and Africa.
Chronic HBV more common with childhood infection (20-30%).
High-risk groups: Pregnant women, immunosuppressed patients, IDUs, MSM.

Hepatitis D

RNA "passenger" virus requiring HBV for replication.
Co-infection with HBV or superinfection on a chronic HBV background.
Increases risk of chronic disease
Typically in IDUs.
Rare in Ireland.

Hepatitis C

Major cause of "non-A, non-B hepatitis" prior to HCV identification.
Major burden of chronic infection worldwide (estimated 180 million).
Prevalence varies widely.
6 genotypes which influence behavior and treatment response.
Transmission: Blood, IDUs, sporadic.
Pathogenesis uncertain.
Acute infection typically silent, seldom recognized.
Most cases progress to chronic infection (>80%).
Chronic infection often identified incidentally.
Symptoms: Fatigue, arthralgia.
Extrahepatic manifestations in a small percentage.

Hepatitis C Histology

Mild chronic hepatitis
Portal tract lymphoid aggregates and follicles
Bile duct infiltration by lymphocytes
Fatty change
Portal and lobular granulomas
Giant cell formation

Hepatitis C Extrahepatic Manifestations

Arteritis
Cryoglobulinaemia plus glomerulonephritis
Porphyria cutanea tarda (PCT)
Higher incidence of diabetes
Association with lichen planus, Sicca syndrome, and non-Hodgkin lymphoma

Diagnosis of Hepatitis C

Serology: Anti-HCV antibody indicates exposure but does not provide protection.
HCV RNA in blood confirms ongoing infection.
Genotype: Type 1a (commonest in US, least responsive to interferon), Type 1b (commonest in Europe).
Polymorphism in IFNL3/IL28B gene predicts response to treatment for Type 1.
Sustained virological response (SVR) reduces progression and risk of complications.

Hepatitis C Clinical Course

Chronic HCV: Risk of progression varies, may take 20-30 years.
Histology indicates damage and predicts risk of progression.
Non-invasive assessments of fibrosis (FibroScan) available.
Biochemistry and clinical presentation may be normal.
Untreated HCV can progress to cirrhosis and HCC.

Hepatitis Definition

Hepatitis is an inflammation of the liver.
Acute hepatitis: abnormality resolves within 6 months.
Some diseases cause only acute hepatitis (HAV).
Other diseases cause only chronic hepatitis (AIH, Wilson’s disease).
Some causes of acute hepatitis may become chronic (HBV, HCV, HEV).
Severe acute hepatitis may rarely cause acute liver failure.

Causes of Acute Hepatitis

Viral causes, especially hepatotropic viruses (HAV, HBV, HCV, HEV, EBV, CMV, rubella).
Drug-induced hepatitis, similar to viral-induced.
Symptoms include vague symptoms like nausea, anorexia, and malaise.
Rarer cases may cause acute liver failure.
Signs include an enlarged, tender liver.
Jaundice is usually absent and is often seen in children.

Causes of Chronic Hepatitis

Chronic viral hepatitis (B, C, B + D or unknown).
Chronic drug hepatitis (rare).
Autoimmune hepatitis (always chronic).
Wilson's disease (very rare, always chronic).
Alpha-1-antitrypsin deficiency (very rare).

Assessment of Chronic Hepatitis

Blood tests like ALT/AST.
Viral load and genotype (e.g., HBV, HCV).
Liver biopsy.
Non-invasive assessments like FibroScan.

Hepatitis Classification

Infective Hepatitis:
- Hepatitis A and E.
- Transmitted via fecal-oral route, no chronic state for HAV, very rare for HEV.
Serum Hepatitis:
- Hepatitis B and C.
- Transmitted parenterally.
- Risk of chronic state.
Other viral causes of Acute Hepatitis:
- EBV, CMV, rubella.
Coinfection/superinfection:
- HCV and/or HBV and/or HIV, HBV + HDV.

Hepatitis A

Transmitted through fecal-oral route, via personal/sexual contact, contaminated water/shellfish.
Usually subclinical or mild illness, more often symptomatic in adults.
Silent infection in childhood is a reservoir of infection.
Very rare cause of ALF, jaundice can be prolonged but has no chronic disease/carrier state.

Hepatitis E

Similar to hepatitis A, mainly in developing countries.
Commonest cause of ALF in South Asia.
Sporadic cases are common in non-endemic countries.
No chronic disease/carrier state except in immunocompromised patients.

Hepatitis B

300 million worldwide have chronic HBV disease.
Leading cause of chronic hepatitis, cirrhosis and liver cancer worldwide.
Prevalence varies greatly by geography and risk.
Higher prevalence in Southeast Asia, China, and Africa.
Childhood infection has a 20-30% chance of developing chronic HBV.
Adults have a 2% prevalence, but higher in pregnant women, patients for immunosuppression, and high-risk groups.

Hepatitis C

Prior to HCV identification in 1987 it was known as “non-A, non-B hepatitis”.
Major cause of chronic infection worldwide (180 million).
Transmission through blood, IDUs, and sporadically.
Acute infection is mostly silent.
Most cases (>80%) progress to chronic infection.
Chronic infection is often identified incidentally.
Chronic HCV presents with vague symptoms like fatigue and arthralgia.
A small percentage develop extrahepatic manifestations.

