The infection with hepatitis C virus(HCV)is one of the most important global chronic viral infections worldwide.It is estimated to affect around 3%of the world population,about 170-200 million people.Great part of the...The infection with hepatitis C virus(HCV)is one of the most important global chronic viral infections worldwide.It is estimated to affect around 3%of the world population,about 170-200 million people.Great part of the infections are asymptomatic,the patient can be a chronic carrier for decades without knowing it.The most severe consequences of the chronic infection are liver cirrhosis and hepatocellular carcinoma,which appears in 20%-40%of the patients,leading to hepatic failure and death.The HCV was discovered 25 years ago in 1989,is a RNA virus and classified by the World Health Organization as an oncogenic one.Hepatocellular carcinoma is one of the most important cancers,the fifth worldwide in terms of mortality.It has been increasing in the Ocidental world,mainly due to chronic hepatitis C.Hepatitis C is not only a liver disease and a cause of cirrhosis,but also a mental,psychological,familiar,and social disease.The stigma that the infected person sometimes carries is tremendous having multiple consequences.The main cause is lack of adequate information,even in the health professionals setting.But,besides the"drama"of being infected,health professionals,family,society and the infected patients,must be aware of the chance of real cure and total and definitive elimination of the virus.The treatment for hepatitis C has begun in the last 80′s with a percentage of cure of 6%.Step by step the efficacy of the therapy for hepatitis C is rapidly increasing and nowadays with the very new medications,the so called Direct Antiviral Agents-DAAs of new generation,is around 80%-90%.展开更多
Sporadic cases of acute viral hepatitis E have been described in developed countries, despite the more common occurrence in endemic areas and developing countries. We present the case of a 58 years old Portuguese fema...Sporadic cases of acute viral hepatitis E have been described in developed countries, despite the more common occurrence in endemic areas and developing countries. We present the case of a 58 years old Portuguese female, with no epidemiological relevant factors, admitted with acute hepatitis with positive anti-nuclear antibodies, anti-smooth muscle antibody and high serum gamma globulin (> 1.5 fold increase). Serologies for hepatitis A virus, hepatitis B virus, hepatitis C virus, Epstein-Barr virus, cytomegalovirus, hereditary sensory neuropathy and varicella zoster virus were negative. Liver biopsy histology revealed changes compatible with autoimmune hepatitis. Prednisolone and azathioprine was started. She tested positive for immunoglobulin M anti hepatitis E virus (HEV) with detectable viremia by reverse transcription polymerase chain reaction (RT-PCR) technique. HEV-RNA was confirmed throughRT-PCR in a liver specimen, establishing the diagnosis of acute hepatitis E. Immunosuppression was stopped. She clinically improved, with resolution of laboratory abnormalities. Therefore, we confirmed acute hepatitis E as the diagnosis. We review the literature to elucidate about HEV infection and its autoimmune effects.展开更多
文摘The infection with hepatitis C virus(HCV)is one of the most important global chronic viral infections worldwide.It is estimated to affect around 3%of the world population,about 170-200 million people.Great part of the infections are asymptomatic,the patient can be a chronic carrier for decades without knowing it.The most severe consequences of the chronic infection are liver cirrhosis and hepatocellular carcinoma,which appears in 20%-40%of the patients,leading to hepatic failure and death.The HCV was discovered 25 years ago in 1989,is a RNA virus and classified by the World Health Organization as an oncogenic one.Hepatocellular carcinoma is one of the most important cancers,the fifth worldwide in terms of mortality.It has been increasing in the Ocidental world,mainly due to chronic hepatitis C.Hepatitis C is not only a liver disease and a cause of cirrhosis,but also a mental,psychological,familiar,and social disease.The stigma that the infected person sometimes carries is tremendous having multiple consequences.The main cause is lack of adequate information,even in the health professionals setting.But,besides the"drama"of being infected,health professionals,family,society and the infected patients,must be aware of the chance of real cure and total and definitive elimination of the virus.The treatment for hepatitis C has begun in the last 80′s with a percentage of cure of 6%.Step by step the efficacy of the therapy for hepatitis C is rapidly increasing and nowadays with the very new medications,the so called Direct Antiviral Agents-DAAs of new generation,is around 80%-90%.
文摘Sporadic cases of acute viral hepatitis E have been described in developed countries, despite the more common occurrence in endemic areas and developing countries. We present the case of a 58 years old Portuguese female, with no epidemiological relevant factors, admitted with acute hepatitis with positive anti-nuclear antibodies, anti-smooth muscle antibody and high serum gamma globulin (> 1.5 fold increase). Serologies for hepatitis A virus, hepatitis B virus, hepatitis C virus, Epstein-Barr virus, cytomegalovirus, hereditary sensory neuropathy and varicella zoster virus were negative. Liver biopsy histology revealed changes compatible with autoimmune hepatitis. Prednisolone and azathioprine was started. She tested positive for immunoglobulin M anti hepatitis E virus (HEV) with detectable viremia by reverse transcription polymerase chain reaction (RT-PCR) technique. HEV-RNA was confirmed throughRT-PCR in a liver specimen, establishing the diagnosis of acute hepatitis E. Immunosuppression was stopped. She clinically improved, with resolution of laboratory abnormalities. Therefore, we confirmed acute hepatitis E as the diagnosis. We review the literature to elucidate about HEV infection and its autoimmune effects.
