Chronic Hepatitis
Chronic hepatitis B and C are often silent for decades.
What our notes say
- Chronic hepatitis B and C are often silent for decades. (Internal Medicine CAT 1 (MBIM 6112), 2019/2020: gastroenterology and hepatology,)
- Many patients, especially with chronic hepatitis B, have no symptoms until the liver is badly scarred. (Hepatitis B and the approach to hepatitis)
- A 45‑year‑old man with chronic hepatitis B is prescribed tenofovir for viral suppression. (Clinical pharmacology and rational prescribing)
- A 25-year-old man with chronic hepatitis B has HBV DNA of 100 million IU/mL. (Internal Medicine 4th Year 1st Semester CAT: HIV and the gut, liver disease and )
- In chronic hepatitis B and in cirrhosis, screen for HCC with ultrasound, with or without AFP, every 6 months. (Hepatitis B and the approach to hepatitis)
- Viral: Chronic hepatitis B (endemic), hepatitis C (especially in people who inject drugs) (Chronic liver disease and cirrhosis)
Study material on Chronic Hepatitis
- 5.Acute and chronic hepatitis
- Acute and chronic hepatitis
- Harrisons Pulmonary and Critical Care Medicine
- Davidson's Essentials of Medicine - 2nd
- Hepatitis
- BABY NELSON PEADS
- Acute Viral Hepatitis
- Liver Histology and Physiology: Structural Units and Acinar Zones — Notes
- Devendra K. Gupta, Krishna M. Goel - Hutchison’s Paediatrics. chdhe-Jaypee Brothers (2012)
- Paediatrics end of 2nd semester exam (MBPE 4300): 5 October 2021, 50 MCQs
- Weekly Pathology Exam - May 15, 2026 (Sections B & C) — Essay Questions
- MCQ: Ompath Study Home Blog Flashcards MCQs Dashboard Toggle the
Practice questions on Chronic Hepatitis
A 62-year-old man with chronic hepatitis B develops hepatocellular carcinoma. Molecular studies reveal inactivation of p53. Which of the following best describes the normal role of p53 in preventing tumor development?
- It promotes cell cycle progression.
- It stimulates angiogenesis.
- It activates telomerase.
- It induces apoptosis in damaged cells.
Answer: D. p53 is a tumor suppressor gene that acts as a 'guardian of the genome'. Its normal functions include inducing cell cycle arrest in response to DNA damage, promoting DNA repair, and initiating apoptosis (programmed cell death) if the damage is irreparable. Inactivation of p53 allows cells with damaged DNA to survive and proliferate, increasing the risk of cancer development.
A 62-year-old male with chronic Hepatitis C and cirrhosis has a solitary liver mass. Which tumor marker, if >1000 ng/ml, is highly suggestive of HCC?
- CA 19-9
- CEA
- CA-125
- Alpha-fetoprotein (AFP)
Answer: D. Markedly elevated levels of Alpha-fetoprotein (AFP) are highly specific for HCC in the setting of chronic liver disease (though its sensitivity varies).
A 50-year-old female with a history of chronic hepatitis C develops ascites and esophageal varices. Liver biopsy shows micronodular cirrhosis. What is the most likely complication leading to this advanced liver disease?
- Hepatitis B co-infection
- Alcoholic liver disease
- Non-alcoholic fatty liver disease (NAFLD)
- Hepatocellular carcinoma
Answer: A. While chronic Hepatitis C is a direct cause of cirrhosis, co-infection with Hepatitis B can accelerate the progression to cirrhosis and hepatocellular carcinoma. In the context of already advanced disease, it's a significant factor that would have contributed to the severity and progression.
A 62-year-old male with a history of chronic Hepatitis C and cirrhosis presents with new onset fatigue and weight loss. Imaging reveals a solitary liver mass. Which tumor marker, if significantly elevated (>1000 ng/ml), would be highly suggestive of Hepatocellular Carcinoma?
- CA 19-9
- Carcinoembryonic Antigen (CEA)
- Alpha-fetoprotein (AFP)
- Cancer Antigen 125 (CA 125)
Answer: C. Alpha-fetoprotein (AFP) levels greater than 1000 ng/ml are highly suggestive of Hepatocellular Carcinoma (HCC), especially in a patient with risk factors like chronic Hepatitis C and cirrhosis.
Which of the following primary liver malignancies is NOT typically associated with chronic Hepatitis B or Hepatitis C virus infection?
- Hepatocellular Carcinoma
- Fibrolamellar Hepatocellular Carcinoma
- Hepatic Angiosarcoma
- Cholangiocarcinoma
Answer: D. Cholangiocarcinoma is explicitly noted as not being associated with chronic Hepatitis B or C virus infection, unlike hepatocellular carcinoma and its variants.
A 54-year-old man with chronic hepatitis C develops a hepatocyte clone with loss of growth control and poor MHC class I expression. Which cell most likely destroys this abnormal clone?
- B lymphocyte
- CD4 lymphocyte
- NK cell
- CD8 lymphocyte
Answer: C. NK cells are programmed to destroy cells with poor or absent MHC class I expression. When a neoplastic or virally infected cell downregulates MHC I, NK cells recognize and kill it — a key mechanism of tumor immune surveillance.