Hepatitis caused by herpes viruses: A review

Area of Science:

• Hepatology
• Virology
• Immunology

Background:

• Hepatitis caused by the Herpesviridae family is uncommon, typically mild, and self-limiting.
• However, it can lead to severe infections, including acute to fulminant hepatic failure, particularly in immunosuppressed individuals.
• Isolated cases of fulminant disease in immunocompetent individuals have also been reported.

Purpose of the Study:

• To review the literature on hepatitis caused by cytomegalovirus, Epstein-Barr virus, and herpes simplex virus.
• To discuss the epidemiology, diagnostic methods, clinical features, and current management of Herpesviridae-mediated hepatitis.
• To identify areas requiring further investigation.

Main Methods:

• Literature review of studies on hepatitis caused by cytomegalovirus, Epstein-Barr virus, and herpes simplex virus.
• Analysis of epidemiological data, diagnostic approaches, clinical presentations, and treatment strategies.
• Synthesis of current knowledge and identification of research gaps.

Main Results:

• Herpes virus hepatitis presentation varies widely, from asymptomatic to acute liver failure.
• While often mild, severe outcomes including fulminant hepatic failure can occur, especially in immunocompromised patients.
• Mortality is high in fulminant hepatic failure without liver transplantation.

Conclusions:

• Herpesviridae-mediated acute liver failure is rare but carries a poor prognosis, even with early treatment.
• High clinical suspicion is necessary due to non-specific presentations.
• Prompt empiric antiviral therapy and consideration of liver transplantation for severe cases are critical.