3. Chronic viral hepatitis (aetiology, types, pathomorphology and differential diagnostics, detection of virus associated antigens and their significance)

Chronic hepatitis? definition

Chronic inflammation of the liver

- defined by the presence of symptomatic, biochemical or serological evidence of continuing or relapsing hepatic disease for more than 3-6 months

Which hepatitis types can become chronic?

- HBV - becomes chronic in less than 10% (20??) of the cases

- HCV - becomes chronic in more than 80% of the cases

How can a chronic HBV infection be detected?

Serology

- HBsAg

- HBeAg

- Anti-HBc

How can a chronic HCV infection be detected?

ELISA or PCR

- Anti-HCV antibodies

- HCV RNA

Histological picture of acute vs. chronic hepatitis?

- Acute viral hepatitis shows mostly inflammation of the lobules

- Chronic viral hepatitis show inflammation around the portal triads

Other histological characteristics of chronic hepatitis?

- Ground glass hepatocytes

- Piecemeal necrosis

What other things than virus can cause chronic hepatitis?

- Hepatotoxic drugs

- Metabolic disorders

- Autoimmune chronic hepatitis

- Alcohol

Clinical course of chronic hepatitis?

The symptoms of chronic hepatitis are highly variable and do not predict the outcome

- can develop into cirrhosis

- increase risk of hepatocellular carcinoma

What are the major consequences of chronic hepatitis?

- Cirrhosis

- Hepatocellular carcinoma