10 O Another hepatocyte injury change: 3 Hepatocyte necrosis: isolated cells or cluster Spotty and focus Cytolysis. in severe cases, Bridging N can occur. The necrotic areas: a number of lymphocytes. Apoptosis body: Councilman body or acidophilic body
● Another hepatocyte injury change : ③Hepatocyte necrosis: isolated cells or cluster ➢ Spotty and Focus Cytolysis. in severe cases, Bridging N can occur. The necrotic areas : a number of lymphocytes. ➢ Apoptosis body: Councilman body or acidophilic body 10
o Portal tracts: inflammation Bile duct
● Portal tracts: inflammation 11 Bile duct
12 Clinical features of acute viral hepatitis: Acute viral hepatitis can be divided into four phases: (1)incubation period: non-symptoms (2) symptomatic pre-icteric phase, non-specific, constitutional symptoms: marked (malaise, nausea, weight loss, loss of appetite and so on) (3)symptomatic icteric phase: Jaundice appears, constitutional symptoms begin to abate. jaundice: serum levels of bilirubin >2.0mg/dl(normal: 1.2mg/dL) (4)convalescence: after a few weeks or several months ---- In some cases, circulating immune-complex is formed, vasculitis AND arthritis
Clinical features of acute viral hepatitis: In some cases, circulating immune-complex is formed, vasculitis AND arthritis Acute viral hepatitis can be divided into four phases: (1) incubation period：non-symptoms (2) symptomatic pre-icteric phase, ◆non-specific, constitutional symptoms: marked (malaise, nausea, weight loss, loss of appetite and so on) (3) symptomatic icteric phase: Jaundice appears, constitutional symptoms begin to abate. ** jaundice: serum levels of bilirubin >2.0mg/dL(normal:<1.2mg/dL) (4) convalescence: after a few weeks or several months---- 12
Jia-2 INCUBATION ACUTE CONVALESCENCE RECOVERY PERIOD DISEASE JAUNDICE SYMPTOMS IgG-anti-HBs IgM-anti-HBC HBeAg lgG-anti-HBc Serum markers HBV-DNA HBSAC Anti-HBe Serum transaminases 4-26 weeks 4-12 weeks 4-20 weeks Years (average 8) the sequence of serologic markers in acute hepatitis b infection, and resolution of acute infection
Jia-2 the sequence of serologic markers in acute hepatitis B infection, and resolution of acute infection
Prognosis for acute viral hepatitis 13 1. most-----Cure 2. Some cases-----may transform --chronic hepatitis 3. A few cases-----may transform --Fulminant hepatitis Subclinical disease 100% (18000 Recovery (240,000) 60%65% Acute hepattis 60000) 20%25% <600 "Healthy carner ACUTE INFECTION %-10%(15.000-30.000 300,000/yr in United States 67%90% Persistent infection Recovery (8000-100) 10%33% Chronic hepatitis (12004000 5002000) Death (50-200)
Prognosis for acute viral hepatitis 1. most-----Cure: 2. Some cases-----may transform --chronic hepatitis 3. A few cases-----may transform --Fulminant hepatitis 13