Fibrosing cholestatic hepatitis as a variant of the course of hepatotropic viruses’ infection

Abstract

Fibrosing cholestatic hepatitis (FCH) is a special variant of the history of infectious hepatitis, with a rapid progressive deterioration of liver function; usually develops in immunosuppression; it has also been reported in immunocompetent patients with viral hepatitis B and C. The diagnosis of FCH is based on histological examination of liver tissue, which reveals the predominance of damage to hepatocytes with their pronounced ballooning over a weak inflammatory reaction, pericellular and perisinusoidal fibrosis, and also intracellular and tubular cholestasis. Analysis of the literature confirms the authors' assumption that pathological changes in the liver, described as FCH, can develop in different conditions under the influence of various infectious agents. Despite the availability of effective antiviral therapy for hepatitis B and C, the outcomes of FCH are often unfavorable, especially in cases not associated with solid organ transplantation. Currently, due to the emergence of a large number of drugs that selectively act on the immune system, the development of new areas of medicine in hematology, rheumatology, oncology, transplantology, and infectious diseases, doctors in these specialties are increasingly faced with unexpectedly severe forms of liver damage on specific therapy. The authors believe that there is an underestimation by doctors who do not work at Liver Transplantation Centers of the possibility of developing FCH in patients with viral hepatitis B and C, both in the clinic of infectious and internal diseases.