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Viral hepatitis is inflammation of the liver caused by hepatotropic viruses, primarily hepatitis A, B, C, D, and E. These infections can range from acute self-limiting illness to chronic progressive disease leading to cirrhosis and hepatocellular carcinoma. The clinical presentation varies from asymptomatic infection to fulminant hepatic failure.
Hepatitis viruses target hepatocytes through different mechanisms, with some causing direct cytopathic effects while others trigger immune-mediated liver damage. The inflammatory response involves activation of Kupffer cells, recruitment of lymphocytes, and release of inflammatory mediators leading to hepatocyte necrosis and fibrosis. Chronic infections result from viral persistence due to immune evasion mechanisms and ongoing hepatocyte destruction with regenerative nodule formation.
Clinical assessment begins with identifying risk factors such as travel history, sexual exposure, drug use, or healthcare exposure to guide testing for specific viral types. Laboratory evaluation includes liver function tests, viral serologies, and PCR testing to determine active versus resolved infection and guide treatment decisions. Management varies from supportive care for acute hepatitis A and E to antiviral therapy for chronic hepatitis B and C to prevent progression to cirrhosis and hepatocellular carcinoma.
Key imaging focus: Hepatomegaly, periportal edema (starry sky), gallbladder wall thickening