Hepatitis abs symptoms. Viral hepatitis B

Viral hepatitis B(serum hepatitis) is an infectious liver disease that occurs in various clinical variants (from asymptomatic carriage to destruction of the hepatic parenchyma). In hepatitis B, the damage to liver cells is autoimmune. The concentration of the virus sufficient for infection is found only in the biological fluids of the patient. Therefore, infection with hepatitis B can occur parenterally during blood transfusion and various traumatic procedures (dental manipulations, tattoos, pedicures, piercings), as well as sexually. In the diagnosis of hepatitis B, the detection of HbsAg antigen and HbcIgM antibodies in the blood plays a decisive role. Treatment of viral hepatitis B includes basic antiviral therapy, mandatory diet, detoxification and symptomatic treatment.

General information

Viral hepatitis B(serum hepatitis) is an infectious liver disease that occurs in various clinical variants (from asymptomatic carriage to destruction of the hepatic parenchyma). In hepatitis B, the damage to liver cells is autoimmune.

Exciter characteristic

Hepatitis B virus is a DNA-containing virus belonging to the genus Orthohepadnavirus. Three types of viruses are found in the blood of infected individuals, differing in morphological characteristics. Spherical and filamentous forms of viral particles do not possess virulence, Dane particles exhibit infectious properties - two-layer rounded full-structural viral forms. Their blood population rarely exceeds 7%. The hepatitis B virus particle has a surface antigen, HbsAg, and three internal antigens: HBeAg, HBcAg, and HbxAg.

The resistance of the virus to environmental conditions is very high. In the blood and its preparations, the virus remains viable for years; it can exist for several months at room temperature on linen, medical instruments, and objects contaminated with the patient's blood. Virus inactivation is carried out by processing in autoclaves when heated to 120°C for 45 minutes, or in a dry-heat oven at 180°C for 60 minutes. The virus dies when exposed to chemical disinfectants: chloramine, formalin, hydrogen peroxide.

The source and reservoir of viral hepatitis B are sick people, as well as healthy virus carriers. The blood of people infected with hepatitis B becomes infectious much earlier than the first clinical manifestations are noted. In 5-10% of cases, chronic asymptomatic carriage develops. The hepatitis B virus is transmitted through contact with various body fluids (blood, semen, urine, saliva, bile, tears, milk). The main epidemiological hazard is blood, semen and, to some extent, saliva, since usually only in these fluids the concentration of the virus is sufficient for infection.

The transmission of the infection occurs mainly parenterally: during blood transfusions, medical procedures using non-sterile instruments, during medical procedures in dentistry, as well as during traumatic processes: tattooing and piercing. There is a possibility of infection in nail salons when performing a trim manicure or pedicure. The contact route of transmission is realized during sexual intercourse and in everyday life when sharing personal hygiene items. The virus enters the human body through microdamages of the skin and mucous membranes.

The vertical route of transmission is implemented intranatally; during normal pregnancy, the placental barrier for the virus is not passed, however, in the case of placental rupture, transmission of the virus before delivery is possible. The probability of infection of the fetus increases many times when HbeAg is detected in a pregnant woman in addition to HbsAg. People have a fairly high susceptibility to infection. With transfusion transmission, hepatitis develops in 50-90% of cases. The probability of developing the disease after infection directly depends on the dose of the pathogen received and the state of general immunity. After the transfer of the disease, a long-term, probably life-long immunity is formed.

The vast majority of people with hepatitis B are aged 15-30 years. Among those who died from this disease, the proportion of drug addicts is 80%. People who inject drugs have the highest risk of contracting hepatitis B. Due to frequent direct contact with blood, medical workers (surgeons and operating nurses, laboratory assistants, dentists, employees of blood transfusion stations, etc.) are also at risk for viral hepatitis AT.

Symptoms of viral hepatitis B

The incubation period of viral hepatitis B varies widely, the interval from the moment of infection to the development of clinical symptoms can range from 30 to 180 days. It is often impossible to estimate the incubation period for chronic hepatitis B. Acute viral hepatitis B often begins similarly to viral hepatitis A, however, its preicteric period can also occur in an arthralgic form, as well as in an asthenovegetative or dyspeptic variant.

The dyspeptic variant of the course is characterized by loss of appetite (up to anorexia), incessant nausea, episodes of causeless vomiting. The flu-like form of the clinical course of the pre-icteric period of hepatitis B is characterized by fever and general intoxication symptoms, usually without catarrhal symptoms, but with frequent, mainly nocturnal and morning, arthralgias (while the joints are not visually changed). After movement in the joint, the pain usually subsides for a while.

If during this period there is arthralgia, combined with rashes like urticaria, the course of the disease promises to be more severe. Most often, these symptoms are accompanied by fever. In the preicteric phase, there may be severe weakness, drowsiness, dizziness, bleeding gums and episodes of nosebleeds (hemorrhagic syndrome).

