Hepatitis E: what is it, how is it transmitted and how is it treated. Viral hepatitis e Viral hepatitis e

- This is a serious pathology associated with liver damage by viruses. Unlike other forms, it is successfully treated and often proceeds favorably. The real threat is only for pregnant women.

The causative agent of the disease is a virus containing ribonucleic acid. It can enter a healthy body in different ways: from incompletely cooked foods, from dirty hands and the feces of an infected person. It can also be passed on to the child from the mother.

This type of hepatitis is difficult to recognize because it presents in the same way as other viral liver diseases. The main symptoms of hepatitis E are discoloration of urine, skin, feces and pain under the ribs on the right side.

An accurate diagnosis can only be made by specialists - a hepatologist or a gastroenterologist. The doctor necessarily conducts a detailed examination, studies the results of instrumental and laboratory studies. Treatment is based on diet and medication. Surgical intervention is not required.

Specificity and transmission of viral hepatitis E

The main causative agent of the disease is the HEV virus. It is characterized by:

• a decrease in performance at a temperature of +20 degrees;
• destruction from freezing and subsequent thawing;
• almost one hundred percent instability to external factors;
• neutralization with iodine- and chlorine-containing disinfectants.

The source and carrier of the virus is always a sick person. People with subtle symptoms and already pronounced ones are equally dangerous. That is why it is important to know how hepatitis E is transmitted. Among the main ways:

• contact with the feces of an infected person;
• the use of incorrectly or incompletely cooked seafood, meat;
• use of poorly disinfected dental instruments;
• non-observance of hygiene rules: the use of infected liquids, the lack of habit of washing hands after the street;
• transmission to the baby from an infected mother during natural childbirth;
• blood transfusion.

There are also situations in which it is almost impossible to catch hepatitis E. These include:

1. intimate relationship with a condom;
2. sharing food with the patient;
3. contact with the mucus or saliva of an infected person;
4. hugs and touches, including a handshake.

In this case, the causative agent of the disease can be transmitted by contact-household. The greatest risk of contracting viral hepatitis E is associated with:

• medical workers;
• women who have been pregnant for 7.5 months or more;
• patients who need a blood transfusion;
• relatives of the patient;
• visitors to dentists and nail salons;
• babies born to mothers diagnosed with hepatitis E.

Having penetrated into the human body, the virus begins to attack the intestines: it actively multiplies in the conditions of microflora. Further, with the bloodstream, it enters the liver, where it becomes even more. An increase in the amount leads to a deterioration in the condition and functioning of the liver. The immune system perceives an organ overflowing with viral agents as a threat and begins to fight it with the help of antibodies.

Symptoms

The incubation period for viral hepatitis E can last from 2 weeks to 60 days. On average, it is 40 days. The first signs of the disease are often confused with banal fatigue and general malaise. People do not pay due attention to them, and the disease progresses in the meantime. Due to the presence of the virus appear:

1. weakness and fatigue;
2. a slight increase in body temperature;
3. memory problems;
4. pain in the shoulder blades and shoulders;
5. nasal congestion;
6. distraction of attention;
7. discomfort in the hepatic region;
8. decreased appetite.

Exactly the same symptoms are found in patients with hepatitis A. Of the specific, characteristic only for type E signs, one can name:

• hepatosplenomegaly;
• constant nausea;
• aversion to food;
• normal body temperature, but a decrease in blood pressure;
• sleep disorder;
• severe pain;
• discomfort in the joints and muscles.

Approximately on the tenth day after the pathological process began to develop, the disease passes into the stage of jaundice. Its duration is 7-20 days. Further, the signs of the disease gradually become less intense, the person begins to feel better and eventually recovers completely.

This is a common clinical picture for hepatitis E, but there are also negative scenarios that are associated with the occurrence of various complications. Some of them pose a danger to human life. In general, the icteric stage is characterized by the presence of:

• bitter taste in the mouth;
• the spread of jaundice throughout the skin: there is itching of varying intensity;
• dark urine color caused by an increase in the level of bilirubin;
• obvious staining in yellow shades of sclera and mucous membranes;
• colorless stools.

The manifestation of one or more of the above signs is a reason for an immediate visit to the doctor.

It is imperative to see a gastroenterologist and undergo diagnostics to clarify the diagnosis. Women who are expecting the birth of a child should be especially attentive to such symptoms. They have a much higher risk of serious complications.

Diagnosis of pathology

It is impossible to recognize hepatitis E solely by external manifestations, because they are identical with other viral liver lesions. To exclude or confirm hepatitis, and most importantly, to determine its type, a number of studies are carried out in medical institutions. As a rule, both laboratory diagnostic methods and instrumental ones are used.

