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Infectious Diseases
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
The clinical presentation of acute hepatitis may depend on the underlying cause. Generally, patients with hepatitis experience non-specific symptoms (fatigue, nausea, vomiting) followed by development of a fever, jaundice, RUQ discomfort and hepatomegaly. Chronic hepatitis presents with similar symptoms or symptoms of cirrhosis and liver failure (see Section 3.4).
The Digestive (Gastrointestinal) System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Agents capable of causing acute hepatitis include several viruses, alcohol, toxins, and drugs. Viral hepatitis is primarily caused by hepatitis A virus (HAV), hepatitis B virus (HBV), or the non-A, non-B agents. Hepatitis B is a common cause of chronic hepatitis. Acute and chronic hepatitis are manifested clinically by fatigue, anorexia, weight loss, malaise, fever, and right upper quadrant abdominal pain. The additional symptoms of spider telangiectases (tela-= web-like; angi-= artery; -ectasia = dilation of a vessel), palmar erythema, gynecomastia, testicular atrophy, and diminished libido suggest cirrhosis. Severe viral hepatitis and cirrhosis are the most commonly observed causes of jaundice.
The liver, gallbladder and pancreas
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Dina G. Tiniakos, Alastair D. Burt
Liver inflammation persisting for more than 6 months without sustained improvement is defined as chronic hepatitis. However, the disease may have a fluctuating course in terms of injury, as assessed biochemically or by liver biopsy. A spectrum of biopsy changes is seen depending on disease activity which itself may be modulated by immunosuppressive drugs and the underlying cause. The pathological features are illustrated in Figure 11.6. The hallmark of chronic hepatitis is the presence of so-called ‘interface hepatitis’. This is a process of chronic inflammation, leading to hepatocyte death and fibrosis, which occurs at the limiting plate of the portal tracts. If interface hepatitis is severe, then bridging necrosis and fibrosis occur between adjacent portal regions, leading to the rapid evolution of cirrhosis.
CpG DNA-triggered upregulation of TLR9 expression affects apoptosis and immune responses in human plasmacytoid dendritic cells isolated from chronic hepatitis B patients
Published in Archives of Physiology and Biochemistry, 2023
Bin Zhu, Tianbao Wang, Xiaoxia Wei, Yancai Zhou, Jiansheng Li
Human peripheral blood was obtained from three healthy donors aged 45.6 ± 5.23 (two males and one female) and three chronic hepatitis B patients aged 47.2 ± 3.68 (two males and one female) in The First Affiliated Hospital of Xinxiang Medical University with the approval of Health Ethic Committee (No.2016–09-11). Inclusion criteria: patients with chronic hepatitis B had different degrees of systemic fatigue, fatigue, loss of appetite and jaundice, and were diagnosed with chronic hepatitis B by liver function, histological diagnosis, hepatitis B virus markers and hepatitis B virus deoxyribonucleic acid (HBV-DNA). The diagnosis of patients with chronic hepatitis B was consistent with the “relevant diagnostic criteria of chronic hepatitis” in the Guidelines for Prevention and Treatment of Chronic Hepatitis B. Exclusion criteria: patients who were positive for HBeAg and anti-Hbe; patients co-infected with hepatitis C virus, hepatitis D virus, or human immunodeficiency virus, hepatic decomposition; patients who had other liver diseases (alcohol liver disease, fatty liver, autoimmune liver disease, metabolic liver disease, or liver cancer), or fibrosis and cirrhosis of the liver which was determined by transient elastography. This study conformed to the ethical guidelines of the 1975 Declaration of Helsinki. All patients provided written informed consent before the participation into the study.
Health care costs related to hepatitis B in Finland are mostly due to chronic infections: a register-based study
Published in Infectious Diseases, 2022
Tanja Nieminen, Heini Salo, Markku Nurhonen, Tuija Leino
However, our study also has some limitations. We could not separate compensated and decompensated cirrhosis nor inactive and active chronic hepatitis B in our evaluations as has been done elsewhere [20–22]. We excluded the liver transplantation costs from this study due to small number of performed hepatitis B-related liver transplantations in Finland. We restricted the analyses of antiviral medication to chronic disease and did not account for acute hepatitis B as the vast majority of newly infected adults recover spontaneously [23,24]. Furthermore, we restricted the evaluation of costs related to chronic hepatitis B, liver cirrhosis, and liver cancer to 15, 7, and 2 years, respectively, since register data were not available from each individual from the detection of the disease until death. We based these periods of time on the register data and the typical progression of diseases. For instance, 65% of the hepatitis B-related liver cancer cases died from cancer within 2 years of the cancer detection. Instead, chronic hepatitis B is a persistent disease [5]. In addition, we estimated the average health care resource use by hepatitis B-related outcome of those individuals with valid IDs and full follow-up time excluding those individuals with overlapping health care resource use due to other hepatitis B-related outcome or liver transplantation (Supporting Information, Figure S1). Nevertheless, the estimates on the total annual health care costs were based on the average number of cases in 2004–2012.
Application of hepatitis B immunoglobulin in prevention of mother-to-child transmission of chronic hepatitis B in HBsAg- and HBeAg-positive mother
Published in Journal of Obstetrics and Gynaecology, 2022
Hong Wang, Jia Wei Fang, Zhao Wen Gu, Dong Jie Song, Yuan Chen, Guang Di Chen, Baihui Zhao, Ce Sun, Yue Ma, Ke Xin Wang, Jia Qi Shen, Xiao Fu Yang, Qiong Luo
Chronic hepatitis B is a crucial global health problem. About 350 million people worldwide are bothered with chronic hepatitis B according to the World Health Organisation (WHO). In high-endemic areas, including China, the hepatitis B virus is most commonly transmitted from mother to child at birth, due to child’s exposure to maternal blood and secretions during childbirth, or from person to person during early childhood (Goldstein et al. 2005). The implementation of immunisation programme serves as a catalyst for reducing the spread of HBV. Before HBV vaccine was included in the planned immunisation in China, the incidence of perinatal infection was up to 80% when pregnant women were HBsAg- and HBeAg-positive (Stevens et al. 1979; Xu et al. 1985). The incidence of hepatitis B was approximately 60% lower than that before the implementation of immunisation program in Shanghai (Yu and Li 2019). Reducing the incidence of MTCT of HBV during pregnancy and perinatal period is therefore considered as the initial and effective step to elimination of chronic hepatitis B, especially for Chinese and other endemic populations.