Chronic Liver diseases

CLD 9/4/2017
Chronic Liver diseases
Chronic hepatitis is defined as a chronic necro inflammatory reaction in the liver of more than 3 – 6 months
CLD Causes
Viral B & C Autoimmune - Autoimmune hepatitis, PBC, PSC Genetic - Wilson’s, Haemochromatosis, Alpha 1 antitrypsin deficiency Toxic / Drugs – alcoholic, paracetamol Non-alcoholic fatty liver (DM / metabolic syndrome, pregnancy, idiopathic)
Hepatitis B & C
HBV DNA = infectious HBsAg = currently infected Anti-HBs + Anti-HBc = past infection , Anti-HBs alone = vaccinated

Hepatitis B Presentation : Fever, malaise, anorexia, nausea, arthralgia, jaundice, RUQ pain Usually asymptomatic early on % Chronic : HBV 5-10% HCV 85% HBV : Treatment Supportive. Chronic: antivirals (nucleoside analogues). Transplant HCV : Nucleoside analogues, protease inhibitors (anti-retroviral). Liver transplant