Hepatites virais

Abstract

Viral hepatitis are caused by five hepatotropic viruses: A, B, C, Delta and E. The recently recognized viruses G and TTV are not related, as demonstrated so far, to pathogenicity of the liver. During acute fase of viral hepatitis, ALT levels are very high; however, only 30% of patients are icteric. Clinical picture and laboratorial abnormalities are quite similar, regardless the type of virus causing the infection. The etiological diagnosis is based on serological markers, specific for each virus. There is no treatment for acute hepatitis and no dietetic restrictions are recommended. Virus A and E are related to self-limited infections, whereas virus B, C and Delta can cause chronic infections. Chronic hepatitis are usually asymptomatic and its diagnosis is established by finding serological markers of infection (HBsAg and anti-HCV) or ALT abnormalities. Histological exam of fiver tissue should be done whenever ALT levels are abnormal for more than 6 months or there is evidence of viral replication. Interferon is the treatment of choice for chronic hepatitis B e also Lamivudine can represent an alternative for intolerant or non-responders to Interferon. Hepatitis C should be treated with the combination of Interferon and Ribavirin. Responders to treatment will present normalization of ALT levels and disappearance of replication markers.