3. Chronic Hepatitis - Sarm

• Common cause of chronic hepatitis?

  HBV and HCV
• Chronic hepatitis can result in?

  cirrhosis --> splenomegaly and ascites
• Chronic hepatitis can lead to

  • liver failure
  • hepatocellular carcinoma
  • encephalopathy
• What is absent in chronic hepatitis?

  jaundice
• signs of cholestasis

  • ** pale stool
  • steatorrhea
  • hemolytic anemia
  • pruritis
  • jaundice
• Chronic hepatitis - diagnosis

  • incidentally found elevated transaminases
  • previously diagnosed with acute hep
• Chronic hepatitis Treatment - suppress viral replication

  • interferon or pegylated
  • antiviral
• Chronic hepatitis - suppress inflammation

  • corticosteroid
• Positive HBs or HBsAb indicates?

  immunity to Hep B from exposure or vaccine
• Hep C antibodies does not give immunity against re-infection
• Alcoholic hepatitis

  • AST > ALT
• ascites is developed due to edema - because of low albumin
• Drug induced hepatitis

  • direct toxicity - with overdose
  • idiosyncrasy - within therapeutic dose
• who should be treated with antiviral drugs?

  everyone with chronic hep B infection with evidence of cirrhosis regardless of ALT levels
• Who should treated with antiviral drugs without evidence of cirrhosis with Hep B?

  • persistent abnormal ALT
  • high level of HBV replication
  • > 30 years old
• Spider nevus - occur in estrogen excessive states