[29] However, the degree of elevation (i.e. Rates of mortality increase with progression of the underlying liver disease. Acute hepatitis can resolve on its own, progress to chronic hepatitis, or (rarely) result in acute liver failure. Řadí se mezi alimentární onemocnění.Příznaky jsou v mnoha případech mírné, nebo se vůbec nevyskytují, zvláště u mladých lidí. for hepatitis virus DNA/RNA), blood chemistry, and complete blood count. [76], Routine vaccination for hepatitis B starts with the first dose administered as  a shot into the muscle before the newborn is discharged from the hospital. These newborns should also be regularly tested for infection for at least the first year of life. Waterborne outbreaks, though infrequent, are usually associated with sewage-contaminated or inadequately treated water. What is the evidence for the effectiveness of interventions to reduce hepatitis C infection and the associated morbidity? Unfortunately, a small number of patients develop Fulminant hepatic failure, which is very serious. [113], Hepatitis D infections can transform benign cases of hepatitis B into severe, progressive hepatitis, a phenomenon known as superinfection. [100], Because people with alcoholic hepatitis may have no symptoms, it can be difficult to diagnose and the number of people with the disease is probably higher than many estimates. Acute viral hepatitis follows three distinct phases: Both drug-induced hepatitis and autoimmune hepatitis can present very similarly to acute viral hepatitis, with slight variations in symptoms depending on the cause. [98] It is primarily transmitted via non-sexual contact and via needles. [138] Others in the medical community spoke out in support of Krugman's research in terms of its widespread benefits and understanding of the hepatitis virus, and Willowbrook continues to be a commonly cited example in debates about medical ethics.[139]. [29] Hepatitis usually develops over years-long exposure to alcohol, occurring in 10 to 20% of alcoholics. [29] In late infection and after recovery, IgG antibodies are present and remain in the body for up to years. [1] U mnogim slučajevima javlja se veoma malo simptoma ili ih uopće nema, posebno kod mlađih osoba. [16] It accounts for more than 55,000 deaths annually with approximately 20 million people worldwide thought to be infected with the virus. [85][9], The CDC recommends the hepatitis A vaccine for all children beginning at age one, as well as for those who have not been previously immunized and are at high risk for contracting the disease. Hepatitis A is inflammation of the liver caused by the hepatitis A virus. [16][98] Currently in the United States, approximately 3.5 million adults are estimated to be infected. In people who have chronic hepatitis B infection and are at risk for superinfection with the hepatitis D virus, the preventive strategies are the same as for hepatitis B. [90] It affects predominantly young adults, causing acute hepatitis. This will make them immune against … hemokromatoza) ali celo spremenjen lasten imunski odziv (avtoimunski hepatitis).Najpogosteje ga povzročajo virusi, med njimi … From Wikipedia, the free encyclopedia Hepatitis A is an infectious disease of the liver caused by the hepatitis A virus (HAV). [82], For women who are HCV-positive and HIV-negative, breastfeeding is safe; however, CDC guidelines suggest avoiding breastfeeding if a woman's nipples are "cracked or bleeding" to reduce the risk of transmission. [98] In Egypt, rates of hepatitis C infection as high as 20% have been documented and are associated with iatrogenic contamination related to schistosomiasis treatment in the 1950s–1980s. [29] Liver biopsy is the only definitive diagnostic test that is able to assess inflammation and fibrosis of the liver. [29], When the liver is involved, alpha-1-antitrypsin deficiency and Wilson's disease tend to present as hepatitis in the neonatal period or in childhood. The Sumerians believed that the liver was the home of the soul, and attributed the findings of jaundice to the attack of the liver by a devil named Ahhazu. [1][2] Hepatitis is acute if it resolves within six months, and chronic if it lasts longer than six months. Signs and symptoms Jaundice (yellow skin and eyes) Abdominal pain Fever Nausea and Vomiting Fatigue Anorexia (loss of the desire to eat) Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. [29], Many types of drugs can cause liver injury, including the analgesic paracetamol; antibiotics such as isoniazid, nitrofurantoin, amoxicillin-clavulanate, erythromycin, and trimethoprim-sulfamethoxazole; anticonvulsants such as valproate and phenytoin; cholesterol-lowering statins; steroids such as oral contraceptives and anabolic steroids; and highly active anti-retroviral therapy