Hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV, delta agent), drugs (methyldopa, nitrofurantoin, isoniazid, dantrolene), autoimmune hepatitis, Wilson's disease, hemochromatosis, α1-antitrypsin deficiency.
Chronic hepatitis can be classified based on its cause, grade, and stage. The grade is a histologic assessment of necrosis and inflammatory activity and is based on examination of the liver biopsy. The stage of chronic hepatitis reflects the level of disease progression and is based on the degree of fibrosis (see Table 334-2, HPIM-20).
Wide clinical spectrum ranging from asymptomatic serum aminotransferase elevations to apparently acute, even fulminant, hepatitis. Common symptoms include fatigue, malaise, anorexia, low-grade fever; jaundice is frequent in severe disease. Some pts may present with complications of cirrhosis: ascites, variceal bleeding, encephalopathy, coagulopathy, and hypersplenism. In chronic HBV or HCV and autoimmune hepatitis, extrahepatic features may predominate.