MATERIALS AND METHODS: Thirty patients with chronic active hepatitis B were included in our present study. [ncbi.nlm.nih.gov]

• Fever

  A 28-year-old man was admitted to our department with intermittent fever, hepatosplenomegaly and pancytopenia. Liver parameters and serum ferritin were markedly elevated. [ncbi.nlm.nih.gov]

  If you have symptoms such as jaundice, fatigue or fever or have been exposed to hepatitis B, don’t delay: make an appointment to see a liver specialist who is experienced in diagnosing and treating the virus. [cpmc.org]

  Several randomized controlled studies established that corticosteroid not only prolong life but decrease the symptoms and signs of fatigue, loss of appetite and fever. [hepatitiscentral.com]

  Serum sickness-like syndrome can develop during the prodromal (preicteric) period ; : rash, polyarthritis, fever Subclinical hepatitis (70% of cases) Symptomatic hepatitis (30% of cases; see also acute viral hepatitis ) Fever, skin rash, arthralgias, [amboss.com]

• Fatigue

  People with symptoms most commonly complain of fatigue. Fatigue worsens throughout the day and may even be debilitating. [drugs.com]

  If you have symptoms such as jaundice, fatigue or fever or have been exposed to hepatitis B, don’t delay: make an appointment to see a liver specialist who is experienced in diagnosing and treating the virus. [cpmc.org]

  Several randomized controlled studies established that corticosteroid not only prolong life but decrease the symptoms and signs of fatigue, loss of appetite and fever. [hepatitiscentral.com]

  Many people have no symptoms, but some have vague symptoms, such as a general feeling of illness, poor appetite, and fatigue. Chronic hepatitis can result in cirrhosis with portal hypertension and liver failure. [merckmanuals.com]

  […] spontaneously recover most neonates progress to chronic infection worse prognosis with coinfection with hepatitis D or hepatitis C infection Presentation Symptoms acute hepatitis anorexia nausea right upper quadrant pain chronic hepatitis many are asymptomatic fatigue [medbullets.com]

• Malaise

  Transient side effects of malaise and influenza like symptoms occurred in all patients and resolved rapidly after treatment. [ncbi.nlm.nih.gov]

  Snapshot A 35-year-old presents to the emergency department due to abdominal pain and malaise. He also reports "yellow-ing" of his skin. Medical history is noncontributory. [medbullets.com]

  Patients with IACAH most often present with insidious onset of malaise, anorexia, fever and fatigue. Approximately 75% of these patients are female with the most frequent ages of onset between 10-40 years. [hepatitiscentral.com]

  Symptoms of chronic hepatitis often include a vague feeling of illness (malaise), poor appetite, and fatigue. Sometimes affected people also have a low-grade fever and some discomfort in the upper abdomen. Jaundice is rare. [merckmanuals.com]

  These symptoms abate with the onset of jaundice, although anorexia, malaise, and weakness can persist. [clevelandclinicmeded.com]

• Loss of Appetite

  The symptoms of liver cancer include weight loss, loss of appetite, nausea and vomiting, and jaundice. Fulminant hepatitis B This is a rare complication of acute hepatitis B where the immune system attacks the liver and causes severe damage. [news-medical.net]

  Long-term complications Liver cirrhosis Hepatocellular carcinoma ( HCC ) Post‑hepatitis syndrome Chronic fatigue, weakness Nausea, loss of appetite Possible upper quadrant pain Reactivation of previous HBV infection due to immunosuppression References [amboss.com]

  Several randomized controlled studies established that corticosteroid not only prolong life but decrease the symptoms and signs of fatigue, loss of appetite and fever. [hepatitiscentral.com]

  However, common symptoms include: fatigue dark urine joint and muscle pain loss of appetite fever abdominal discomfort weakness yellowing of the whites of the eyes (sclera) and skin (jaundice) Any symptoms of hepatitis B need urgent evaluation. [healthline.com]

  Symptoms of an acute infection may include loss of appetite, joint and muscle pain, low-grade fever, and possible stomach pain. [hepb.org]

• Abdominal Pain

  Many people don't have any troublesome symptoms, but if you do feel unwell, it can help to: get plenty of rest take over-the-counter painkillers, such as paracetamol or ibuprofen, for tummy (abdominal) pain maintain a cool, well-ventilated environment [nhs.uk]

  Snapshot A 35-year-old presents to the emergency department due to abdominal pain and malaise. He also reports "yellow-ing" of his skin. Medical history is noncontributory. [medbullets.com]

  […] hepatitis: ↑ with AST/ALT ratio of < 1 ( > 1 in fulminant infection) Chronic hepatitis: variable values (usually < 100 U/L ; ; in active infection > 100 U/L) with AST/ALT ratio of ≥ 1 ↑ γ‑GT, bilirubin, GLDH, and/or AP In cirrhosis : ↓ albumin, CHE Abdominal [amboss.com]

  Symptoms include feeling sick (nausea), being sick (vomiting), tummy (abdominal) pains, high temperature (fever) and feeling generally unwell. You may look yellow (become jaundiced). [patient.info]