When jaundice appears, there is no improvement in well-being, more often the general symptoms worsen: dyspepsia, asthenia increases, skin itching appears, hemorrhages intensify (in women, hemorrhagic syndrome can contribute to the early onset and intensity of menstruation). Arthralgia and exanthema in the icteric period disappear. The skin and mucous membranes have an intense ocher hue, petechiae and rounded hemorrhages are noted, the urine darkens, the feces become lighter up to complete discoloration. The liver of patients increases in size, its edge protrudes from under the costal arch, it is painful to the touch. If, with intense icterus of the skin, the liver retains its normal size, this is a harbinger of a more severe infection.

Complications of viral hepatitis B

The most dangerous complication of viral hepatitis B, characterized by a high degree of mortality, is acute liver failure (hepatargia, hepatic coma). In the case of massive death of hepatocytes, significant loss of liver functionality, a severe hemorrhagic syndrome develops, accompanied by a toxic effect of substances released as a result of cytolysis on the central nervous system. Hepatic encephalopathy develops through the following stages.

• Precoma I: the patient's condition deteriorates sharply, jaundice and dyspepsia (nausea, repeated vomiting) worsens, hemorrhagic symptoms appear, patients have a specific hepatic odor from the mouth (sickeningly sweet). Orientation in space and time is disturbed, emotional lability is noted (apathy and lethargy is replaced by hyperexcitation, euphoria, increased anxiety). Thinking is slowed down, sleep inversion takes place (at night, patients cannot fall asleep, during the day they feel irresistible drowsiness). At this stage, there are violations of fine motor skills (missing during a finger-nose test, handwriting distortion). In the area of ​​the liver, patients may notice pain, body temperature rises, and the pulse is unstable.
• Precoma II(threatening coma): impaired consciousness progresses, it is often confused, complete disorientation in space and time is noted, short-term outbreaks of euphoria and aggressiveness are replaced by apathy, intoxication and hemorrhagic syndromes progress. At this stage, signs of edematous-ascitic syndrome develop, the liver becomes smaller and hides under the ribs. Small tremors of the limbs and tongue are noted. Precoma stages can last from several hours to 1-2 days. In the future, neurological symptoms worsen (pathological reflexes, meningeal symptoms, respiratory disorders like Kussmul, Cheyne-Stokes may be noted) and hepatic coma itself develops.
• End stage - coma, is characterized by oppression of consciousness (stupor, stupor) and further its complete loss. Initially, reflexes (corneal, swallowing) are preserved, patients can respond to intense irritating actions (painful palpation, loud sound), later reflexes are inhibited, the reaction to stimuli is lost (deep coma). The death of patients occurs as a result of the development of acute cardiovascular insufficiency.

In severe viral hepatitis B (fulminant coma), especially when combined with hepatitis D and hepatitis C, hepatic coma often develops early and ends fatally in 90% of cases. Acute hepatic encephalopathy, in turn, contributes to secondary infection with the development of sepsis, and also threatens the development of renal syndrome. Intense hemorrhagic syndrome can cause significant blood loss during internal bleeding. Chronic viral hepatitis B develops into cirrhosis of the liver.

Diagnosis of viral hepatitis B

Diagnosis is carried out by detecting in the blood of patients specific antigens of the virus in the blood serum, as well as immunoglobulins to them. Using PCR, you can isolate the DNA of the virus, which allows you to determine the degree of its activity. Detection of HbsAg surface antigen and HbcIgM antibodies plays a decisive role in making the diagnosis. Serological diagnosis is made using ELISA and RIA.

To determine the functional state of the liver in the dynamics of the disease, regular laboratory tests are performed: a biochemical analysis of blood and urine, a coagulogram, and ultrasound of the liver. A significant role is played by the value of the prothrombin index, the fall of which to 40% and below indicates the critical condition of the patient. For some indications, a liver biopsy may be performed.

Treatment of viral hepatitis B

Complex therapy of viral hepatitis B includes dietary nutrition (a liver-sparing diet No. 5 is prescribed in variations depending on the phase of the disease and the severity of the course), basic antiviral therapy, as well as pathogenetic and symptomatic agents. The acute phase of the disease is an indication for inpatient treatment. Recommended bed rest, plenty of fluids, a categorical rejection of alcohol. Basic therapy involves the appointment of interferons (alfa-interferon is the most effective) in combination with ribavirin. The course of treatment and dosage are calculated individually.

As an auxiliary therapy, detoxification solutions are used (in severe cases, infusions of crystalloid solutions, dextran are carried out, corticosteroids are prescribed according to indications), means for normalizing the water-salt balance, potassium preparations, lactulose. To relieve spasms of the biliary system and the vascular network of the liver - drotaverine, aminofillin. With the development of cholestasis, UDCA preparations are indicated. In case of severe complications (hepatic encephalopathy) - intensive care.

Forecast and prevention of viral hepatitis B

Acute viral hepatitis B rarely leads to death (only in cases of severe fulminant course), the prognosis worsens significantly with concomitant chronic liver pathologies, with a combined lesion of hepatitis C and D viruses. Death of those infected with hepatitis B often occurs after several decades as a result of a chronic course and development of cirrhosis and liver cancer.