used in the treatment of HIV/AIDS. [45] Other autoantibodies that are less common but more specific to autoimmune hepatitis are the antibodies against liver kidney microsome 1 (LKM1) and soluble liver antigen (SLA). [16][75] Treatment is supportive and includes such measures as providing intravenous (IV) hydration and maintaining adequate nutrition. [82][158] Vertical transmission occurs largely via a neonate's exposure to maternal blood and vaginal secretions during birth. Hepatitis B and hepatitis C can also begin as short-term, acute infections, but in some people, the virus remains in the body, resulting in chronic disease and long-term liver problems. [27] However, infection in infants and children frequently leads to chronic infection. Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that primarily affects the liver; it is a type of viral hepatitis. This allows for early treatment, which can both prevent disease progression and decrease the likelihood of transmission to others. [27] In endemic regions, transmission is thought to be associated with exposure during birth and close contact between young infants. [114], Acute hepatitis B infections become less likely to progress to chronic forms as the age of the patient increases, with rates of progression approaching 90% in vertically transmitted cases of infants compared to 1% risk in young adults. Hepatitis A virus (HAV) is a member of the picornavirus family. [131], Around 400 B.C., Hippocrates recorded the first documentation of an epidemic jaundice, in particular noting the uniquely fulminant course of a cohort of patients who all died within two weeks. [158] While the risk of progression to chronic infection is approximately 5% among adults who contract the virus, it is as high as 95% among neonates subject to vertical transmission. [16] Natural killer cells are the primary drivers of the initial innate response and create a cytokine environment that results in the recruitment of CD4 T-helper and CD8 cytotoxic T-cells. Hepatitis lahko povzročajo različni dejavniki, kot so okužbe, pretirano uživanje alkohola, razna zdravila, kemične snovi in strupi, motnje v presnovi (npr. [19] Cirrhosis can lead to other life-threatening complications such as hepatic encephalopathy, esophageal varices, hepatorenal syndrome, and liver cancer.[18]. [163], The ACOG states that the evidence available does not suggest any particular mode of delivery (i.e. [164], Evidence does not indicate that mode of delivery (i.e. [1][6] Acute hepatitis can resolve on its own, progress to chronic hepatitis, or (rarely) result in acute liver failure. [16][29] In early infection (i.e. Hepatitis (plural hepatitides) implies inflammation of the liver characterized by the presence of inflammatory cells in the tissue of the organ. This is an acute (short-term) type of hepatitis, which usually requires no treatment. [103] The best way to reduce the long-term risk of HCC is to achieve sustained virological response (SVR). Ischemic hepatitis rarely causes permanent liver damage. [16][17] In addition to the signs of acute hepatitis, people can also demonstrate signs of coagulopathy (abnormal coagulation studies with easy bruising and bleeding) and encephalopathy (confusion, disorientation, and sleepiness). The next insight regarding hepatitis B was a serendipitous one by Dr. Baruch Blumberg, a researcher at the NIH who did not set out to research hepatitis, but rather studied lipoprotein genetics. Generally, there is an initial insult that causes liver injury and activation of an inflammatory response, which can become chronic, leading to progressive fibrosis and cirrhosis. [158][161] A systematic review of the Antiretroviral Pregnancy Registry database found that there was no increased risk of congenital anomalies with Tenofovir; for this reason, along with its potency and low risk of resistance, the AASLD recommends this drug. [42] 9 to 25% of patients with NASH develop cirrhosis. [104][105] The indirect acting antivirals include pegylated interferon (PEG IFN) and ribavirin (RBV), which in combination have historically been the basis of therapy for HCV. [3], Hepatitis is most commonly caused by the viruses hepatitis A, B, C, D, and E.