Hepatitis

Acute Hepatitis

Tx - supportive care only

Testing indicating a negative HBsAg with a positive IgM anti-HBc indicates that the infection is resolving. Anti-HBs titers may not increase for up to 1–2 weeks following the disappearance of HbsAg from serum (window period), which is why measuring anti-HBc titers in a patients with suspected acute hepatitis B infection is important.

Chronic Hepatitis

6 months

Alcoholic Hepatitis

Maddrey's Discriminant Function for Alcoholic Hepatitis - look at PT, PT control and Bilirubin

Suggests which patients with alcoholic hepatitis may have a poor prognosis and benefit from steroid administration.

Hepatitis B

Chronic Hepatitis B can have 4 phases:

1. Immune tolerance

• HBsAg and HBeAg positive; elevated HBV DNA
• minimal immune-mediated destruction of infected hepatocytes
• transaminase levels and biopsy findings are relatively normal
• can last 10-30 years

1. Immune clearnace