• Jaundice

  Eventually, the liver damage can lead to symptoms such as weakness, loss of appetite, nausea, vomiting, itchy skin, jaundice, pain in the right upper abdomen, and fluid build up in the abdomen (ascites). [news-medical.net]

  High levels of bilirubin cause jaundice. [drugs.com]

  Physical examination is remarkable for right upper quadrant tenderness, generalized jaundice, and scleral icterus. Laboratory studies demonstrate the presence of HBsAg and significantly elevated IgM anti-HBc, and HBeAg. [medbullets.com]

  If you have symptoms such as jaundice, fatigue or fever or have been exposed to hepatitis B, don’t delay: make an appointment to see a liver specialist who is experienced in diagnosing and treating the virus. [cpmc.org]

  You may also have jaundice, a yellowing of skin and eyes, dark-colored urine, and pale bowel movements. Some people have no symptoms at all. A blood test can tell if you have it. HBV usually gets better on its own after a few months. [icdlist.com]

• Hepatomegaly

  Clinical signs include liver tenderness, hepatomegaly, and splenomegaly. Acute HBV infection typically lasts two to four months. [aafp.org]

  […] intake in excess of 80 grams of alcohol a day in men and 40 grams a day in women is associated with development of alcoholic hepatitis (1 beer or 4 ounces of wine is equivalent to 12g of alcohol). [27] Alcoholic hepatitis can vary from asymptomatic hepatomegaly [en.wikipedia.org]

• Scleral Icterus

  Physical examination is remarkable for right upper quadrant tenderness, generalized jaundice, and scleral icterus. Laboratory studies demonstrate the presence of HBsAg and significantly elevated IgM anti-HBc, and HBeAg. [medbullets.com]

• Urticaria

  Arthritis may be accompanied by urticaria, palpable purpura, erythema multiforme, erythema nodosum, liken planus. [meddean.luc.edu]

HBV DNA >2000 copies/mL along with an elevated alanine aminotransferase (ALT) suggests further workup and possible therapy is needed. Viral copies/mL above 10,000 suggest ongoing hepatitis with greater risk for carcinoma. [library.med.utah.edu]

An extensive workup for the etiology of MM including fasting blood sugar, cerebrospinal fluid examination, and tests for cryoglobulin and immunoglobulins (IgM, IgG, IgA, and IgE) with serum protein electrophoresis, antinuclear, antineutrophil cytoplasmic [synapse.koreamed.org]

• Hyperglobulinemia

  Additionally, some authorities require the presence of immunologic features, particularly high titers (usually more than 1:40) of certain non organic specific autoantibodies and polyclonal hyperglobulinemia. [hepatitiscentral.com]

• Hyperglobulinemia

  Additionally, some authorities require the presence of immunologic features, particularly high titers (usually more than 1:40) of certain non organic specific autoantibodies and polyclonal hyperglobulinemia. [hepatitiscentral.com]

• Hepatic Necrosis

  However, periportal necroinflammation, portal fibrosis, focal hepatic necrosis, regeneration and polyploid nuclear changes were more prominent in the CAH-B group than in the CAH-C group. [ncbi.nlm.nih.gov]

  Massive and submassive hepatic necrosis Fig 101 - Massive and submassive hepatic necrosis: Massive necrosis is fatal, involving the entire liver parenchyma. [meddean.luc.edu]

  The term pan-lobular or pan-acinar hepatic necrosis is used for necrosis affecting the entire lobule or acinus. Such extensive forms of necrosis are generally uncommon in chronic hepatitis. [hepatitisbannual.org]

  Acute infection may occasionally lead to fulminant hepatic necrosis, which is often fatal. The illness usually starts insidiously - with anorexia and nausea and an ache in the right upper abdomen. Fever, when present, is usually mild. [patient.info]

• Liver Biopsy

  This information is included to help assess the results of a liver biopsy. Nomenclature, grading, staging of liver biopsies. [hon.ch]

  Thus, liver biopsy is often essential in the patient with an elevated serum AT but low levels of HBV DNA. Liver biopsy may also be helpful in many patients with mutations in the HBV genome. [healio.com]

  Liver biopsy revealed cirrhosis in each patient. With the development of anti-HBs, these patients became serologically indistinguishable from patients with a cryptogenic cirrhosis who had prior unrelated exposure to hepatitis B. [ncbi.nlm.nih.gov]

• Hepatocellular Carcinoma

  Transforming growth factor alpha was expressed in 26 (68.4%) of 38 chronic active hepatitis B, 18 (56.3%) of 32 cirrhosis and 16 (51.6%) of 31 hepatocellular carcinoma tissue samples. [ncbi.nlm.nih.gov]

  A poor response can lead to chronic active hepatitis with ongoing hepatocellular damages and liver remodeling, with consequences of cirrhosis and potentially hepatocellular carcinoma. Hepatitis B viral DNA can be measured by PCR. [library.med.utah.edu]

  carcinoma, from seroclearance to hepatocellular carcinoma, from inactive to active CHB, from inactive CHB to seroclearance, from active hepatitis to hepatocellular carcinoma, and from hepatocellular carcinoma to HBV-related death (see Figures A-6, A- [nap.edu]