General prevention of viral hepatitis B implies a set of sanitary and epidemiological measures aimed at reducing the risk of infection during blood transfusion, monitoring the sterility of medical instruments, introducing disposable needles, catheters, etc. into mass practice. Individual prevention measures involve the use of individual personal hygiene items ( razors, toothbrushes), skin injury prevention, safer sex, avoidance of drugs. Vaccination is indicated for persons in the occupational risk group. Immunity after vaccination against hepatitis B lasts about 15 years.

Viral hepatitis is a group of common and dangerous infectious diseases for humans, which differ quite significantly from each other, are caused by different viruses, but still have one thing in common - this is a disease that primarily affects the human liver and causes inflammation.

Therefore, viral hepatitis of different types are often grouped together under the name "jaundice" - one of the most common symptoms of hepatitis.

Classification

According to the duration of the process, viral hepatitis are:

• Acute - up to 3 months (hepatitis A);
• Prolonged - up to 6 months (hepatitis B, C);
• Chronic - over 6 months (hepatitis B, C, D).

According to the severity of clinical manifestations, there are:

1. Asymptomatic forms (carriage of the virus is typical for hepatitis B, C, subclinical form can be with any hepatitis).
2. Manifest forms (may be icteric and anicteric).

Viral hepatitis is characterized by a cyclic and acyclic (with exacerbations) course.

How is viral hepatitis transmitted?

Infections are transmitted from a sick person to a healthy person. Transmission routes can be as follows:

• Hepatitis A - feces, saliva;
• Hepatitis B - blood, semen, saliva, perinatal (infection of the child from the mother);
• - blood;
• Hepatitis E - feces, saliva;
• Hepatitis D - blood, semen.

The incubation period varies greatly in duration.

• Hepatitis A - from 2 to 6 weeks;
• Hepatitis B - from 8 to 24 weeks;
• Hepatitis C - from 6 to 12 weeks;
• Hepatitis E - from 2 to 8 weeks;
• Hepatitis D - not established.

You can get hepatitis A, E and F only once in a lifetime, hepatitis caused by other types of viruses can occur again in the same person. There is a chance of developing the disease even after a liver transplant.

What happens after the hepatitis virus enters the body?

With the bloodstream, the viruses enter the liver. On liver cells there is a receptor protein CD81, by binding to which the virus penetrates into the cell. Then begins the pernicious work characteristic of all viruses. The virus integrates its RNA into the genetic apparatus of the cell. And already here, as on a matrix, exact copies of the virus begin to “print” one after another, growing inside the cell with a new membrane.

This continues until the cell itself dies due to life-incompatible disorders caused by the virus, or is destroyed by the body's own immune system. After the death of the cell and its destruction, newborn viruses enter the extracellular space and infect other, not yet affected cells. The process is repeated again.

Signs of viral hepatitis

Regardless of the form of the disease, viral hepatitis has similar general symptoms:

1. Dyspeptic disorders (nausea, vomiting, belching, bitterness in the mouth, loss of appetite);
2. General malaise (sometimes the onset of viral hepatitis resembles - observed, headache, body aches);
3. (prolonged, paroxysmal, aching, dull, radiating to the right shoulder blade or shoulder);
4. Jaundice - yellowing of the skin and mucous membranes (but there are also anicteric forms of hepatitis);
5. Skin itching.

The most unfavorable outcome of acute hepatitis is chronic disease. are dangerous because they gradually lead to the development of liver cancer.

Hepatitis A - Botkin's disease

The most common and least dangerous viral hepatitis. The incubation period of infection ranges from 7 days to 2 months. Infection occurs through the consumption of poor-quality food. In addition, acute hepatitis A is transmitted through direct contact with the things of a sick person and dirty hands.

In most cases, the infection ends in spontaneous recovery, but sometimes patients are prescribed droppers that reduce the intensity of toxic effects on the liver.

Hepatitis B

It is more severe than hepatitis A because hepatitis B can lead to severe liver damage. Hepatitis B virus can be transmitted through blood, sexual contact, and the virus can also be transmitted from mother to fetus during childbirth.

Just like Botkin's disease, hepatitis B begins with. The patient is concerned about pain in the joints, weakness, nausea and vomiting. Hepatitis B may cause enlargement of the liver and spleen, as well as darkening of the urine and discoloration of the stool. Jaundice is rare in hepatitis B. Liver damage can be very severe, up to the development of cirrhosis of the liver and cancer. Treatment of hepatitis B is complex with the use of hepatoprotectors, antibiotics, hormones and drugs for the immune system.

Hepatitis C

In turn, it has 11 subspecies, which differ in the set of genes of the pathogen virus. In this regard, at the moment, there is no effective vaccine against the disease. Among all viral hepatitis, hepatitis C is the most severe form, which predisposes to the chronic course of the disease.

The most common ways of infection are through the transfusion of infected blood, the use of surgical and dental instruments, and promiscuity. Treatment of hepatitis C is the most expensive among other types of the disease.

Hepatitis D

The symptoms of hepatitis D fully correspond to the symptoms of hepatitis B. Infection with hepatitis B and D viruses usually occurs simultaneously, since the hepatitis D virus cannot exist in the human body on its own. With the development of a mixed infection of hepatitis B and D, severe forms of the disease often develop, leading to cirrhosis of the liver.

