Hepatite Flashcards
Cauze hepatita acuta
Infectii virale
* Hepatitice (toate)
* EBV
* CMV
* Virusul febrei galbene
* altele - rar
Infectii NON-virale
* Toxoplasma gondii
* Coxiella burnetii (febra Q)
* Leptospira icterohaemorrhagiae
Alcool
Medicamente - paracetamol
Toxice/otravuri
* Amanita phalloides
* Aflatoxina (Aspergillus flavus)
* Tetraclorura de carbon
Alte cauze
* Sarcina
* Boala Wilson
* Insuficienta circulatorie
Cauze hepatita cronica
Virala
* VHB +/- VHD
* VHC
* VHE (imunocompromisi)
Medicamente
* Metildopa
* Izoniazida
* Nitrofurantoina
* Ketoconazol
Metabolica - NAFLD = steatoza hepatica non-alcoolica
Alcoolica
Autoimuna
Ereditara - boala Wilson, hemocromatoza
Cauze neobisnuite
* Infectii - sifilis, TB, infectii tropicale
* Boli infiltrative - amiloidoza
* Limfom
* Toxine
Dimensiuni virusuri hepatitice (nm)
VHA = 27-32
VHE = 27-35
VHD = 36 (cu invelis AgHBs)
VHB = 42
VHC = 50
Complicatii extrahepatice VHA
Artrita
Vasculita
Miocardita
IRA
Prevalenta VHC
0.4% Europa
1-3% Europa Sudica
6% Africa
19% Egipt
Incidenta HVC la dependentii de droguri i.v
Crescuta = 40-60%
Distributie geografica VHC pe genotipuri
1a, 1b = SUA 70%, Europa 50%
3 = India
4 = Egipt
Inhibitori de NS3/4
Glecaprevir
Grazoprevir
Voxilaprevir
Paritaprevir
Simeprevir
Inhibitori de NS5A
Velpatasvir
Ledipasvir
Pibrentasvir
Elbasvir
Daclatasvir
Inhibitori de NS5B = ARNpol
Nucleotidici - sofosbuvir
Non-nucleotidici - dasabuvir
Manifestari extrahepatice in HVC
Artrita
CG +/- GN
Porfiria cutanea tarda
Lichen plan
Cu ce boli se asociaza HVC
Sindrom sicca
LNH
HVC creste incidenta de
DZ
Factorii asociati cu o progresie rapida a fibrozei VHC
Obezitate
DZ
Alcool
Coinfectie VHC-HIV
Genotipul 3
Beneficiile in curs de urmarire ale vindecarii VHC dpdv al sanatatii publice
Mai putine persoane infectate
Eliminarea VHC la populatiile la risc (consumatorii de droguri i.v)