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Hepatitis viruses: Not always what it seems to be / Los virus de las hepatitis no siempre son habituales
GALLEGOS-OROZCO, JUAN FERNANDO; RAKELA-BRÖDNER, JORGE.
Afiliação
  • GALLEGOS-OROZCO, JUAN FERNANDO; Mayo Clinic Arizona. Scottsdale. US
  • RAKELA-BRÖDNER, JORGE; Mayo Clinic Arizona. Scottsdale. US
Rev. méd. Chile ; 138(10): 1302-1311, oct. 2010. ilus
Artigo em Inglês | LILACS | ID: lil-572945
Biblioteca responsável: CL1.1
ABSTRACT
The classic hepatotropic viruses, hepatitis A through E, are not the only viral agents able to infect the liver. Other systemic viruses may cause hepatic injury that can range from mild and transient elevation of aminotransferases to acute hepatitis and occasionally acute liver failure and fulminant hepatitis. The clinical presentation may be indistinguishable from that associated with classic hepatotropic viruses. These agents include cytomegalovirus; Epstein-Barr virus; herpes simplex virus; varicella-zoster virus; human herpesvirus 6, 7, and 8; human parvovirus B19; adenoviruses among others. Wide spectrums of clinical syndromes are associated with cytomegalovirus disease. Unique clinical syndromes may present in neonates, young adults and immunocompromised hosts infected with cytomegalovirus. Cases of fulminant hepatitis have been reported in both immunocompromised and immunocompetent hosts infected with Epstein Barr virus. Occasionally, these patients with acute hepatic failure may need liver transplantation. Herpes simplex viruses may involve the liver in neonatal infections, pregnancy, immunocompromised hosts and occasionally, immunocompetent adults. Varicella-Zoster virus has also been associated with severe acute hepatitis and fulminant hepatitis in adults. The drug of choice for these conditions is intravenous acyclovir. These may also need liver transplantation in the more severe forms of clinical presentation. Typical liver biopsy findings can be useful in determining the diagnosis of these viral infections. Human herpesviruses 6, 7, and 8, human parvovirus B19, and adenoviruses can also be present with features of acute liver injury and occasionally as fulminant hepatitis. The clinical syndromes are less well delineated than those associated with herpesviruses. It is important to consider these viruses as possible etiologic agents in patients who have acute liver injury and their serologic markers for the classic hepatotropic viruses are not indicative of an active infection.
RESUMEN
Los agentes de la hepatitis viral A, B, C, D y E no son los únicos virus que pueden causar un síndrome de daño hepático agudo. Agentes virales como el citomegalovirus, Epstein-Barr, herpes simplex 1 y 2, Varicella-Zoster, virus herpes humano 6, 7, y 8, parvovirus B19 y adenovirus pueden causar daño hepático agudo e inclusive presentarse como hepatitis fulminante. Los cuadros clínicos de daño hepático agudo por citomegalovirus, Epstein Barr y herpes simplex 1 y 2 han sido caracterizado mejor. Se ha intentado el uso de drogas antivirales específicas como el uso intravenoso de aciclovir. Ocasionalmente, se ha requerido el trasplante hepático para rescatar pacientes con hepatitis fulminantes por estos agentes virales. La biopsia hepática puede ser de utilidad en estos casos puesto que los hallazgos son bastante característicos. La expresión clínica asociada a infecciones por virus herpes humano 6, 7 y 8, parvovirus B19 y adenovirus son menos características. Ha habido varios casos de hepatitis fulminante causada por estos agentes virales. Estos agentes virales deben ser considerados en el diagnóstico de casos de daño hepático agudo e inclusive hepatitis fulminante cuando los marcadores virales para los virus de hepatitis A-E son negativos.
Assuntos


Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Hepatite Viral Humana / Fígado Limite: Humanos Idioma: Inglês Revista: Rev. méd. Chile Assunto da revista: Medicina Ano de publicação: 2010 Tipo de documento: Artigo País de afiliação: Estados Unidos Instituição/País de afiliação: Mayo Clinic Arizona/US

Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Hepatite Viral Humana / Fígado Limite: Humanos Idioma: Inglês Revista: Rev. méd. Chile Assunto da revista: Medicina Ano de publicação: 2010 Tipo de documento: Artigo País de afiliação: Estados Unidos Instituição/País de afiliação: Mayo Clinic Arizona/US
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