Can Increased Liver Enzymes Be Caused By Herpes?

Acute liver failure (ALF) is a life-threatening condition that remains challenging for physicians despite advances in supportive care. Herpes simplex virus (HSV) hepatitis is a rare cause of ALF, accounting for only one of all cases and carrying a mortality rate of 80 if untreated. Early identification and treatment are critical, as HSV hepatitis can mimic symptoms such as anemia, thrombocytopenia, and transaminitis.

Abdominal CT scan showed mild ascites and pancreatic, portal, and caval lymphadenopathy. Liver biopsy revealed well-circumscribed foci of coagulative necrosis. HSV hepatitis is rare and accounts for only one of all acute liver failures. The importance of HSV-induced acute liver failure is based on its extremely high mortality rate.

Disseminated herpes simplex infection may lead to acute liver failure (ALF) and the need for emergency liver transplantation (LT). This study aimed to determine the prevalence of HSV hepatitis and its impact on maternal and fetal outcomes. It was found that 90 of patients with HSV hepatitis have a 100 to 1000-fold increase in transaminases, particularly with an “anicteric pattern”.

HSV hepatitis is rare and accounts for only 1 of all acute liver failure cases and only 2 of all viral causes of acute liver failure. Hepatitis secondary to HSV is a rare diagnosis that can rapidly progress to fulminant liver failure. Early recognition and treatment within the first 72 hours from HSV hepatitis can improve maternal and fetal outcomes.

In conclusion, HSV hepatitis is a rare cause of rapidly progressive acute hepatitis that often results in fulminant hepatic failure. Early identification and treatment are critical for managing this rare condition.

Can herpes mess with your liver?

Herpes simplex virus (HSV) infection manifests with a variety of symptoms. Although it is known that HSV infections cause liver dysfunction, acute hepatitis caused by HSV is rare. Acute hepatitis has been noted in 2–4% of cases of viral hepatitis and in 0. 8% of cases of acute liver failure (1, 2).

• Case report
• Open access
• Published: 10 August 2023

• Makoto Kako 1,
• Sakue Masuda 1,
• Makomo Makazu 1 &
• .
• Kazuya Koizumi 1

Journal of Medical Case Reports volume 17, Article number: 338 Cite this article.

What is the most common cause of elevated liver enzymes?

Common causes of elevated liver enzymes include: Nonprescription pain medicines, particularly acetaminophen (Tylenol, others). Certain prescription medicines, including statins, which are used to control cholesterol. Drinking alcohol.

What can be mistaken for herpes in a blood test?

Conditions that may resemble genital herpes include:Other sexually transmitted infections. Syphilis. Genital warts (HPV) Chancroid. Lymphogranuloma venereum. Bacterial vaginosis. Yeast infection. Irritation from shaving. Ingrown hairs. Pimples. Bug bites. Hemorrhoids.

Genital herpes can cause genital sores (but not always) and can be confused with other conditions such as syphilis, genital warts (HPV), chancroid, Lymphogranuloma venereum, bacterial vaginosis, yeast infection, irritation from shaving, ingrown hairs, pimples, molluscum contagiosum, and others.

Genital herpes is a viral infection that may cause blisters and open sores on the genitals. It is a type of sexually transmitted infection (STI ) caused by herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

A number of different conditions could be mistaken for genital herpes. Treatment for each condition may be different, which is why it is important to see a doctor for an accurate diagnosis. Conditions that may resemble genital herpes include:

Can acyclovir damage the liver?

Hepatotoxicity. Despite widespread use, there is little evidence that acyclovir when given orally causes significant liver injury. Serum enzyme levels generally do not change during oral acyclovir therapy. High dose intravenous administration of acyclovir is associated with renal dysfunction and thrombocytopenia, and occasionally with transient mild-to-moderate elevations in serum ALT levels, which have been asymptomatic and self-limited. There have rare instances of acute, clinically apparent liver injury reported that were attributed to acyclovir or valacyclovir (a prodrug of acyclovir with better oral absorption), but these have not been particularly convincing. Some degree of liver injury and even jaundice can occur during the course of herpes simplex or varicella zoster infection, and these complications could be mistaken for drug induced liver injury. Furthermore, in the reported cases, patients were receiving other medications and had other unlying comorbidities that may have been responsible for the liver injury.

Likelihood score: D (possible rare cause of clinically apparent liver injury).

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Can herpes be detected in urine?

Does Herpes show in a urine test? Herpes will show in a urine test if and only if you have symptoms at the time of the test. So, a positive urine test means that you do have herpes. If it is negative, it means you did not have an outbreak at the time of the test.

Does herpes turn into hepatitis?

Abstract. Herpes simplex virus (HSV) is a rarely reported cause of viral hepatitis. Aggressive in nature, most cases of HSV hepatitis rapidly progress to fulminant hepatic failure. Present day, its pathogenesis is yet to be elucidated, but its complications and associated high mortality rate are clear. Clinically, its symptoms mimic those of other causes of acute hepatic failure thus making the diagnosis of HSV hepatitis a precarious task. Although treatment in the form of acyclovir is readily available, most cases have a poor prognosis due to late initiation of therapy. This makes the early identification of HSV essential in improving outcomes and potentially preventing mortality.

Keywords: viral hepatitis, herpes simplex virus (hsv), liver failure.

