Key Points 1 The major causes of cirrhosis include chronic hepatitis B, chronic hepatitis C, alcoholic liver disease, nonalcoholic steatohepatitis (NASH), and hemochromatosis. 2 Etiologic classification of cirrhosis is more clinically relevant than morphologic classification (micronodular, macronodular, mixed), because morphologic…
Key Points 1 The 10 most frequent causes of acute drug-induced liver injury (DILI) in the prospective Drug-Induced Liver Injury Network (DILIN) are amoxicillin-clavulanic acid (amox-clav), isoniazid (INH), nitrofurantoin, sulfamethoxazole-trimethoprim (SMX-TMP), minocycline, cefazolin, azithromycin, ciprofloxacin, levofloxacin, and diclofenac. These 10…
Key Points 1 Hepatic steatosis, the accumulation of triglyceride droplets in hepatocytes, is found in one third to one half of all adults in the United States and is an important cause of elevated serum aminotransferase levels (typically <250 U/L).…
Key Points 1 Alcoholic liver disease (ALD) remains one of the most prevalent forms of liver disease in the United States. Worldwide, numerous epidemiologic studies have confirmed a correlation between per capita alcohol consumption and liver-related deaths. 2 The risk…
Key Points 1 Criteria for the diagnosis of autoimmune hepatitis have been codified with development of two diagnostic scoring systems that can support clinical judgment in the diagnosis of difficult cases. 2 Presentations range from acute severe (fulminant) to asymptomatic…
Key Points 1 Systemic viral infections can cause liver injury that ranges from mild asymptomatic and transient elevation of serum aminotransferase levels to acute icteric hepatitis or rarely severe hepatitis with acute liver failure (ALF). 2 The clinical presentation may…
Key Points 1 Infection with the hepatitis C virus (HCV) is a major cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC), as well as the leading indication for liver transplantation in Western countries. 2 HCV infection is also implicated…
Key Points 1 Hepatitis B virus (HBV) infection is a major cause of acute liver failure, cirrhosis, and hepatocellular carcinoma (HCC). 2 HBV infection can be prevented by hepatitis B vaccination. 3 Acute HBV infection is most likely to resolve…
Key Points 1 Infection by the nonenveloped, enterically transmitted viruses, hepatitis A virus (HAV) and hepatitis E virus (HEV), generally causes self-limited infection, but severe hepatitis may develop in some cases; chronic hepatitis E has been recognized in immunosuppressed patients…
Key Points 1 Acute liver failure (ALF) is an uncommon but dramatic clinical syndrome that is associated with a high risk of mortality. 2 The defining features of ALF reflect mental status changes (i.e., hepatic encephalopathy [HE]) and coagulopathy in…