6. What are the characteristics of a healthy liver?

This is the diagram of a healthy liver and is made up of cells in a skeletal structure of fibrous tissue. In the normal liver, the cells are in between the fibrous tissue - which you can barely see in this slide - which is the psuedostructure of the cells are based in. When the virus attacks the liver you get inflammation the same as you would get a sore on your hand with inflammatory cells. The inflammatory cells are an immune reaction to the virus and stimulate the production of scar tissue and this is where the problem comes in. So, first you get a killing of the liver cells from the acute hepatitis and if you get all your liver cells knocked out, you get what’s called fulminant hepatic failure and you die. Fortunately this doesn’t happen very often. The average Western person is able to mount an immune response because they get the disease in adulthood. Their liver blood tests or liver enzyme tests will go up, and then the body’s immune reaction will overcome the virus and eventually it will get better. By definition most people get better within four to six months. And these people are getting over acute hepatitis. They have malaise, fatigue; you know they really feel crummy because fatigue is a major aspect clinically of liver disease. They may turn yellow but they don’t have to. But they get over it over a period of months - and that’s a classic immune competent adult. After the six months is over and all their liver tests are back to normal, you can test their blood and see the virus is gone from their blood.