Hepatitis E

Viral hepatitis E is caused by an RNA virus similar to rotaviruses. Methods for its cloning have been developed, and a test system has been created to confirm the diagnosis. The source of infection are patients with viral hepatitis E from the end of the incubation period and during the acute period of the disease.

The main route of distribution is water, epidemic outbreaks are described in countries with a hot climate. The flow resembles viral hepatitis A with a predominantly mild course and recovery. A distinctive feature of viral hepatitis E is its course in pregnant women: frequent spontaneous abortion and rapidly growing signs of acute liver failure with a mortality rate of up to 25% or more.

Treatment

When prescribing therapy, it is taken into account which particular virus caused the development of the disease. In viral hepatitis, the basis of treatment, as a rule, is antiviral agents, interferons, which contribute to the production of antibodies by the body aimed at fighting viruses, hepatoprotectors, antihistamines. In a severe form of the disease, intravenous infusion of Reamberin, the appointment of hormonal agents, and rarely antibiotics are indicated.

Treatment of viral hepatitis is long-term, carried out in a hospital. During this time, the patient is forbidden to drink alcohol and fatty foods that load the body with work. If the disease is complicated by cirrhosis, a liver transplant may be required.

Prevention of viral hepatitis

To protect yourself from infection with hepatitis, you must follow simple rules of prevention. Do not use unboiled water, always wash fruits and vegetables, do not neglect the heat treatment of food. This can help prevent hepatitis A infection.

In general, contact with other people's body fluids should be avoided. For protection against hepatitis B and C - primarily with blood. In microscopic quantities, blood can remain on razors, toothbrushes, nail scissors. Do not share these items with other people. You can not do piercings and tattoos with non-sterile devices. It is necessary to take precautions during sexual intercourse.

World Health Organization (WHO) statistics show that more than 30% of the adult population of the Earth suffers from certain liver diseases. In Russia, such diseases claim the lives of about 400,000 people every year. At the same time, the number of deaths from hepatitis, cirrhosis and hepatosis is constantly growing.

In this article we will talk about viral hepatitis, since it is they that pose the greatest danger to future generations of residents of our country. Viral hepatitis is the collective name for acute and chronic liver diseases. The causes of hepatitis are different, which determines their wide distribution and variety of forms. Regardless of the etiology, signs of hepatitis always indicate the development of an inflammatory process in a person's liver. For this reason, the people often call the disease "jaundice" - the most characteristic symptom of hepatitis of all types.

Classification of hepatitis

Hepatitis A is the most common and least dangerous viral hepatitis. The incubation period of infection ranges from 7 days to 2 months. Infection occurs through the consumption of poor-quality food. In addition, acute hepatitis A is transmitted through direct contact with the things of a sick person and dirty hands. In most cases, the infection ends in spontaneous recovery, but sometimes patients are prescribed droppers that reduce the intensity of toxic effects on the liver.

Hepatitis B is transmitted through blood, during sexual intercourse, by injection with non-sterile syringes. This form is very dangerous because it causes severe liver damage and is accompanied by severe symptoms: fever, enlarged liver and spleen, nausea, vomiting, severe joint pain. Hepatitis B requires complex treatment in a hospital with the obligatory use of immune preparations, hormones, antibiotics and hepatoprotectors.

Hepatitis C is one of the most severe forms of the disease, often leading to cirrhosis, liver cancer and, as a result, death of the patient. The most likely route of infection is through blood during transfusions, but hepatitis C can also be transmitted during sexual contact and from a sick mother to her fetus. The incidence in Russia and abroad is constantly growing, therefore, when hepatitis C is diagnosed, treatment and prevention require an integrated approach to solving the problem, careful monitoring of the condition of donor blood, and the dissemination of visual propaganda among the population. The danger of this form lies in the fact that hepatitis C is often combined with other forms of viral hepatitis, and, in addition, there is currently no effective vaccine that would reliably protect a healthy person from infection.

Hepatitis D was discovered and studied in 1977. Later, scientists proved that viral hepatitis "delta" is a type of hepatitis B, which appears as a result of the combination of the main strain of the virus and the delta agent.

Hepatitis E - signs of infection are similar to those of hepatitis A, but in severe cases of the disease, not only the liver, but also the kidneys are affected. The prognosis of treatment is almost always favorable. The exception is pregnant women in the third trimester, when the risk of losing a child approaches 100%. Prevention of hepatitis E is similar to that of hepatitis A.

Acute and chronic hepatitis

The acute form of the disease is the most typical for all viral hepatitis. Patients are noted: deterioration of health, severe intoxication of the body, impaired liver function, development of jaundice, an increase in the amount of bilirubin and transaminase in the blood. With adequate and timely treatment, acute hepatitis ends with a complete recovery of the patient.

