9. Acute Hepatitis

Question 1

How common is it?

Answer 1

More common in low-income regions

Question 2

Who does it affect?

Answer 2

IVDUs, alcoholics, people who haven’t been vaccinated, MSM

Question 3

How does it present?

Answer 3

Acute is often asymptomatic
Pyrexia, N+V, anorexia, abdo pain, fatigue, myalgia
Dark urine, pale poo, itchy skin, jaundice

Question 4

What risk factors are there?

Answer 4

IV drug use, excessive alcohol use, poor sanitation,

Question 5

What complications are there?

Answer 5

Acute liver failure

Question 6

What signs may the patient have on examination?

Answer 6

Signs of liver disease (spider naevi, caput medusae, palmar erythema, ascites)

Question 7

What other conditions might present similarly?

Answer 7

Sepsis, systemic hypotension, congestive heart failure, malignancies

Question 8

How would you investigate?

Answer 8

LFTs - raised ALT + bilirubin (+AP, GGT)

Serology

Question 9

What treatments are there?

Answer 9

Further testing in 3 months for asymptomatic patients
Transplant
Symptom management
Alcohol cessation

Question 10

What complications are there?

Answer 10

Acute liver failure, cirrhosis