Fulminant Viral Hepatitis

Jayakumar, Saumya; Chowdhury, Raiyan; Ye, Carrie; Karvellas, Constantine J.

doi:10.1016/j.ccc.2013.03.013

Cited by 27 publications

(32 citation statements)

References 155 publications

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“…Hepatotropic viruses (hepatitis A, B, D, and E) have all been reported to cause ALF with the risk of progressing to ALF variable depending on the certain type of virus . ALF secondary to viral hepatitis can present with moderate (5–10 times the upper limit of normal) or severe (>10 times the upper limit of normal) elevations in transaminases …”

Section: Epidemiology and Etiologymentioning

confidence: 99%

Pathophysiology of Acute Liver Failure

2019

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Acute liver failure (ALF) is a rare syndrome resulting from an acute insult to the liver in patients without known underlying chronic liver disease. It is characterized by loss of synthetic function in the form of jaundice and coagulopathy and development of hepatic encephalopathy. Multiorgan failure (MOF) eventually develops, leading to death. Many different etiologies have been identified, with acetaminophen (APAP) overdose and viral hepatitis being the most common causes worldwide. The pathophysiology of ALF can be divided into cause-specific liver injury pathophysiologies and pathophysiology related to occurrence of secondary MOF. In terms of liver injury pathophysiology, APAP toxicity is the most well known. Secondary MOF is often a result of the initial massive proinflammatory response generating a systemic inflammatory response syndrome followed by a compensatory anti-inflammatory response leading to immune cell dysfunction and sepsis. As the liver is a tremendously important metabolic organ involved in energy metabolism, protein synthesis, fat metabolism, and glycemic control, multiple aspects of nutrition also need to be considered as part of the overall pathophysiology of ALF. (Nutr Clin Pract. 2020;35:24-29)

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Section: Epidemiology and Etiologymentioning

confidence: 99%

Pathophysiology of Acute Liver Failure

2019

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“…51 Hepatitis C virus can only very rarely lead to ALF. 8,19,36,52 Other known viruses that are implicated in ALF are cytomegalovirus, varicella zoster, adenoviruses, and parvovirus B19. 36,53 By evaluating the dynamicity of MELD, MELD-sodium, ALF early dynamic model, chronic liver failure (CLF)-consortium ACLF score, and KCC for predicting outcome in viral-induced ALF, the ALF early dynamic model achieves better than MELD, MELD-Na, and CLF-C ACLF scores and KCC for predicting outcome in viral hepatitis-induced ALF.…”

Section: Etiologymentioning

confidence: 99%

“…Thirty percent of ALF patients develop the aforementioned ARDS or acute lung injury. 52 Critically ill patients are prone to be complicated with HE, CE, and intracranial hypertension (ICH). 3,6,31,36,60,61 These serious complications account for 65% of the patients with third-grade HE and 75% of those with fourth-grade HE.…”

Section: Clinical Presentation At Emergency Roommentioning

confidence: 99%

Acute Liver Failure

Doulberis¹,

Kotronis

Gialamprinou

et al. 2019

Journal of Clinical Gastroenterology

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Acute liver failure is a rare hepatic emergent situation that affects primarily young people and has often a catastrophic or even fatal outcome. Definition of acute liver failure has not reached a universal consensus and the interval between the appearance of jaundice and hepatic encephalopathy for the establishment of the acute failure is a matter of debate. Among the wide variety of causes, acetaminophen intoxication in western societies and viral hepatitis in the developing countries rank at the top of the etiology list. Identification of the clinical appearance and initial management for the stabilization of the patient are of vital significance. Further advanced therapies, that require intensive care unit, should be offered. The hallmark of treatment for selected patients can be orthotopic liver transplantation. Apart from well-established treatments, novel therapies like hepatocyte or stem cell transplantation, additional new therapeutic strategies targeting acetaminophen intoxication and/or hepatic encephalopathy are mainly experimental, and some of them do not belong, yet, to clinical practice. For clinicians, it is substantial to have the alertness to timely identify the patient and transfer them to a specialized center, where more treatment opportunities are available. FIGURE 1. The 3 main well-established classifications for ALF. (i) Williams-Schalm and O'Grady system (ii) Bernuau system, and (iii) Mochida (Japanese) system. ALF indicates acute liver failure.

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“…The leading indication for liver transplantation (LT) in the United States is chronic hepatitis C virus (HCV) infection . A much less common reason for transplantation is fulminant hepatic failure (FHF), which afflicts 2000 people in the United States annually . Despite international trends, viral etiologies of FHF in the United States have been decreasing over the past three decades with less than 12% of cases being attributed to acute hepatitis A and B infections .…”

Section: Introductionmentioning

confidence: 99%

Liver transplantation for fulminant genotype 2a/c hepatitis C virus marked by a rapid recurrence followed by cure

Tracy

Shrestha

Stein

et al. 2017

Transplant Infectious Dis

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Although chronic hepatitis C is still the leading indication for liver transplantation (LT) in the United States and Europe, acute liver failure caused by hepatitis C is distinctly uncommon and transplantation for fulminant hepatitis C virus (HCV) has not been documented in the United States. We present a case report of fulminant hepatic failure caused by genotype 2a/c HCV not only treated with LT but also complicated by severe, rapid recurrence of HCV within 6 days of transplantation. The risk factor for the initial infection was likely sexual, and there were no explanations for acute hepatitis post-transplant other than recurrent hepatitis C. Treatment with all-oral direct antiviral agents was swiftly initiated during the index hospitalization, leading to resolution of the acute hepatitis and resulting in sustained virologic response. It can only be speculated whether this was an infection with the JFH-1 strain or another similarly virulent genotype 2a/c HCV infection.

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Fulminant Viral Hepatitis

Cited by 27 publications

References 155 publications

Pathophysiology of Acute Liver Failure

Pathophysiology of Acute Liver Failure

Acute Liver Failure

Liver transplantation for fulminant genotype 2a/c hepatitis C virus marked by a rapid recurrence followed by cure

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