If the disease lasts more than 6 months, then the patient is diagnosed with chronic hepatitis. This form is accompanied by severe symptoms (asthenovegetative disorders, enlargement of the liver and spleen, metabolic disorders) and often leads to cirrhosis of the liver, the development of malignant tumors. A person's life is at risk when chronic hepatitis, the symptoms of which indicate damage to vital organs, is aggravated by improper treatment, reduced immunity, and alcohol addiction.

Signs of hepatitis and the clinical picture of the development of infection

One of the most characteristic symptoms of hepatitis is jaundice. It occurs at the moment when the bile produced by the liver enters the human bloodstream and spreads throughout the body, giving the skin a yellowish tint. Note also that some forms of the disease occur without jaundice, so the most reliable way to diagnose the virus is a laboratory test for hepatitis.

Common symptoms of hepatitis:

• temperature rise;
• change in skin pigmentation;
• headache;
• aches in the joints;
• general malaise;
• in some cases - the appearance of rashes on the skin;
• decreased appetite.

The intensity of the symptoms depends on the form of the infection. Hepatitis A is characterized by a rapid course, so the signs of hepatitis are pronounced and progress in just a few hours. Hepatitis B and hepatitis C develop gradually. At the initial stages, they can be limited to weakness and loss of appetite, and pain, nausea, vomiting, dark urine and other symptoms appear only after a few days. Note also that after the appearance of jaundice, the patient's condition usually improves. An exception is hepatitis C, in which the process of liver tissue necrosis is most often chronic.

In some cases, patients develop so-called fulminant acute hepatitis. This is an extremely severe form of the disease, in which there is massive tissue death and an extremely rapid development of symptoms. If left untreated, such acute hepatitis ends in the death of a person.

With chronicity, the signs of hepatitis change. The symptoms of the disease are inconsistent, which is why many people do not pay due attention to them. This is the wrong approach. A doctor should be consulted in all cases where there is reason to suspect chronic hepatitis. It is usually accompanied by:

• constant malaise and a feeling of weakness, which intensifies towards the end of the day;
• nausea, vomiting;
• joint and muscle pain;
• pain in the abdomen;
• dark urine;
• skin itching;
• weight loss
• bleeding.

The above symptoms are an undoubted reason for contacting the clinic, where doctors must test for hepatitis, determine the exact cause of the onset of unpleasant phenomena and prescribe adequate treatment.

Complications of hepatitis

Both acute and chronic hepatitis can lead to very serious consequences. Among them it is worth noting:

• inflammatory diseases of the biliary tract;
• hepatic coma (ends in death in 90% of cases);
• cirrhosis of the liver - occurs in 20% of patients with viral hepatitis. The most common cause of cirrhosis is hepatitis B and its derivatives;
• liver cancer;
• dilation of blood vessels and subsequent internal bleeding;
• accumulation of fluid in the abdominal cavity - ascites.

The greatest number of severe complications gives hepatitis C in the chronic stage of development. The problem is exacerbated by the lack of effective treatments for this form, therefore, with any adverse symptoms, a person should definitely consult a doctor. It is not worth neglecting a visit to the clinic, because it is quite possible that timely prescribed treatment will save not only health, but also the life of the patient.

Hepatitis A, B, C - treatment and prognosis

Treatment of hepatitis A is based on basic therapy, bed rest and a strict diet. If there are indications, patients are prescribed symptomatic and detoxification therapy (intravenously or orally). In most cases, viral hepatitis A is cured without any problems and does not have serious complications.

A similar situation is observed in the case of the B-form infection. With adequate treatment, hepatitis B ends with a complete recovery of the patient in 80% of cases. It is very important to prevent the transition of the disease into a chronic form, which is often accompanied by the development of cirrhosis. Patients are prescribed basic therapy, taking drugs that improve metabolic processes, if indicated, antiviral therapy (recombinant interferon alfa). Hepatitis b requires long-term treatment. In some situations, there is a need for repeated courses of therapy.

Hepatitis C often becomes chronic and causes the development of cirrhosis and liver cancer in every 7th patient. Accordingly, in the diagnosis of hepatitis C, treatment has two important goals:

• reduce the intensity of inflammatory processes in the liver to reduce the risk of cirrhosis;
• eliminate the virus from the body (in whole or in part). The priority direction again is work with the liver.

The main method of treatment involves the use of interferon alfa. This drug prevents the appearance of new infected cells, but has side effects (fever, weakness, loss of appetite), which disappear after 1.5-2 weeks after the start of the course. Note that interferon alfa does not guarantee complete elimination of hepatitis C, however, it reduces the risk of developing cirrhosis and improves the quality of life. To increase the positive effect, the drug is used in combination with ribavirin.

After the end of treatment, the patient must donate blood every month for the timely detection of signs of re-inflammation of the liver.

Prevention of hepatitis

To prevent acute or chronic hepatitis from becoming a reality for you, you must follow a number of simple rules:

• do not drink unboiled water;
• always wash fruits and vegetables;
• wash hands before eating;
• do not share personal hygiene items with other people;
• just in case, regularly take an analysis for hepatitis for early detection of infection;
• refrain from piercings and tattoos;
• be careful when using syringes and needles (relevant for people who take drugs);
• carefully choose a sexual partner;
• get vaccinated on time.