The entire diagnosis procedure includes several stages. The first is directly related to the doctor's work with the patient. To be precise, it consists of:

1. Acquaintance with the history of the disease.
2. Collection and study of facts from life that directly relate to the disease: the path of transmission of the pathogen.
3. Physical examination, during which the abdomen is certainly palpated to see if and how much the liver and spleen have increased. In addition, the doctor examines the condition of the mucous membranes, as well as the sclera and skin. Be sure to measure the body temperature with blood pressure at the reception.
4. Detailed questioning about well-being and symptoms in order to fully form a clinical picture.

At the second stage, laboratory diagnostics are performed. The most reliable and informative research experts include:

• general clinical blood and urine tests;
• biochemical blood tests;
• liver tests;
• serological tests to detect antibodies to the pathogen;
• coprogram;
• PCR diagnostics;
• coagulogram.

The third and last stage involves the necessary instrumental procedures. Patients are subjected to:

• endoscopic liver biopsy;
• ultrasound examination of the abdominal cavity and liver;
• computed or magnetic resonance imaging.

How is the treatment

Like any other type of hepatitis, E is treated conservatively. If the disease has become severe or has been detected in a child, a pregnant woman, hospital observation is required. In other cases, you do not need to stay in the hospital, it is enough to follow all medical prescriptions at home.

In general, the treatment of this viral liver disease involves four factors. Let's briefly talk about them:

1. Bed rest which must be strictly adhered to. It is important not to overload yourself and fully relax.
2. Getting rid of toxins that poison the body. To do this, you need to use a lot of clean water and other healthy types of liquid. Also, to accelerate the removal of harmful substances and support organs and systems, saline solutions and glucose are periodically injected through the veins.
3. Change in diet according to the nature of the disease. With viral hepatitis E, you must adhere to diet number 5.
4. Ingestion of drugs from different groups. These are choleretic and painkillers, as well as hepatoprotectors, immunomodulars, specially selected vitamin and mineral complexes. Also, having studied in detail the clinical picture of the patient, the doctor prescribes drugs that eliminate specific symptoms of the disease.

For very severe cases, this treatment is not enough. With severe complications, patients are quickly taken to the hospital. If all necessary conditions are met, platelet masses and blood plasma are transfused. A special approach is required for the treatment of advanced forms in pregnant women. Conservative methods can be used in such situations only before childbirth.

In some cases, it is necessary to provoke the premature birth of the baby or even terminate the pregnancy.

What are the complications of hepatitis E?

In general, this type of hepatitis is characterized by a relatively mild course. Almost all patients recover, but occasionally there are exceptions to the rule. Complications may develop due to specific features or untimely access to doctors. Most often you have to deal with:

• hepatic / renal insufficiency;
• the formation of hepatocellular carcinoma;
• hepatic encephalopathy;
• steatohepatitis;
• polyarthritis;
• cirrhosis / fibrosis of the liver;
• portal hypertension;
• coma.

Women in position, due to the problems described above, may encounter:

• spontaneous miscarriage;
• common complications that will develop rapidly;
• intrauterine fetal death;
• premature birth.

No one excludes also the possibility of death. This applies to both the woman and her newly born child.

Forecasts and prevention of viral hepatitis E

Scientists have not yet developed a specific vaccine for this virus. To exclude the possibility of infection, doctors recommend that people be attentive to their health: their own and loved ones. It is desirable to learn all about the ways of transmission of the pathogen and preventive measures. Nothing complicated, you just have to accustom yourself to follow some rules.

Viral hepatitis E, or HEV, infects more than 20 million people each year, causing 56,000 deaths.

Most often, the virus is infected through water sources or while swimming in water bodies that do not meet sanitary standards for swimming.

Type E virus is most common in Asia. Hepatitis affects most of all the population living in conditions of low standards of sanitation, lack of drinking running water, where it is supplied.

According to the latest data, the Chinese have developed a vaccine to prevent a viral infection of this type of hepatitis, a license for the vaccine has already been received, but this preventive measure has not yet received distribution in the world.

There are 4 genotypes of the virus, with 3 and 4 freely circulating in wild animals, being transmitted to humans only in rare cases. Types 1 and 2 are common among people.

The hepatitis E virus can be contracted by eating raw shellfish caught in contagious water.

Hepatitis E: what is it?

Hepatitis E is conditionally included in the Calicivirus genus of RNA genomic viruses, but has genetic differences from other representatives of this genus. Viral cells - virions - have a rounded shape, without supercapsids. Type E virus is less resistant to temperature conditions than hepatitis A.

