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Symptoms of chronic hepatitis
Last reviewed: 04.07.2025
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Symptoms of chronic hepatitis in children and adults are largely similar.
Chronic viral hepatitis with moderate activity (grade I) is characterized by a benign course. Dull pain in the right hypochondrium, moderate hepatomegaly. Subicteric mucous membranes and skin only during periods of exacerbation. Hemorrhagic syndrome, "liver signs" are not typical. In the blood of 65-70% of patients, the surface antigen of hepatitis B (HBsAg) is detected, in some cases - the nuclear antigen of hepatitis B (HBeAg). During the period of exacerbation, a moderate increase in the activity of cytolytic enzymes, gamma globulins, sedimentary tests is observed.
Chronic viral hepatitis with activity of II-III degree often has a relapsing course with exacerbations similar to acute hepatitis. Hepatosplenomegaly gradually develops, hemorrhagic manifestations are possible. Most patients develop "vascular asterisks", "liver tongue and palms". Subictericity, asthenovegetative and dyspeptic phenomena persist even outside of exacerbation. Along with cytolysis indicators, signs of inflammatory process activity and hepatodepression, signs of virus replication and hyperreactivity of the immune system are characteristic. Often the disease has a progressive course with transition to liver cirrhosis.
Autoimmune hepatitis is more often observed in girls. In addition to pronounced liver and extrahepatic symptoms of hepatitis, manifestations of the pathoimmune process are characteristic: lymphadenopathy, arthritis, polyserositis, anemia and cytopenia, glomerulonephritis, endocrinopathy. The appearance of LE cells, autoantibodies (antinuclear, antimitochondrial) to the tissues of the liver, smooth muscles, lungs, kidneys, etc. is possible. The disease has a tendency to rapid progression and transition to liver cirrhosis.
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