Several things can cause chronic hepatitis:
- Viral infection: Hepatitis B, C, and D
- Autoimmune liver disease
- Drugs: metaldopa, isoniaszid
- Genetic Abnormalities
Pathophysiology of Chronic HepatitisDamage caused lysis hepatosid heposit through immunological mechanisms khonik infection occurs, if there is interference imonologis response to viral infection. During acute viral infection infiltration inflammatory cells, among others (ie T Lymfosit NK cells (Non-Specific Killer) and selsitoksik Cytotoxic T Lymphoctes). Viral antigen and HBc Ag HBc mainly expressed on the surface hepatosid Agyang together with glycoprotein HLA Class I (Human Leveoccyte Antigen), Causes heposit infected targets for lysis by T lymphocytes Although HLA expression by normal hipayosid enough, this expression will be further strengthened by the increased activity of endogenous interveron diprodoksi during the early phase of virus infection.
Interveron will also lead to cellular enzymes including 2-3 Oligoadenilat synthesis, endonuclease and proteinkinase. This enzyme would inhibit viral protein synthesis by mRNA degradation or inhibit the process of translation. These changes will lead to a result interveron anti viral status on non-infected hepatocytes and prevents reinfection during the lysis of infected hepatocytes.
Hepatitis virus that continues to chronicle shows cellular immunological responses to viral infections is not good. If the poor immunological response, lysis of infected hepatocytes is not going to happen, or take it lightly. Viruses continue to proliferate while liver function remained normal. The case is called healthy carriers. Here are found higher serum levels of HBs AG and liver contains a large number of Hbs AG hepatosid without necrosis.
Failure lysis of virus infected hepatocytes by T lymphocytes may occur due to a variety of mechanisms:
- Suppressor T-cell function (TS) increased
- Impaired T cell function is Cytotoxic (Tc)
- The existence of antibodies that inhibit the surface heaptosit
- The failure of the introduction of viral antigen expression or HLA class I on the surface of hepatocytes.
Clinical picture of chronic hepatitisSymptoms prodomal
- Malaise and low-grade fever, Feeling lazy, anorexia, Headaches
- Many people develop antralgia, artristis, urticaria and temporary skin rash, discomfort upper right quadrant
Symptoms of jaundice phase (lasts 4-6 weeks)
- Patients feel better and your appetite back
- Fever modestly
- Dark urine and faeces paled
- Enlarged hearts
- In some patients can often be found painful lymphadenopathy.
- Elevated levels of AST (aspartic amino transferase) and ALT (alanine amino transferase)