Hepatitis Viruses and Liver Damage

Study Notes

Hepatitis A virus causes acute infection, transmitted through fecal-oral route, and lacks an envelope in its structure.
Hepatitis B virus can cause both acute and chronic infections, transmitted through sexual intercourse, blood, and perinatal transmission, and has an envelope in its structure with double-stranded DNA.
Hepatitis C virus can also cause both acute and chronic infections, transmitted through similar routes as HBV, and has an envelope in its structure with single-stranded RNA.
Hepatitis D virus mainly causes chronic infection, requires HBV for infection through co-infection or superinfection, and has an envelope in its structure with circular single-stranded RNA.
Hepatitis E virus mainly causes acute infections, transmitted fecal-orally, and lacks an envelope in its structure with single-stranded RNA.
The process of how these viruses infect hepatocytes involves shedding off outer coatings, releasing RNA, synthesizing proteins, using host cell machinery to replicate, and causing cell damage through lysis.
HBV utilizes reverse transcriptase to convert RNA to DNA within the host cell, leading to continuous replication and potential incorporation into the host genome.
The immune response to infected hepatocytes involves cytotoxic T cells recognizing viral proteins presented on MHC-1 complexes, leading to cell death through apoptosis.
Liver damage from viral infection triggers the production of cytokines like interleukin-1 and interferon gamma, leading to inflammation and destruction of liver cells.- Interleukin-6 and tumor necrotic factor alpha trigger a prostaglandin process in the brain, causing fever, malaise, and discomfort.
Liver damage leads to accumulation of hepatotoxins in the blood, causing nausea, vomiting, and potential dehydration.
Hepatotoxins can stimulate the chemo trigger zone in the brainstem, leading to vomiting and electrolyte imbalances.
Liver damage can result in jaundice, with bilirubin accumulating in the sclera and skin, causing a yellowish discoloration.
Conjugated and unconjugated bilirubin levels increase in the blood due to liver cell damage.
Decreased bile production by the liver leads to clay-colored stools due to decreased stercobilin.
Inflammation of the liver can cause hepatomegaly and right upper quadrant abdominal pain.
Liver enzymes AST and ALT increase in the blood as an indicator of liver damage.
Decreased clotting proteins production by the liver can result in prolonged PT and PTT.
Chronic infections with hepatitis B and C viruses can lead to extrahepatic manifestations like arthritis, vasculitis, myocarditis, and glomerulonephritis.
Chronic hepatitis B and C infections can increase the risk of fibrosis, cirrhosis, cellular dysplasia, and hepatocellular carcinoma.- SLE can present with various clinical manifestations and detectable abnormalities in lab tests.
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