Hepatitis E can survive at -20 degrees Celsius and below, but quickly breaks down when it thaws. The virus is also unstable to the effects of chlorine- and iodine-containing disinfectants. Therefore, to prevent the virus from entering running water, it is subjected to chlorination.

Viral hepatitis E, getting into the human body, causes the destruction of liver cells. This disease was first described in the early 80s of the last century. At the same time, this type of hepatitis did not have a name at that time - it was categorized as all other types that did not fit the description of hepatitis A or B. A feature of hepatitis E is the seasonality of manifestation. Its epidemics are observed in southern countries, and the death of the virus occurs during freezing and thawing. There are differences in the course of the disease, but we will talk about this in more detail in the section "Hepatitis E: symptoms and treatment."

How is hepatitis E transmitted?

You have learned what hepatitis E is, and how this virus is transmitted, we will understand further.

Type E differs from the rest in the way it is transmitted - through water, hands, food and blood. Hepatitis E passes from a sick person to a healthy person through secretions that the patient passes into the environment. So, you can get infected through water, food, blood and feces, saliva.

Since the incubation period of the disease is from 10 to 60 days, the patient, without suspecting it, can spread the virus among people around him. For example, a cook in a public cafeteria can transmit the virus through cooked food. Sharing a public toilet shared by infected people also causes the spread of infection, etc. The mode of transmission of hepatitis E is oral-fecal.

Symptoms of Hepatitis E

Having received the hepatitis E virus, a person can live peacefully from two weeks to two months, not suspecting that they have already become ill. Symptoms appear at the end of the incubation period, and they are very similar to the manifestations of hepatitis A. Although it is possible to distinguish between them - type A is characterized by relief of the patient's well-being during the icteric period.

In type E, the icteric period becomes the peak of the exacerbation of the disease and the patient's condition worsens even more, 10-60 days after infection.

The patient may feel:

• loss of appetite;
• lethargy and weakness;
• mild nausea;
• rarely vomiting;
• severe dizziness.

Symptoms are too mild, so the patient can ignore them until they appear. This occurs 7-8 days after the end of the incubation period, the stage of jaundice begins.

The liver signals a malfunction, yellowing of the skin and sclera, while the color of the discharge changes - the urine darkens, and the feces become colorless. Nausea and abdominal pain intensify, itching of the skin is often felt.

The liver can be felt on its own, as it increases significantly in size. This period ends within 10-20 days, and the recovery stage following it can last more than 2 months.

Complications of hepatitis can manifest as internal bleeding, the main symptom of which will be:

• vomiting the color of coffee grounds;
• stomach ache;
• feces with bloody discharge.

The prognosis of hepatitis E is favorable for everyone except pregnant women. Their disease most often ends in fetal death and miscarriage.

Hepatitis E treatment and diagnosis

If the visible signs of hepatitis are yellowing of the skin and sclera, pain in the right upper abdomen may not give an accurate diagnosis, because hepatitis A has the same symptoms, then laboratory tests can clearly identify one or another type of hepatitis E virus, the treatment of which is started immediately .

First, donating blood for biochemistry will clarify the level of bilirubin and the activity of liver transaminases, and a laboratory test for antibodies will make it possible to establish the presence of immunoglobulins M and G, which are produced in the body in response to manifestations of the hepatitis E virus. It is important to identify viral particles at an early stage, using PCR analysis in order to keep the condition of the liver under control in the future, preventing bleeding.

The hepatitis E virus itself is not very dangerous, but complications can lead to extremely serious consequences, even death.

Treatment is aimed at supporting the body's strength in the fight against the virus and preventing the spread of the virus among people around. Ideally, the patient is placed in the infectious department for the entire period of the disease. The prescribed therapy includes drugs that relieve the symptoms of the disease, as well as protecting and restoring the liver.

Basic principles of hepatitis E treatment:

1. Diet.
2. Hospital regime in the infectious department.
3. Means for the relief of intoxication of the body. This tactic involves infusion of intravenous gemodez, 10% glucose solution, potassium and magnesium preparations combined with water for injection or saline sodium chloride solution. Hemorrhagic syndrome is removed by transfusion of plasma and platelets, infusion of trental and dicyone.
4. Hepatoprotectors.
5. symptomatic treatment.

Principles of treatment of pregnant women:

• enhanced administration of detoxifiers and hepatoprotectors;
• ensuring maximum rest;
• counteraction to hemorrhagic syndrome and its prevention;
• timely detection of possible symptoms of miscarriage or premature birth, preservation of pregnancy;
• if childbirth or abortion is already taking place, eliminate severe bleeding as much as possible, anesthetize labor activity;
• during the entire disease and six months after the cure, the patient must follow a special diet, which in medical language is called diet number 5.