[3][2] Other causes include heavy alcohol use, certain medications, toxins, other infections, autoimmune diseases,[2][3] and non-alcoholic steatohepatitis (NASH). [16], In healthy patients, 95–99% recover with no long-lasting effects, and antiviral treatment is not warranted. [91], Hepatitis E is spread primarily through the oral-fecal route but may also be spread by blood and from mother to fetus. [98], Alcoholic hepatitis (AH) in its severe form has a one-month mortality as high as 50%. [52][53], The specific mechanism varies and depends on the underlying cause of the hepatitis. [18] This results in jaundice, weight loss, coagulopathy, ascites (abdominal fluid collection), and peripheral edema (leg swelling). [157] The prevalence of HIV-HCV co-infection worldwide was estimated to be 6.2% representing more than 2.2 million people. [32][62][108] Without any treatment, 20-50% of patients may die within a month, but evidence shows treatment may extend life beyond one month (i.e., reduce short-term mortality). [79][80][81][82] Specifically, these populations include people who are: Screening consists of a blood test that detects hepatitis B surface antigen (HBsAg). within 1 week), IgM antibodies are found in the blood. [30] The liver flukes Fasciola hepatica and Clonorchis sinensis live in the bile ducts and cause progressive hepatitis and liver fibrosis. [41] While imaging can show fatty liver, only liver biopsy can demonstrate inflammation and fibrosis characteristic of NASH. [161] A growing body of evidence shows that antiviral therapy initiated in the third trimester significantly reduces transmission to the neonate. [154] Over 550 people who visited the restaurant between September and October 2003 were infected with the virus, three of whom died as a direct result. [16] The most common mode of transmission of hepatitis C virus is exposure to blood products via blood transfusions (prior to 1992) and intravenous drug injection. The method of transmission is referred to as the fecal-oral route. 1. [31], Excessive alcohol consumption is a significant cause of hepatitis and is the most common cause of cirrhosis in the U.S.[29] Alcoholic hepatitis is within the spectrum of alcoholic liver disease. [157] In a study of HIV-HCV co-infection among HIV positive men who have sex with men (MSM), the overall prevalence of anti-hepatitis C antibodies was estimated to be 8.1% and increased to 40% among HIV positive MSM who also injected drugs. [79][83] People who are high-risk whose blood tests negative for HBsAg can receive the hepatitis B vaccine to prevent future infection.[79][80][81][82]. [30], Bacterial infection of the liver commonly results in pyogenic liver abscesses, acute hepatitis, or granulomatous (or chronic) liver disease. [108], Weak evidence suggests milk thistle extracts may improve survival in alcoholic liver disease and improve certain liver tests (serum bilirubin and GGT) without causing side effects, but a firm recommendation cannot be made for or against milk thistle without further study. [16], Acute cases of hepatitis are seen to be resolved well within a six-month period. [107] Hospitalization may be required for particularly severe cases or for pregnant women. [154] The restaurant was closed once it was discovered to be the source, and over 9,000 people were given hepatitis A immune globulin because they had either eaten at the restaurant or had been in close contact with someone who had. [29] Patients are asymptomatic 25–34% of the time, and the diagnosis is suspected on the basis of abnormal liver function tests. Hepatitida A (známá jako infekční žloutenka) je akutní infekční onemocnění jater způsobené virem hepatitidy A (HAV). [105] Certain patients with early disease need only 8 weeks of treatment while those with advanced fibrosis or cirrhosis who have not responded to prior treatment require 24 weeks. Most people who are infected recover completely with no permanent liver damage.Practicing go… [20], Fulminant hepatitis, or massive hepatic cell death, is a rare and life-threatening complication of acute hepatitis that can occur in cases of hepatitis B, D, and E, in addition to drug-induced and autoimmune hepatitis. [20][21] Cases of drug-induced hepatitis can manifest with systemic signs of an allergic reaction including rash, fever, serositis (inflammation of membranes lining certain organs), elevated eosinophils (a type of white blood cell), and suppression of bone marrow activity. [156][157] In a recent study by the WHO, the likelihood of being infected with hepatitis C virus was six times greater in individuals who also had HIV. Hepatitis is inflammation of the liver tissue. [136], His research was received with much controversy, as people protested the questionable ethics surrounding the chosen target population. [62] Though the inciting event may differ, the progression of events is similar and begins with accumulation of free fatty acids (FFA) and their breakdown products in the liver cells in a process called steatosis. [16][27], Chronic hepatitis C is a major cause of liver cirrhosis and hepatocellular carcinoma. [32] For those who abstain completely from alcohol, reversal of liver disease and a longer life are possible; patients at every disease stage have been shown to benefit by prevention of additional liver injury. Clay tablets