Acute viral hepatitis is inflammation of the liver parenchyma for less than 6 months caused by viruses.
Causes acute viral hepatitis:
- Hepatotropic viruses: including A, B, non-A non-B (C, E) viruses and Delta agent when combined with B viruses.
- Non-hepatotropic viruses: such as Epstein Barr virus (EBV), herpes simplex virus, and cytomegallo (CMV).
Clinical picture of hepatotropic viral hepatitis (A, B, C, E, Delta + B):
It could be of two types; Without jaundice hepatitis or jaundice hepatitis as follows:
- No jaundice hepatitis: it is a mild form of hepatitis, although it can go unnoticed, clinically there is a mild flu disease with anorexia (the patient does not even like the smell of food and if he were a smoker he would not tolerate the smell of ciggartes), Destiny: Resolution or you could develop chronic hepatitis.
- Jaundice hepatitis: has 3 phases (pre-jaundice, jaundice and post jaundice)
- Preicteric phase symptoms (about 1 week): fever, headache, malaise with marked anorexia and dislike of cigarettes and right upper quadrant pain (anatomical site of the liver)
- Jaundice phase (2-4 weeks): there is some improvement in fever, malaise and headache but jaundice appears (jaundice: yellowish discoloration of the skin and mucosa), with jaundice there is dark urine and clay stools.
- Post-icteric phase (convalescence): there is an improvement in the general condition gradually but the jaundice persists for some time, then after about 3-6 months the patient normalizes.
Complications:
- chronic hepatitis especially with hepatitis C.
- liver cirrhosis (loss of liver pattern with portal hypertension).
- Fulmination that rapidly develops into liver cell failure and hepatic encephalopathy (especially with hepatitis E infection during pregnancy).
- prolonged cholestasis (prolonged jaundice).
- a relapse could occur.
- posthepatitis syndrome that is psychogenic.
- Hepatoma (liver cancer).
- Aplastic anemia, purpura.
- hives, arthritis and pancreatitis.
- glumerulonephritis.
- vasculitis.
- polyneuropathy.
the last 5 points of complications are rare except with hepatitis B and C.
Treatment: (non-specific treatment)
- Rest: it is advisable, but it is not necessary a strict confinement in bed, rest until the patient is clinically normalized.
- Diet: high carbohydrate diet, low fat diet and no protein restrictions except with fulminant hepatitis.
- steroids are contraindicated, as they do not have any benefit and can provoke an exacerbation.
- vitamins
- antiemetics.
- immunoprophylaxis: vaccines and immunoglobulins.
Interferon therapy is not necessary in acute viral hepatitis, as it is a simple disease that can be cured by the immune system. Interferon has been used in some acute cases of hepatitis C with some success.