HEPATITIS FACTOIDS.....Made Simple

We'll review some important generalizations about "HEPATITIS"
while keeping it simple, easy to recall....and fun to memorize.


HINT: the CAPITALIZED words, are the KEY features to remember!!!





IgM ----- implies a CURRENT/ACTIVE process.
IgG------ implies a RESOLVED process. HINT: "G" Gone!!!



Hepatitis A Virus (HAV).....does NOT have a chronic form.

Hepatitis E Virus (HEV).....also does NOT have a chronic form. With PREGNANCY it has
> 20% mortality, in endemic areas, esp. Asia.

Hepatitis B Virus (HBV)....99% patients recover from ACUTE form of infection, without
treatment. Symptoms are usually SERUM SICKNESS-like
with URTICARIA, ARTHRALGIA, ANGIOEDEMA, prior to
jaundice.

Hepatitis C Virus (HCV)....acute form is rarely symptomatic. Thus, most patients are
diagnosed incidentally. GENOTYPE 1 is most common, @ 75%
and also has the WORST PROGNOSIS in USA. No vaccine
available, yet.

Autoimmune Hepatitis.....is non infective, but can cause FALSE positive HCV test.
NO PRURITUS involved. If patient c/o itching, look for
an alternate diagnosis.

Drug Induced Hepatitis....generally causes an ELEVATED LDH and normal hepatitis
profile. Moderate-severe elevated LFT's. Accounts for about
40% cases of hepatitis in USA.


Hepatitis D Virus (HDV)....requires CO-INFECTION with Hepatitis B (HBV).
Thus, cannot diagnose HDV infection without HBV.


Ischemic Hepatitis...........Most common cause is POOR CARDIAC OUTPUT, with
systemic hypotension/hypoxia. AST/ALT elevation in the
THOUSANDS within hours of HYPOPERFUSION injury.


Alcoholic Hepatitis..........Has 10-40% mortality. Patients are usually malnourished
and present with FEVER, jaundice, RUQ pain, modest AST/ALT
elevations (2:1/3:1 ratios) and ELEVATED IgA levels!!!


Glucocorticoids.................are CONTRAINDICATED in any form acute VIRAL Hepatitis.


Chronic Hepatitis............. requires the illness to be present for > SIX MONTHS by definition.



Thanks for you time. Next posting we'll review interpretation of viral hepatitis
laboratory tests......made simple.