A 45-year-old woman presents with a 2-month history of fatigue and recurrent fever. She also complains of tenderness below the right costal margin and dark urine. Physical examination reveals jaundice and mild hepatomegaly. The serum is positive for hepatitis B virus antigen. Which of the following best describes the mechanism of indirect virus-mediated hepatocyte cell death in this patient?
Immune recognition of viral antigens on the cell surface. Viral cytotoxicity is either direct or indirect (immunologically mediated). Viruses may injure cells directly by subverting cellular enzymes and depleting the cell's nutrients, thereby disrupting the normal homeostatic mechanisms. Some viruses also encode proteins that induce apoptosis once daughter virions are mature. Viruses may also injure cells indirectly through activation of the immune system. Both humoral and cellular arms of the immune system protect against the harmful effects of viral infections by eliminating infected cells. In brief, the presentation of viral proteins to the immune system in the context of a self major histocompatibility complex on the cell surface immunizes the body against the invader and elicits both killer cells and antiviral antibodies. These arms of the immune system eliminate virus-infected cells by inducing apoptosis or by lysing the virally infected target cell with complement. None of the other choices describe mechanisms of indirect viral cytotoxicity.Diagnosis: Hepatitis, viral
Accumulation of abnormal cytoplasmic proteins
Immune recognition of viral antigens on the cell surface
Generation of cytoplasmic free radicals
Impaired plasma membrane Na+/K+ ATPase activity
Cellular Pathology