Introduction and background. Fulminant hepatic failure is defined as severe liver injury resulting in impaired synthetic capacity and encephalopathy in patients with previously normal liver function . It is typically characterized by increases in transaminases, which serves as the first clue to the clinician that acute liver injury is occurring. Depending on how elevated the patient’s transaminases are, one can then narrow the list of differential diagnoses. Elevations in transaminases greater than ten times the upper limit of normal are suggestive of ischemic, toxic or viral liver injury . Of these, toxic (acetaminophen) and viral are the most common etiologies worldwide . Hepatitis A, B, C, D, and E are the most frequently encountered forms of viral hepatitis in the medical literature. Rarely will non-hepatitis viruses cause fulminant hepatic failure. The goal of this review article is to aid clinicians in the early identification of herpes simplex virus (HSV) hepatitis in order to initiate rapid treatment and ultimately prevent mortality.

What kind of virus attacks the liver?

Herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), and human herpesvirus type 6 (HHV6) are viral infections that directly affect the liver, making it a major blood-filtering organ. Hepatitis viruses, a subgroup of viruses, are primarily aimed at the liver due to their high affinity for it. Other viral infections, such as respiratory and systemic infections, can cause viral hepatitis as part of a systemic infection or lead to hepatic complications under certain conditions, such as immunodeficiency.

Infections caused by viruses other than hepatitis viruses can be classified into three major categories: liver disease in patients with fever returning from tropical and subtropical areas, severe liver damage in patients with immunodeficiency due to de novo infection or exacerbations of common agents, and liver involvement in patients with respiratory and systemic infections.

Approximately 8 of travelers to the developing world require medical care during or after travel, with fever being the underlying problem in 28 of them. Travel-associated liver disease caused by exotic infections such as Ebola virus, Rift Valley fever, or Lassa fever has been reported sporadically in the literature but currently does not represent a frequent health problem. Dengue is among the top three etiologic agents, accounting for approximately 6 of febrile illnesses in travelers. Chikungunya is an emerging novel viral infection that has recently been reported in Asia and Africa to cause fever with prominent myalgia, arthralgia, and rash in increasing numbers of patients.

Which STD attacks the liver?

Over time, hepatitis B and hepatitis C infections can lead to scarring of the liver ( cirrhosis ). Symptoms of cirrhosis include:

• Swelling in the belly and legs, and fluid build-up in the lungs
• Bruising or bleeding easily
• Feeling of fullness
• Difficulty breathing
• Confusion that can come on suddenly
• Coma
• Increased risk of developing liver cancer

Viral hepatitis is diagnosed with a patient history, a physical examination, and blood tests. Blood tests show which type of hepatitis is present and can be used to determine the proper treatment.

Other tests may be indicated to check for liver damage, including:

What STD causes elevated liver enzymes?

Conclusions. Syphilitic hepatitis is a rare but an important cause of abnormal liver enzymes. Syphilis infection should be a consideration in patients with high-risk features (HIV positive, MSM, and multiple sexual partners) and disproportionate elevation of alkaline phosphate. The importance of identifying syphilis as a cause of elevated liver enzymes lies in the ease of resolution of transaminitis with treatment, thus avoiding unnecessary and expensive workup.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

The authors have declared that no competing interests exist.

Which viral STI can lead to liver failure?

The hepatitis B virus (HBV) causes hepatitis (inflammation of the liver) and can also cause long term liver damage. There is a vaccine available to prevent hepatitis B infection, which should be given to all individuals who are at risk from hepatitis B infection.

The Blood Borne Virus/STI team. The blood-borne viruses and sexually transmitted infections (STIs) team is responsible for surveillance and control activities for hepatitis B, hepatitis C, HIV, syphilis, chlamydia and other sexually transmitted infections. As these are all largely preventable by avoiding risks, and in the case of hepatitis B, by vaccination, we work with a wide range of partners to reduce the numbers of people infected and ensure good treatment.

The multi-disciplinary team includes doctors, nurses and information officers. Some of the activities of the team include:

• Contributing to surveillance of blood-borne infections and STIs
• Ensuring actions are taken to prevent infections, working with a range of other healthcare professionals and voluntary groups
• Following up notified cases of hepatitis to reduce onward transmission
• Organising and contributing to education activities
• Preparation of annual reports
• Management of incidents and outbreaks
• Chairing and contributing to work of Hepatitis B and C Managed Clinical Network

What labs are elevated with herpes?

IgM vs. IgG. When an individual contracts herpes, the immune system responds by developing antibodies to fight the virus: IgG and IgM. Blood tests can look for and detect these antibodies—not the virus itself. IgG appears soon after infection and stays in the blood for life. IgM is actually the first antibody that appears after infection, but it may disappear thereafter.

IgM tests are not recommended because of three serious problems:

• Many assume that if a test discovers IgM, they have recently acquired herpes. However, research shows that IgM can reappear in blood tests in up to a third of people during recurrences, while it will be negative in up to half of persons who recently acquired herpes but have culture-document first episodes. Therefore, IgM tests can lead to deceptive test results, as well as false assumptions about how and when a person actually acquired HSV. For this reason, we do not recommend using blood tests as a way to determine how long a person has had herpes. Unfortunately, most people who are diagnosed will not be able to determine how long they have had the infection.
• In addition, IgM tests cannot accurately distinguish between HSV-1 and HSV-2 antibodies, and thus very easily provide a false positive result for HSV-2. This is important in that most of the adult population in the U. S. already has antibodies to HSV-1, the primary cause of oral herpes. A person who only has HSV-1 may receive a false positive for HSV-2.
• IgM tests sometimes cross-react with other viruses in the same family, such as varicella zoster virus (VZV) which causes chickenpox or cytomegalovirus (CMV) which causes mono, meaning that positive results may be misleading.