anti-HDV, Hepatitis D virus antibody; anti-HEV, hepatitis E virus antibody; HAV, hepatitis A virus; HBc, hepatitis B core; HBe, hepatitis B e antigen; HBs, hepatitis B surface; HCV, hepatitis C virus.
From Hoofnagle JH: Acute viral hepatitis. In Goldman L, Ausiello D, eds. Cecil’s Textbook of Medicine. 23rd ed. Philadelphia: Saunders; 2008: 1101.
Acute viral hepatitis may evolve into a chronic active syndrome, which develops in 3% to 10% of cases involving hepatitis B and in 10% to 50% of cases involving hepatitis C. Many patients become asymptomatic infectious carriers of hepatitis B and C. These patients include many who are immunosuppressed or require chronic hemodialysis.
Drug-induced hepatitis
Drug-induced hepatitis results from an idiosyncratic drug reaction, from direct hepatic toxicity or from a combination of the two, as shown in the box below. Clinically, its manifestations resemble those of viral hepatitis, thereby complicating diagnosis. Alcoholic hepatitis is probably the most common form of drug-induced hepatitis and results in fatty infiltration of the liver (causing hepatomegaly), with impairment in hepatic oxidation of fatty acids, lipoprotein synthesis and secretion, and fatty acid esterification.