that served as medical handbooks for the ancient Sumerians described the first observations of jaundice. [16], Chronic hepatitis B management aims to control viral replication, which is correlated with progression of disease. [154] The outbreak was brought to the attention of health officials when local emergency medicine physicians noticed a significant increase in cases of hepatitis A in the county. Når der er symptomer, vil de typisk vare omkring otte uger og kan omfatte: kvalme, opkastning, … The industrial toxin carbon tetrachloride and the wild mushroom Amanita phalloides are other known hepatotoxins. Blumberg continued to study the antigen, and eventually developed the first hepatitis B vaccine using plasma rich in HBsAg, for which he received the Nobel Prize in Medicine in 1976. [151] Chronic hepatitis B infections are not as endemic in the United States, but accounted for $357 million in hospitalization costs in the year 1990. [60][61] In alcoholic hepatitis, chronic excess alcohol use is the culprit. In most cases, the infection resolves on its own. [104][105] Duration of and response to these treatments varies based on genotype. [63] Other contributing factors include younger age <60, binge pattern drinking, poor nutritional status, obesity and hepatitis C co-infection. [16] Most chronic carriers of hepatitis C are unaware of their infection status. This ranges in order of severity and reversibility from alcoholic steatosis (least severe, most reversible), alcoholic hepatitis, cirrhosis, and liver cancer (most severe, least reversible). [16] Viral particles have also been found in saliva and breastmilk. [16][82][158] A 2016 systematic review and meta-analysis of 47 studies that included 3968 people found maternal case-fatality rates (CFR) of 20.8% and fetal CFR of 34.2%; among women who developed fulminant hepatic failure, CFR was 61.2%. [59] In chronic Hepatitis B and C, natural killer cell function is impaired. [33] There are wide variations in the mechanisms of liver injury and latency period from exposure to development of clinical illness. [33][34][39], Non-alcoholic hepatitis is within the spectrum of non-alcoholic liver disease (NALD), which ranges in severity and reversibility from non-alcoholic fatty liver disease (NAFLD) to non-alcoholic steatohepatitis (NASH) to cirrhosis to liver cancer, similar to the spectrum of alcoholic liver disease. [108][109] Unfortunately, there are currently no drug treatments that decrease these patients' risk of dying in the longer term, at 3–12 months and beyond. [49], Hepatitis can also occur in neonates and is attributable to a variety of causes, some of which are not typically seen in adults. [106], Similar to hepatitis A, treatment of hepatitis E is supportive and includes rest and ensuring adequate nutrition and hydration. [29], In the case of hepatitis B, blood tests exist for multiple virus antigens (which are different components of the virion particle) and antibodies. [22] Chronic hepatitis is often asymptomatic early in its course and is detected only by liver laboratory studies for screening purposes or to evaluate non-specific symptoms. [29] Hemochromatosis typically presents in adulthood, with the onset of clinical disease usually after age 50. [29] NASH is recognized as the third most common cause of liver disease in the United States. [63] It is estimated that a high proportion of individuals (70%) who have AH will progress to cirrhosis. [144][145], People infected with chronic hepatitis C tend to be frequent users of the health care system globally. [161][162] A 2010 systematic review and meta-analysis found that Lamivudine initiated early in the third trimester also significantly reduced mother-to-child transmission of HBV, without any known adverse effects. [156], Vertical transmission is a significant contributor of new HBV cases each year, with 35–50% of transmission from mother to neonate in endemic countries. [73][74] People in these groups who are not already immune can receive the hepatitis A vaccine. [108] Data suggest that CS alone or CS with NAC are most effective at reducing short-term mortality. There are three main types of hepatitis: hepatitis A, B, and C…. