Chronic hepatitis

What is it?

These are liver diseases characterized by chronic inflammation and elevated plasma levels of transaminases (liver cell enzymes).
They are caused by chronic infection by hepatitis B or C viruses, following acute unhealed hepatitis. In rarer cases, they may have an autoimmune origin or accompany autoimmune diseases (e.g., systemic lupus erythematosus) or be drug-induced. Chronic inflammation can develop liver cirrhosis; the time required for this process to occur is variable, depending on the degree of inflammatory activity present. If inflammatory activity is minimal or absent the evolution towards cirrhosis will never occur; if inflammatory activity is present the speed of evolution will depend on the degree of inflammation.

Which are the symptoms?

Symptoms are absent in most cases. When present, the most frequent symptoms are: asthenia and easy fatigability, general malaise, lack of appetite, nausea, joint pain and weight loss.
The discovery of the disease is often completely accidental, during laboratory tests performed perhaps for a different reason. In fact, acute hepatitis, especially in the case of hepatitis C, often progresses without causing any symptoms. Chronic hepatitis is also asymptomatic.

How is it diagnosed?

There is an increase in the values of some liver function tests (transaminases, gamma-gt) and laboratory tests show positivity of the so-called markers for hepatitis B or C. Liver ultrasound is mostly within normal limits. The diagnosis is confirmed by liver biopsy.

Suggested exams

How is it treated?

The available therapies (interferon or, in the case of hepatitis C, interferon plus ribavirin) are able to cure only a percentage of patients with active chronic hepatitis, but a therapeutic attempt, if there are no contraindications, is always necessary to try to avoid or slow down the evolution of the disease towards cirrhosis. In the presence of autoimmune hepatitis, the only effective therapy will be cortisone. There are no other effective therapies.

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