  Meta-analysis: surveillance with ultrasound for early-stage hepatocellular carcinoma in patients with cirrhosis. Aliment Pharmacol Ther. 2009;30(1):37–47. 30. El-Serag HB, Mason AC. Rising incidence of hepatocellular carcinoma in the United States. [aafp.org]

• HLA-B8

  The apparent predisposition of individuals with HLA-B8 and DR3 haplotypes to develop IACAH suggests that genetically conditioned abnormalities may have a role in pathogenesis. [hepatitiscentral.com]

Loss of cytoplasmic expression was related to the outcome of treatment in 5 of 9 HBeAg--/anti-HBe+ patients. Four patients expressed no HBcAg before or at the end of treatment. [ncbi.nlm.nih.gov]

In conclusion, the prognosis of anti-HBe-positive patients with chronic hepatitis B is poor, as 54% of the cases developed cirrhosis during a mean histologic follow-up period of 4.5 years, mainly in association with hepatitis delta virus infection or [ncbi.nlm.nih.gov]

[…] most immunocompetent adult patients spontaneously recover most neonates progress to chronic infection worse prognosis with coinfection with hepatitis D or hepatitis C infection Presentation Symptoms acute hepatitis anorexia nausea right upper quadrant [medbullets.com]

Soloway RD, Summerskill WHJ, Baggenstoss AH et al. (1972) Clinical biochemical and histological remission of severe chronic active liver disease: A controlled study of treatments and early prognosis. [link.springer.com]

The former have a good prognosis with a low risk of complications, while the latter patient population have active liver disease with a high risk of progression to liver cirrhosis and/or hepatocellular carcinoma (HCC). [bjmp.org]

Prognosis The prognosis for chronic hepatitis has improved dramatically over the last few years. In fact, for hepatitis C, many people can now be cured. Despite treatment, some people will progress to cirrhosis. [drugs.com]

However, it is unequivocally heterogenous with regard to etiology. [hepatitiscentral.com]

It is a syndrome of diverse causes including diabetes mellitus, demyelinating, infectious, or neoplastic etiology. In association with chronic active hepatitis B, MM associated with PAN is relatively common. [synapse.koreamed.org]

Etiology Virus Transmission The frequency and patterns of transmission vary worldwide. [amboss.com]

This old system is no longer in use because it does not include the disease stage and etiology, and cannot be correlated with the newer semi-quantitative scoring systems. [hepatitisbannual.org]

The terminology will also include the etiologic agent or cause, if known (International Working Party, 1994). [hon.ch]

Epidemiology References: [1] [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified. Etiology Virus Transmission The frequency and patterns of transmission vary worldwide. [amboss.com]

Introduction Classification a Hepadnavirus in the Hepadnaviridae family circular, partially double-stranded DNA virus Epidemiology risk factors not receiving hepatitis B virus (HBV) vaccine sexual contact with a person with HBV illicit drug use having [medbullets.com]

However, such a high prevalence is not recognized in the United States; this may be because of the differences in epidemiology of HBV, which may be predominantly perinatal in other geographic areas of the world (see Epidemiology ). [emedicine.medscape.com]

Hepatocellular carcinoma in HIV-infected patients: epidemiological features, clinical presentation and outcome. AIDS. 2004 Nov 19;18(17):2285-93. 47. Shire NJ, Welge JA, Sherman KE. [hivinsite.ucsf.edu]

Epidemiology and natural history of hepatitis B. Semin Liver Dis. 2005; 25 Suppl 1 : 3-8[ DOI ][ PubMed ] 9. Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology. 2009; 50 (3): 661-2[ DOI ][ PubMed ] 10. [hepatmon.com]

Furthermore, treatment with AM3 may help to elucidate the pathophysiology of CAHB. [ncbi.nlm.nih.gov]

References: [5] [6] [7] [8] Pathophysiology Acute infection Hepatocytes infected by the hepatitis B virus express viral peptides on their surfaces ; → lymphocytes recognize HBV -derived peptides and become activated ( CD8+ cytotoxic T cells ) → lymphocytes [amboss.com]

Pathophysiology of Disease: An Introduction to Clinical Medicine, 7e. McGraw-Hill. ISBN 978-1-25-925144-3. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag ah ai aj ak al am Dienstag, JL (2015). [en.wikipedia.org]

In general the data show that hepatitis B virus infection does not prevent hepatocytes from undergoing ductular metaplasia. [ncbi.nlm.nih.gov]

WHO has recently launched a new policy on injection safety that will also help prevent new hepatitis B infections. The policy calls for the worldwide use of “smart” syringes to prevent the re-use of syringes or needles. [who.int]

Clinical trials Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease. [mayoclinic.org]

Hepatitis virus panel (Medical Encyclopedia) Preventing hepatitis B or C (Medical Encyclopedia) [ Read More ] [icdlist.com]