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Ways of transmission of parenteral hepatitis

Viruses that cause parenteral hepatitis belong to different families. But they are united by one fact: they are very tenacious in the external environment. For example, the hepatitis B virus can stay alive for three to six months at room temperature. And in a frozen form (at a temperature of -20 degrees) it is completely preserved for more than ten years. Hepatitis viruses are also resistant to most disinfectants.

The source of infection are virus carriers, as well as all patients with parenteral viral hepatitis in any form of the disease. That is, patients with both acute and chronic viral hepatitis pose a danger. Moreover, a person becomes contagious from the middle of the incubation period. This is the most dangerous situation, since during this period the disease does not manifest itself in any way. A person does not even know that he is sick and now certain measures must be followed so as not to infect others.

Viruses of parenteral hepatitis B and C are contained in all biological fluids of the body, but in the maximum concentration in the blood and semen. To infect a person, a small drop of infected blood is enough, not even noticeable to the human eye.

Based on this, the following transmission routes are distinguished:

Parenteral - during surgical, dental procedures, during tattooing, manicure, intravenous injections using contaminated instruments;

Sexual - through sexual contact with an infected partner without the use of condoms;

Vertical - infection of a child from an infected mother in utero or already directly during childbirth;

Contact-household - when using razors, a toothbrush, manicure accessories of an infected person.

When communicating, shaking hands when meeting, hugging and kissing, as well as with HIV, a viral infection is not transmitted.

According to current data, about 240 million people worldwide are chronically infected with hepatitis B, and approximately 150 million people suffer from hepatitis C! Not only injection drug addicts or people with promiscuous sex life get sick with hepatitis. Given the prevalence of infection, other people are also at risk during routine dental and manicure procedures. When visiting nail salons in general, you need to be very careful, because, as practice shows, not all masters process the tools properly.

Symptoms of viral hepatitis B, C

The incubation period for hepatitis B is 50-180 days, and for hepatitis C, an average of 6-8 weeks. At this time, the disease does not make itself felt. After the incubation, a preicteric period begins, lasting an average of four to ten days. During this period, general weakness, fatigue, joint pain, skin rashes, and fever may appear. Such symptoms are absolutely non-specific, so they are often associated with other diseases at this stage.

In the next period - icteric, the clinical picture of viral hepatitis is already becoming more pronounced.

The course of viral hepatitis B and C may be accompanied by symptoms such as:

Enlargement of the liver, spleen;

dark urine;

discoloration of feces;

Yellowness of the skin, sclera;

itchy skin;

Heaviness in the right hypochondrium;

Weakness;

Loss of appetite;

There may be nausea, vomiting.

Basically, the icteric period lasts two to six weeks, but in some people it can even be delayed for several months. In the future, several options for development are possible. In an uncomplicated course, viral hepatitis ends with recovery after three to four months. However, unfortunately, such a favorable outcome does not always occur. It is noteworthy that hepatitis C is often asymptomatic and without jaundice, but, ultimately, ends very badly. In this regard, he received the name "affectionate killer."

Possible adverse outcomes of viral hepatitis:

Chronization - observed in 10-15% of all cases with viral hepatitis B and in 80-85% of cases with hepatitis C.

Cirrhosis of the liver is the growth of fibrous tissue in the organ. Cirrhosis of the liver is observed in 20-40% of patients with hepatitis C.

Liver carcinoma - with hepatitis C, the risk of developing a malignant process in the liver is three to four times higher than with hepatitis B.

Diagnosis of viral hepatitis B, C

Laboratory studies are the main ones in the diagnosis of hepatitis. They represent the detection in the human body of specific antigens and antibodies, as well as viral genetic information. The biochemical composition of the blood can change significantly in the presence of liver diseases, so do not neglect such an important analysis as liver tests.

Tests to detect hepatitis:

• Liver tests (ALT, AST, LDH, SDH, alkaline phosphatase, GLDH, GGT, thymol test);
• Biochemical blood test (albumin, globulins, bilirubin, prothrombin, fibrinogen);
• Analysis for the presence of hepatitis markers (antigens and antibodies specific to a specific hepatitis virus);
• PCR (detection of the genetic information of viruses).

Biochemical analysis of blood and liver tests only indirectly indicate hepatitis, their indicators change in other liver diseases. Therefore, to accurately confirm the diagnosis of hepatitis, it is necessary to conduct an analysis for the presence of hepatitis markers, as well as PCR.

Currently, rapid tests for hepatitis are gaining more and more popularity, allowing you to quickly and reliably determine the presence of hepatitis markers in the blood at home. They are a set of test strips soaked in a chemical that changes color when it comes into contact with a specific marker of hepatitis. Such tests are quite easy to use, and the reliability of the results reaches about 99%.

The rapid test kit includes a test strip in a sealed package, a wipe with a disinfectant solution, a finger pricker, a pipette for taking a blood sample from a finger (one or two drops are enough), and a chemical to dilute the blood sample.

