b. Chronic Active (Aggressive) Hepatitis.
(1) Etiology. This is a serious disorder which can be thought of as a group
of closely related conditions rather than one disease. This form of hepatitis frequently
results in cirrhosis of the liver and/or liver failure. In most patients, the cause is
unknown. It is known, however, that type B hepatitis virus causes a small number of
chronic active hepatitis cases. Drugs such as methyldopa and isoniazid (INH) are
occasionally responsible for this type of hepatitis.
(2) Clinical features. About one-third of the cases of chronic active hepatitis
follow the patient having had acute hepatitis. The disease usually develops gradually.
The patient may have a kind of nonspecific feeling of not being well. He may be
anorexic and fatigued. Sometimes jaundice is present but not always. Signs of chronic
liver disease usually develop and include the following:
Splenomegaly (spleen enlargement).
Spider nevi (an enlarged arteriole in the skin spreading out like the
legs of a spider).
Treatment. Included are the following:
(a) Stop the patient taking any drugs which could cause the disease.
(b) Manage any complications which the patient is experiencing.
Corticosterioids may be given.
(4) Prognosis. The prognosis varies. When the disease is caused by
drugs, signs and symptoms of this type of hepatitis may become less severe. With
adequate therapy, the patient usually lives several years.
This lesson has addressed the various types of hepatitis. It is important to
identify hepatitis, but it is of greater importance to know the measures which can be
taken to prevent the spread of this disease.