Hepatitis D

Also known as the Delta agent.
Passenger RNA virus requiring the presence of HBV for replication.
Either co-infection with HBV or superinfection on a background of existing chronic HBV.
Increases risk of chronic disease in HBV patients.
Typically found in IDUs.
Rare in Ireland.

Hepatitis C Diagnosis

Serology: Anti-HCV antibody indicates exposure but most with anti-HCV have active chronic infection.
HCV RNA in blood: Confirms ongoing infection.
Genotype: Type 1a is most common in the US and least responsive to interferon.
Treatment Response: SVR (sustained virological response) reduces progression, risk of cirrhosis and HCC.

Hepatitis C Clinical Course

Risk of progression varies, but usually takes about 20-30 years.
20% chance of cirrhosis over 20 years.
Histology and non-invasive assessments like FibroScan help determine risk of progression.

Piecemeal Necrosis/Interface Inflammation

Portal tract is inflamed, blurring the boundary with the liver parenchyma and damage to liver cells.
Prototypical pattern of chronic hepatitis, especially HBV and autoimmune hepatitis.

Acute Viral Hepatitis Pathological Features

Spotty focal necrosis of individual hepatocytes.
Confluent bridging necrosis, linking vascular structures, typically in zones 1 and 2.
Panacinar necrosis is present when zones 1, 2, and 3 show necrosis.

Hepatitis Definitions

Acute hepatitis: Inflammation of the liver resolving within 6 months.
Chronic hepatitis: Liver inflammation persisting for over 6 months, evidenced through biochemical, histological, or clinical findings.

Causes of Hepatitis

Acute Hepatitis: Can be caused by viruses (HAV, HBV, HCV, HEV, EBV, CMV, Rubella), drugs, and toxins.
Chronic Hepatitis: Can be caused by chronic viral hepatitis (HBV, HCV, HDV), autoimmune hepatitis, Wilson's disease, Alpha-1-antitrypsin deficiency, and chronic drug hepatitis.

Hepatitis A

Transmitted faecal-orally, typically via contaminated water or food.
Most commonly encountered in endemic areas.
Usually results in a mild illness, but can be severe in adults.
Rarely causes acute liver failure.
No chronic disease or carrier state.
Lifelong immunity is conferred by anti-HAV antibody.
IgM anti-HAV signifies recent infection.
Vaccination is recommended for those at risk.

Hepatitis B

A major global health concern, causing chronic hepatitis, cirrhosis, and liver cancer.
Over 300 million individuals worldwide suffer from chronic HBV infection.
Prevalence varies geographically, with higher rates in Southeast Asia, China, and Africa.
Transmission occurs through bloodborne routes.
Infected mothers can transmit the virus to their newborns.
Up to 90% of infected children develop chronic HBV infection.
Co-infection with HDV (Delta agent) significantly increases the risk of chronic disease.

Hepatitis C

Identified in 1987, previously referred to as "non-A, non-B hepatitis."
A significant cause of chronic liver disease and cirrhosis.
A major global health concern due to the high number of individuals infected (~180 million).
Prevalence varies, with different genotypes affecting treatment response.
Transmission occurs mainly through bloodborne routes, especially in IDUs.
Acute infections are often silent and go unrecognized.
Most cases rapidly progress to chronic infection.
Chronic HCV can be diagnosed incidentally, and may have vague symptoms.

Hepatitis E

Closely resembles hepatitis A in its illness and epidemiology.
Prevalent in developing nations, with waterborne outbreaks.
Can cause acute liver failure, particularly in South Asia.
Rare instances of chronic disease have been reported in immunosuppressed individuals.

Hepatitis D

An RNA virus that requires pre-existing HBV infection for replication.
Co-infection or superinfection with HBV increases the risk of chronic HBV infection.
Typically observed in IDUs.

Chronic Hepatitis Assessment

Evaluation includes blood tests (ALT/AST), viral load/genotype (for HBV and HCV), and liver biopsy.
Treatment aims to eliminate, reduce, or postpone the progression to cirrhosis and reduce the risk of liver cancer.
Non-invasive methods like FibroScan are used to assess liver fibrosis.

Histological Features

Acute Viral Hepatitis: Characterized by spotty focal necrosis, bridging necrosis, and panacinar necrosis.
Chronic Hepatitis: Marked by periportal inflammation with plasma cells, cholestasis, and the presence of Councilman bodies.

Hepatitis C Histology

Mild Chronic Hepatitis: Involves portal tract lymphoid aggregates, bile duct infiltration by lymphocytes, and fatty changes.
Giant cell formation: Can be present in chronic hepatitis C.

Hepatitis C Extrahepatic Manifestations

Can include arteritis, cryoglobulinaemia, porphyria cutanea tarda, diabetes, lichen planus, Sicca syndrome, and non-Hodgkin lymphoma.

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Description

This quiz explores key concepts related to acute and chronic hepatitis, including their definitions, causes, and implications. Learn about the role of various viruses, the symptoms, and the clinical signs associated with these liver conditions. Test your knowledge on the pathological differences between acute and chronic hepatitis and their impact on liver health.