re persistent vs chronic in article blue cis pitt edu kxgst pitt edu kenneth gilbert writes in article rm k i t hsdndev harvard edu rind enterprise bih harvard edu david rind writes in article enea enea apple com enea applelink apple com horace enea writes can anyone out there tell me the difference between a persistent disease and a chronic one for example persistent hepatitis vs chronic hepatitis i don t think there is a general distinction rather there are two classes of chronic hepatitis chronic active hepatitis and chronic persistent hepatitis i can t think of any other disease where the term persistent is used with or in preference to chronic much as these two terms chronic active and chronic persistent sound fuzzy the actual distinction between the two conditions is often fairly fuzzy as well i beg to differ chronic active hepatitis implies that the disease remains active and generally leads to liver failure at the very minimum the patient has persistently elevated liver enzymes what some call transaminitis chronic persistant hepatitis simply means that the patient has hbsag in his her blood and can transmit the infection but shows no evidence of progressive disease if i had to choose i d much rather have the persistant type being a chronic hbsag carrier does not necessarily mean the patient has chronic persistent anything persons who are chronic carriers may have no clinical biochemical or histologic evidence of liver disease or they may have chronic persistent hepatitis chronic active hepatitis cirrhosis or hepatocellular carcinoma most cases of chronic persistent hepatitis cph are probably the result of a viral infection although in a good number of cases the cause cannot be determined the diagnosis of cph is made on the basis of liver biopsy it consists of findings of portal inflammation an intact periportal limiting plate and on occasion isolated foci of intralobular necrosis but in contrast to chronic active hepatitis cah there is no periportal inflammation bridging necrosis or fibrosis cph has indeed an excellent prognosis if i had to choose between cah and cph there is no question i would also choose cph however as david pointed out the distinction between the two is not as neat as some of us would have it the histology can sometimes be pretty equivocal with biopsies showing areas compatible with both cph and cah maybe it is a sampling problem maybe it is a continuum i don t know howard doyle doyle pitt edu