Diet number 5 - description:

• vegetables, fruits and cereals containing fiber, low-fat protein foods are added to the diet;
• the consumption of a large amount of fluid to remove toxins is welcomed;
• all dishes are baked without oil, boiled, steamed;
• too hard protein foods are rubbed before eating;
• cold dishes are prohibited - everything should be slightly or moderately heated.

Allowed:

• bread (second day of baking) made from rye flour or 1-2 varieties;
• baked pies with apple, fish or white meat chicken;
• white chicken meat, veal, rabbit, turkey, pilaf, cabbage rolls, boiled sausage of the highest grade;
• fish - low-fat boiled or baked;
• soups without frying and excess fat, milk soups;
• kefir, low-fat cottage cheese, a small amount of 10-15% sour cream, low-fat cheese, acidophilus, bifilife, biolact;
• eggs - only proteins;
• vegetables, except sorrel, onion, garlic and radish, radish;
• non-acidic fruits, dried berries, kissels, compotes, jelly, marshmallow, marmalade, jam, honey;
• tea, weak coffee with milk, decoctions of vegetables, fruits, dried fruits.

Forbidden:

• chocolate, cocoa, ice cream, cream confectionery;
• black coffee, cold carbonated drinks;
• boiled, fried eggs;
• mayonnaise;
• fatty homemade cottage cheese and sour cream;
• fat meat;
• fast food;
• muffin;
• canned food, smoked meats;
• unrefined oil.

Prognosis for hepatitis E

The prognosis of the disease is mostly favorable, in case of compliance with the regimen, diet and liver support with prescribed drugs:

• Hepatosan;
• Glutargin;
• Artichoke extract.

The exception, as mentioned earlier, is pregnant women. Very rarely, this disease provokes liver failure or impaired kidney function. The most dangerous complication is cirrhosis of the liver, which occurs in 5 cases out of a hundred. Hepatic bleeding, liver failure, coma, or kidney failure may be unpredictable.

Prevention

As the prevention of hepatitis, personal security measures and preventive measures at the state level can be distinguished.

Personal measures include hygiene, especially in public places or in a hostel. Washing hands after using the toilet and before eating, regularly disinfecting the premises with disinfectant solutions.

At the state level, hepatitis prevention includes control of water sources and improvement of living conditions.

Pregnant women are advised to control their well-being and consult a doctor even in case of minor ailments, take regular blood tests and limit visits to southern countries, where outbreaks of hepatitis E occur more often than in temperate latitudes. Expectant mothers should be doubly careful, as the hepatitis E virus is especially dangerous for the fetus.

Useful video

General information about viral hepatitis is in the following video with Dr. Komarovsky:

Conclusion

We found that hepatitis E is a viral infection transmitted by the oral-fecal route, mainly through water and food sources, as well as when visiting public places together with the patient.

A long incubation period leads to the spread of the disease by the carrier, and mild symptoms in the first stage do not always force a person to see a doctor. The hepatitis E virus usually goes through three stages and an incubation period.

The prognosis for cure is favorable, but complications occur in 5% of cases.

During the course of the disease and after recovery, diet table number 5 should be followed, eliminating all fatty, spicy and fried foods. Prevention of hepatitis - purification and disinfection of water, personal hygiene.

Viral hepatitis- this 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.

Epidemics of jaundice have been described as early as the 5th century BC. Hippocrates, but the causative agents of hepatitis were discovered only in the middle of the last century. In addition, it should be noted that the concept of hepatitis in modern medicine can mean not only independent diseases, but also one of the components of a generalized, that is, affecting the body as a whole, pathological process.

Hepatitis (a, b, c, d), i.e. inflammatory liver disease, is possible as a symptom of yellow fever, rubella, herpes, AIDS and some other diseases. There is also toxic hepatitis, which includes, for example, liver damage due to alcoholism.

We will talk about independent infections - viral hepatitis. They differ in origin (etiology) and course, however, some symptoms of various types of this disease are somewhat similar to each other.

Classification of viral hepatitis

Classification of viral hepatitis is possible on many grounds:

The danger of viral hepatitis

Especially dangerous for human health hepatitis viruses B and C. The ability to exist in the body for a long time without noticeable manifestations leads to severe complications due to the gradual destruction of liver cells.

Another characteristic feature of viral hepatitis is that anyone can get infected. Of course, in the presence of factors such as blood transfusion or work with it, drug addiction, promiscuity, the risk of contracting not only hepatitis, but also HIV increases. Therefore, for example, healthcare workers should regularly donate blood for markers of hepatitis.

