The combination of episodic elevations in serum transaminase levels along with fatty change in hepatocytes is most suggestive of infection with
A. Hepatitis A virusB. Hepatitis B virus
C. Hepatitis C virus
D. Hepatitis D virus
The
answer is c.
The hepatitis viruses are responsible for most cases of chronic hepatitis, but
the chance of developing chronic hepatitis varies considerably depending on
which type of hepatitis virus is the infecting agent. Neither hepatitis A nor
hepatitis E virus infection is associated with the development of chronic
hepatitis.
About 5% of adults infected with
hepatitis B develop chronic hepatitis, and about one-half of these patients
progress to cirrhosis. In contrast to hepatitis B, chronic hepatitis develops
in about 50% of patients with hepatitis C.
Clinically,
chronic hepatitis C is characterized by episodic elevations in serum
transaminases, and also by fatty change in liver biopsy specimens. Hepatitis D infection occurs in two clinical
settings. There might be acute coinfection by hepatitis D and hepatitis B,
which results in chronic hepatitis in less than 5% of cases. If, instead,
hepatitis D is superinfected upon a chronic carrier of hepatitis B virus, then
about 80% of cases progress to chronic hepatitis.
