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[Surgery in hepatitis]
G Gerken1, K H Meyer zum Büschenfelde
1I. Medizinische Klinik und Poliklinik, Universität Mainz.
Insights
Viral hepatitis affects millions globally, with types B, C, and D causing chronic liver disease, cirrhosis, and liver cancer. This review covers surgical issues, including liver transplantation, for these viral infections.
Area of Science:
- Hepatology
- Infectious Diseases
- Surgical Pathology
Context:
- Viral hepatitis is a major global health concern, with over 300 million chronic carriers of Hepatitis B (HBsAg) and Hepatitis C (HCV).
- High endemicity is observed in Asia, Africa, Latin America, and the Middle East, posing significant risks to healthcare workers.
- Hepatitis types A and E cause acute illness, while B, C, and D can lead to chronic progressive liver disease, cirrhosis, and hepatocellular carcinoma (HCC).
Purpose:
- To review the surgical challenges and management strategies for viral hepatitis.
- To highlight the link between chronic viral hepatitis and severe liver conditions like cirrhosis and HCC.
- To discuss the role of liver transplantation in managing end-stage liver disease caused by viral hepatitis.
Summary:
- Viral hepatitis encompasses types A through G, distinguished by diagnostic assays.
- Hepatitis B, C, and D are significant causes of chronic liver disease, portal hypertension, and primary liver cancer (HCC).
- This review specifically addresses the surgical aspects of viral hepatitis, including liver transplantation.
Impact:
- Provides a comprehensive overview of viral hepatitis's impact on surgical patient populations.
- Emphasizes the long-term consequences of chronic viral hepatitis, such as cirrhosis and HCC.
- Informs clinical practice regarding the surgical management and treatment options for viral hepatitis, including transplantation.
Abstract:
Viral hepatitis belongs to the most important infectious diseases worldwide. More than 300 million chronic HBsAg carriers and chronic HCV carriers exist, respectively. High endemic areas of viral hepatitis are Asia, Africa, Latin America and the Near, Middle and Far East. Viral hepatitis is also very important in health care workers. Today viral hepatitis can be differentiated from type A to type E (G) based on immunological and molecular assays. While enterally transmitted hepatitis type A and type E only induce acute and rare fulminant disease, hepatitis type B, C and D often induce chronic progressive disease including liver cirrhosis with typical complications due to the portal hypertension and with a high rate of association with the development of primary liver cancer (HCC). This review focusses on viral hepatitis-related surgical problems, including liver transplantation.