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. [105] First-line therapy for GT1 is a combination of sofosbuvir and ledipasvir (SOF/LDV) for 12 weeks for most patients, including those with advanced fibrosis or cirrhosis. [37] However, the National Institutes of Health maintains the LiverTox database for consumers to track all known prescription and non-prescription compounds associated with liver injury. [79][81] For infants who have received HBIG and the HBV vaccine, breastfeeding is safe. However, in those who use alcohol, the diagnosis may just as likely be alcoholic or nonalcoholic hepatitis especially if there is concurrent obesity, diabetes, and metabolic syndrome. [27] Carrier rates in developed nations are significantly lower, encompassing less than 1% of the population. [16], Parasites can also infect the liver and activate the immune response, resulting in symptoms of acute hepatitis with increased serum IgE (though chronic hepatitis is possible with chronic infections). jetra). [112] Mortality rates in cases of fulminant hepatitis rise over 80%, but those patients that do survive often make a complete recovery. It was first provisionally classified as enterovirus 72, but subsequent determinations of its nucleotide and amino acid sequences showed them to be sufficiently distinct to assign the virus to … There is a Hepatitis A vaccine available for … If given, two doses are recommended beginning after the age of one. In 1996, the Advisory Committee on Immunization Practices (… vaginal vs. cesarean) has an effect on vertical transmission. The restaurant was purchasing its green onion stock from farms in Mexico at the time. [99] The data are unclear as to whether the decline can be attributed to needle exchange programmes. Hepatitis A vaccine is a vaccine that prevents hepatitis A. Mange tilfælde har få eller ingen symptomer, især i yngre mennesker. [130], Initial accounts of a syndrome that we now think is likely to be hepatitis begin to occur around 3000 B.C. Fulminant hepatitis most commonly occurs in hepatitis B, D, and E. About 1–2% of cases of hepatitis E can lead to fulminant hepatitis, but pregnant women are particularly susceptible, occurring in up to 20% of cases. When hepatitis is continued for more than six months it is termed chronic hepatitis. [5][3] Some people with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes (jaundice), poor appetite, vomiting, tiredness, abdominal pain, and diarrhea. [72], Of note, liver biopsy shows identical findings in patients with ASH and NASH, specifically, the presence of polymorphonuclear infiltration, hepatocyte necrosis and apoptosis in the form of ballooning degeneration, Mallory bodies, and fibrosis around veins and sinuses.[29]. [2], From Simple English Wikipedia, the free encyclopedia, "Hepatitis A: Questions and Answers for the Public", https://simple.wikipedia.org/w/index.php?title=Hepatitis_A&oldid=5832643, Creative Commons Attribution/Share-Alike License, Using ice that was made from contaminated water, Foods that are not cooked are more likely to spread hepatitis A because cooking food will kill the virus. [47] Hemochromatosis and Wilson's disease are both autosomal recessive diseases involving abnormal storage of minerals. [29] As with other autoimmune diseases, autoimmune hepatitis usually affects young women (though it can affect patients of either sex of any age), and patients can exhibit classic signs and symptoms of autoimmunity such as fatigue, anemia, anorexia, amenorrhea, acne, arthritis, pleurisy, thyroiditis, ulcerative colitis, nephritis, and maculopapular rash. When a person has hepatitis A, the virus stays in their feces. [29] In Wilson's disease, excess amounts of copper accumulate in the liver and brain, causing cirrhosis and dementia. [29][40] The estimated prevalence of NASH in the world is 3–5%. [60][61][62] This initially reversible process overwhelms the hepatocyte's ability to maintain lipid homeostasis leading to a toxic effect as fat molecules accumulate and are broken down in the setting of an oxidative stress response. The purpose of screening for viral hepatitis is to identify people infected with the disease as early as possible, even before symptoms and transaminase elevations may be present. [110], Nearly all patients with hepatitis A infections recover completely without complications if they were healthy prior to the infection. The World Health Organization recommends universal vaccination in areas where the disease is … [65], Blood testing includes liver enzymes, serology (i.e. [82], Given the high risk of perinatal transmission, the CDC recommends screening all pregnant women for HBV at their first prenatal visit. Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). [30], Of the worms, the cestode Echinococcus granulosus, also known as the dog tapeworm, infects the liver and forms characteristic hepatic hydatid cysts. A vaccine is available to prevent hepatitis A, and anti-hepatitis A immunoglobulin is also used. [62][63][125] Most people who develop AH are men but women are at higher risk of developing AH and its complications likely secondary to high body fat and differences in alcohol metabolism. Hepatitis A, caused by the hepatitis A virus (HAV), is the most common worldwide. Hepatitis A is found throughout the world and manifests as large outbreaks and epidemics associated with fecal contamination of water and food sources. Hepatitis A is an infection of the liver caused by the hepatitis A virus. [33] Toxins and medications can cause liver injury through a variety of mechanisms, including direct cell damage, disruption of cell metabolism, and causing structural changes. Viral hepatitis is the most common type of hepatitis worldwide. [32] Long-term alcohol intake in excess of 80 grams of alcohol a day in men and 40 grams a day in women is associated with development of alcoholic hepatitis (1 beer or 4 ounces of wine is equivalent to 12g of alcohol). Hepatitis A adalah penyakit akut yang disebabkan oleh virus hepatitis tipe A yang disebarkan dari tinja penderita yang biasanya menyebar melalui makanan dan minuman. When the liver is inflamed or … [116] While the major causes of mortality in hepatitis C is end stage liver disease, hepatocellular carcinoma is an important additional long term complication and cause of death in chronic hepatitis. [66][67] Generally, AST and ALT are elevated in most cases of hepatitis regardless of whether the person shows any symptoms. Hepatitis means inflammation of the liver. Beberapa kasus hanya menampakkan sedikit gejala atau tanpa gejala terutama bagi yang berusia muda. [3] population. [29] As the disease progresses, symptoms typical of chronic hepatitis may develop. [19] In patients with compensated cirrhosis, treatment is recommended regardless of HBeAg status or ALT level, but recommendations differ regarding HBV DNA levels; AASLD recommends treating at DNA levels detectable above 2x103 IU/mL; EASL and WHO recommend treating when HBV DNA levels are detectable at any level. [50] Metabolic diseases such as glycogen storage disorders and lysosomal storage disorders are also implicated. After observing the temporary protection against infection this antibody provided, he then tried injected live hepatitis virus into students. for autoantibodies), nucleic acid testing (i.e. [16] The chronic presence of the virus within liver cells results in multiple waves of inflammation, injury and wound healing that over time lead to scarring or fibrosis and culminate in hepatocellular carcinoma. [133] During World War II, estimates of soldiers affected by hepatitis were upwards of 10 million. [33][34] The spectrum of drug-induced liver injury varies from acute hepatitis to chronic hepatitis to acute liver failure. Series of patients with compensated cirrhosis due to HCV have shown 3,5, and 10-year survival rates of 96, 91, and 79% respectively. live or have sex with) people known to have hepatitis B, Incarcerated, or who have been in the past, On long-term hemodialysis, or who have been in the past, Recipients of tattoos in an "unregulated setting", Recipients of blood products or organs prior to 1992 in the United States, Adults in the United States born between 1945 and 1965, Pregnant, and engaging in high-risk behaviors, Workers in a healthcare setting who have had a needlestick injury, Women – ≤ 3 drinks on any given day and ≤ 7 drinks per week, Men – ≤ 4 drinks on any given day and ≤ 14 drinks per week. [29], Many chemical agents, including medications, industrial toxins, and herbal and dietary supplements, can cause hepatitis. [46] Autoimmune hepatitis is distinct from the other autoimmune diseases of the liver: primary biliary cirrhosis and primary sclerosing cholangitis. [148], Hepatitis B accounts for a much larger percentage of health care spending in endemic regions like Asia. [153], The largest outbreak of hepatitis A virus in United States history occurred among people who ate at a now-defunct Mexican food restaurant located in Monaca, Pennsylvania in late 2003. Hepatitis A causes an acute illness that does not progress to chronic liver disease. [3] Hepatitis B is mainly sexually transmitted, but may also be passed from mother to baby during pregnancy or childbirth and spread through infected blood. The CDC, WHO, USPSTF, and ACOG recommend routine hepatitis B screening for certain high-risk populations. [29] In the 1970s and 1980s, blood transfusions were a major factor in spreading hepatitis C virus. [29], Many people with autoimmune hepatitis have other autoimmune diseases. 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Biopsy is the most common cause of cirrhosis in individuals with weakened immune systems, such as occur. Medication that can cure hepatitis a & B, and yellowing of the underlying liver in. Disease usually after age 50 high burden of HIV-HCV co-infection worldwide was estimated to be as high 50! The infection for some people, hepatitis B linked more than 16 % at 20 years after.! These newborns should also be caused by the hepatitis these groups who HIV-positive...

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