Treatment of viral hepatitis B, C

All patients with parenteral hepatitis are subject to hospitalization. The patient must comply with bed rest and diet No. 5a according to Pevzner. Food should be high in calories. The required calorie content is mainly achieved through proteins and carbohydrates. Lipid intake should be limited. Dishes boiled, mashed, necessarily warm. It is recommended to eat small portions, but often.

It is mandatory for a patient with viral hepatitis to undergo detoxification therapy using enterosorbents and infusion solutions (hemodez, glucose, Ringer's solution). To correct metabolic disorders, vitamin preparations, cocarboxylase, potassium orotate, etc. are prescribed.

In the treatment of patients with severe hepatitis, interferons (Viferon, Laferon) are used in long courses. The use of these drugs does not kill the virus, but slows down its further reproduction. When determining the signs of an active inflammatory process, the patient is prescribed glucocorticosteroids (Prednisolone). In chronic forms of the disease, hepatoprotectors (Essentiale, Phosfonciale) are used.

Prevention of viral hepatitis B, C

Parenteral hepatitis is a very dangerous disease. It can be avoided by taking certain precautions.

Preventive measures to prevent parenteral hepatitis:

Vaccination - carried out for newborns, as well as adults from certain risk groups (medical workers, blood donors);

Do not use drugs;

Use condoms;

Observe personal hygiene, do not use other people's razors, toothbrushes;

Avoid dubious manicure and tattoo parlors. Learn how to do a manicure yourself or visit the master with your own manicure tools.

There is an opinion in society that infection with hepatitis is equated to a death sentence. But not everyone knows that there are several varieties of this disease that are successfully treated. The danger of hepatitis is that it is asymptomatic for a long time. The first signs of the presence of a pathological process occur when the disease has led to irreversible consequences.

Hepatitis is an inflammation of the liver tissue, it develops against the background of:

• viral infection of the body;
• toxic effects;
• decrease in immune defense.

Researchers have identified 6 viruses that provoke the development of hepatitis.

Hepatitis A, or Botkin's disease

Hepatitis A is diagnosed more often than other forms of pathology. The virus is transmitted through:

• non-compliance with the rules of personal hygiene (dirty hands);
• unwashed food.

Prevention of hepatitis A is carried out through vaccination and hygiene.

For the first time, pathology manifests itself in the form of fever. The remaining signs characteristic of hepatitis A are largely similar to the clinical picture that is observed with influenza. Approximately 2-4 days after infection with the virus, the patient's urine becomes dark in color. The feces become colorless. As the pathological process develops, jaundice develops, which indicates liver dysfunction. However, it was during this period that the patient's condition improved.

The course of the pathology takes from 1 week to 2 months. The duration of the rehabilitation period, during which the main functions of the body are restored, is approximately 6 months. In most patients, hepatitis A proceeds without complications. Bed rest is recommended during treatment. Hepatitis A therapy involves taking hepatoprotectors (drugs that restore liver function) and correcting the daily diet.

Hepatitis B (b, B), or Serum hepatitis

Hepatitis B is more likely to cause complications. Liver damage in this form of pathology is more severe.

The hepatitis B virus is transmitted:

• through the blood;
• with unprotected sexual intercourse;
• through the placenta from mother to child.

The first symptoms indicating infection with hepatitis B are manifested in the form of:

• elevated body temperature;
• general weakness;
• pain in the joints;
• bouts of nausea and vomiting;
• Less often there is a change in the color of urine (darkens) and feces (lighten).

The clinical picture of hepatitis B is characterized by the appearance of skin rashes, an increase in the size of the liver and spleen. Jaundice in this form of pathology usually does not occur.

Hepatitis B is complicated in severe cases by cancer or cirrhosis of the liver.

The disease develops as a result of infection of the body with a virus containing DNA. The diagnosis is confirmed when specific antibodies are detected during a blood test. Treatment of the disease is carried out in a complex manner. It provides for:

• hormonal drugs;
• immune preparations;
• hepatoprotectors;
• antibiotics.

Vaccination against hepatitis B is carried out several times. For the first time, serum is administered a few hours after the birth of the child. During the first year of life, 2 more vaccines are administered.

Hepatitis C

It is considered the most severe form of pathology. The disease is also known as post-transfusion hepatitis. More often, the pathology develops due to the transfusion of infected blood. In addition, infection occurs when using non-sterile medical devices, during cosmetic procedures. Less commonly, transmission of the virus occurs through unprotected sex or through the placenta from mother to child.

Today, in order to prevent the spread of the hepatitis C virus, donor blood is checked without fail.

The disease is often asymptomatic. The absence of pronounced signs indicating liver damage is observed in approximately 95% of patients. The remaining 5% of patients are diagnosed with jaundice, manifested as:

• dark urine;
• yellow skin and mucous membranes of the eyes.

Jaundice in hepatitis C is mild, so it usually goes unnoticed.

The asymptomatic course of the disease takes several years. The virus does not manifest itself during this period, so the patient does not seek help. Sometimes complaints of worsening condition are received when inflammation of the liver tissues has led to the development of cirrhosis of the organ. In such circumstances, the disease is difficult to treat.

