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Viral hepatitis—clinical aspects 

Viral hepatitis—clinical aspects
Chapter:
Viral hepatitis—clinical aspects
Author(s):

H.J.F. Hodgson

DOI:
10.1093/med/9780199204854.003.152101_update_002

Update:

Treatment of hepatitis C—discussion of new and effective treatment regimens, with links to the website giving most up-to-date recommendations.

Updated on 28 Aug 2014. The previous version of this content can be found here.
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date: 21 October 2017

There are five major hepatitis viruses—A, B, C, D, and E—with the clinical picture depending on the severity of the inflammation induced in the liver, and on whether the virus is cleared from the liver or persists long-term.

Acute icteric hepatitis, characterized by jaundice and right upper quadrant abdominal tenderness, is the commonest clinically recognized consequence of infection. This is generally a self-limited condition with low mortality and complete recovery: only hepatitis B and C have the propensity to cause chronic viral hepatitis. Typically, hepatocellular enzyme levels in blood are prominently raised at the time of the onset of symptoms, whilst the serum alkaline phosphatase level is only slightly increased. Specific diagnosis is made by serological testing for particular viruses. Uncomplicated cases recover spontaneously; there is no proven therapy to enhance recovery, but alcohol and potentially hepatotoxic drugs should be withdrawn. Fulminant hepatic failure caused by viral hepatitis has 80% mortality and should be treated (if possible) by orthotopic liver transplantation....

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