In 70-80% of patients, hepatitis C becomes chronic. It carries the greatest danger, as it is often complicated by cancer or cirrhosis of the liver. Modern medicine is not yet able to offer an effective vaccine against hepatitis C.

Hepatitis D

Hepatitis D (delta hepatitis) differs from other forms of the disease in developmental features. The virus of this pathology remains inactive for a long time. It begins to multiply only if infection with hepatitis B has occurred. The clinical picture for both pathologies is similar. The only difference between the diseases is that the course of hepatitis D causes more severe complications.

Hepatitis E

The symptoms of hepatitis E resemble the phenomena characteristic of hepatitis A. The peculiarity of this form of pathology is that with complications caused by inflammation of the liver tissues, the affected area extends to the kidneys. Hepatitis E develops due to the consumption of contaminated foods and due to non-compliance with hygiene rules. The maximum risk of infection with the virus is observed in countries with a hot climate and poor water.

In most cases, the prognosis for recovery from hepatitis E is favorable.

Hepatitis G

Hepatitis G is characterized by symptoms similar to those of hepatitis C. But the first form of pathology is less dangerous for humans than the latter. In particular, the development of hepatitis G does not lead to cirrhosis or liver cancer. With a combination of both forms of pathology, these complications often occur.

How to protect yourself from hepatitis

If there is a person in the family with hepatitis A, it is necessary to wash hands thoroughly and regularly with soap and not use the patient's dishes.

1. Despite the fact that hepatitis B and C viruses are not transmitted through the air or through saliva, it is not recommended to use personal hygiene items for a sick person.
2. Use contraception during sexual intercourse.
3. Control (require) compliance with the rules for disinfection of devices used in medical institutions by dentists, hairdressers.
4. Comply with sanitary and epidemiological standards.

Hepatitis A, B and C carry the greatest danger due to their relatively high prevalence. At the same time, one should not forget about the prevention of other forms of the disease.

Pregnant women are at risk

The greatest danger for women during pregnancy is hepatitis E. During this period, the protective functions of the body are weakened. In addition, in the case of infection in the third trimester of pregnancy, the probability of a fatal outcome reaches 9-40%. The fetus in such circumstances almost always dies.

It is important to take preventive measures during pregnancy.

Diet food

Regardless of the form of hepatitis, the carrier of the virus must be excluded from the daily diet of dishes that load the liver. These include spicy, acidic and poorly digestible foods.

Dietary nutrition for hepatitis includes the following:

1. Fat containing products. The patient is allowed to eat butter and vegetable (sunflower, olive) oils.
2. Vegetable and milk soups, as well as soups that include fruits, noodles or cereals.
3. Lean meats (beef, rabbit, veal). It needs to be steamed.
4. Beef sausages.
5. Dietary and doctoral sausages.
6. Low-fat fish (perch, cod, carp).
7. Dairy. It is better to consume homemade products with a low fat content. Sour cream can only be used as a dressing.
8. One egg per day without yolk.
9. Fresh vegetables and fruits. They can be consumed boiled.

The exact list of prohibited and permitted products is compiled by the attending physician.

Hepatitis vaccination

Vaccination is considered the main measure to prevent infection and spread of viral hepatitis. They reduce the activity of the disease, creating conditions for managing their development and complete cure. Viral hepatitis is relatively difficult to treat. This is especially evident when treating chronic forms of diseases. Usually, in such circumstances, the action of therapy is aimed at maintaining the vital functions of the body and relieving symptoms.

With liver damage, hepatoprotectors are mainly used, which are not always able to suppress or stabilize the development of the inflammatory process in the tissues of the organ. In the treatment of viral hepatitis, specific antiviral drugs show good results. However, they are not able to completely cure the patient. A number of hepatitis causes cancer and cirrhosis of the liver. Therefore, many patients have to be treated all their lives after the disease.

Hepatitis virus vaccines

Modern medicine offers effective vaccines against viral hepatitis A, E and B. At the same time, no drugs have yet been developed that can prevent infection with hepatitis C. In order to prevent hepatitis A and E, vaccines are used that include live, killed or recombined viruses. In the treatment of these diseases, gamma globulin is also used, which in some cases can prevent the development of pathology.

Vaccination against hepatitis B is carried out recently with the help of T-cell vaccine (DNA vaccine).

Who is at risk

In modern conditions, vaccination against hepatitis viruses is mainly prescribed to persons at risk. Selective conduct of the procedure is due to financial reasons: medicines are expensive to manufacture, so not every person is able to pay for them.

The risk group for infection with hepatitis A and E viruses includes:

• housing and communal services employees, including people serving sewer systems;
• tourists, sailors and other persons visiting countries and territories where the likelihood of contracting the virus is extremely high;
• group associations of people and so on.

The risk group for contracting hepatitis B includes people who are constantly in contact with blood. These are, first of all, medical employees: employees of the blood transfusion station, surgeons and others.

Vaccination is mandatory in cases where an epidemic of pathology has been detected in a separate area.

Vaccination against viral hepatitis is free and paid. Therefore, every person who wants to protect himself from infection can go to the clinic to undergo the procedure.