But you can also become infected after a blood transfusion, an injection with a non-sterile syringe, after an operation, a visit to the dentist, in a beauty parlor or for a manicure. Therefore, a blood test for viral hepatitis is recommended for anyone exposed to any of these risk factors.

Hepatitis C can also cause extrahepatic manifestations such as autoimmune diseases. The constant fight against the virus can lead to a perverted immune response to the body's own tissues, resulting in glomerulonephritis, skin lesions, etc.

Important: in no case should the disease be left untreated, since in this case the risk of its transition to a chronic form or rapid damage to the liver is higher.

Therefore, the only available way to protect yourself from the consequences of hepatitis infection is to rely on early diagnosis with the help of tests and subsequent visits to a doctor.

Forms of hepatitis

Acute hepatitis

The acute form of the disease is the most typical for all viral hepatitis. Patients have:

• deterioration of well-being;
• severe intoxication of the body;
• liver dysfunction;
• development of jaundice;
• an increase in the amount of bilirubin and transaminase in the blood.

With adequate and timely treatment, acute hepatitis ends complete recovery of the patient.

chronic hepatitis

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.

Human life is in danger when chronic hepatitis, the symptoms of which indicate damage to vital organs, is aggravated by improper treatment, reduced immunity, and alcohol addiction.

General symptoms of hepatitis

jaundice appears with hepatitis as a result of bilirubin, which is not processed in the liver, enters the bloodstream. But it is not uncommon for the absence of this symptom in hepatitis.

Usually hepatitis in the initial period of the disease manifests flu symptoms. It notes:

• temperature rise;
• body aches;
• headache;
• general malaise.

As a result of the inflammatory process, the patient's liver increases and its membrane stretches; at the same time, a pathological process may occur in the gallbladder and pancreas. All this is accompanied pain in the right hypochondrium. Pain often have a long course, aching or dull character. But they can be sharp, intense, paroxysmal and give to the right shoulder blade or shoulder.

Descriptions of symptoms of viral hepatitis

Hepatitis A

Hepatitis A or Botkin's disease is the most common form of viral hepatitis. Its incubation period (from the moment of infection to the appearance of the first signs of the disease) is from 7 to 50 days.

Causes of Hepatitis A

Hepatitis A is most widespread in the countries of the "third world" with their low sanitary and hygienic standard of living, however, isolated cases or outbreaks of hepatitis A are possible even in the most developed countries of Europe and America.

The most common mode of transmission of the virus is through close household contact between people and ingestion of food or water contaminated with faecal material. Hepatitis A is also transmitted through dirty hands, so children most often fall ill with it.

Symptoms of Hepatitis A

The duration of hepatitis A disease can vary from 1 week to 1.5-2 months, and the recovery period following the disease sometimes stretches up to six months.

The diagnosis of viral hepatitis A is made taking into account the symptoms of the disease, anamnesis (that is, the possibility of the onset of the disease due to contact with patients with hepatitis A is taken into account), as well as diagnostic data.

Hepatitis A treatment

Of all forms, viral hepatitis A is considered the most favorable in terms of prognosis, it does not cause severe consequences and often ends spontaneously, without requiring active treatment.

If necessary, hepatitis A is treated successfully, usually in a hospital setting. During illness, bed rest is recommended for patients, a special diet and hepatoprotectors are prescribed - drugs that protect the liver.

Prevention of hepatitis A

The main measure for the prevention of hepatitis A is the observance of hygiene standards. In addition, children are recommended to be vaccinated against this type of viral hepatitis.

Hepatitis B

Hepatitis B or serum hepatitis is a much more dangerous disease characterized by severe liver damage. The causative agent of hepatitis B is a virus containing DNA. The outer shell of the virus contains a surface antigen - HbsAg, which causes the formation of antibodies to it in the body. Diagnosis of viral hepatitis B is based on the detection of specific antibodies in the blood serum.

Viral hepatitis b remains infective in the blood serum at 30–32 degrees Celsius for 6 months, at minus 20 degrees Celsius - 15 years, after warming up to plus 60 degrees Celsius - for an hour, and only with 20 minutes of boiling she disappears completely. That is why viral hepatitis B is so common in nature.

How is hepatitis B transmitted?

Infection with hepatitis B can occur through the blood, as well as through sexual contact and vertically - from mother to fetus.

Symptoms of Hepatitis B

In typical cases, hepatitis B, like Botkin's disease, begins with the following symptoms:

• temperature increase;
• weaknesses;
• pain in the joints;
• nausea and vomiting.

Symptoms such as dark urine and discoloration of feces are also possible.

Other symptoms of viral hepatitis B may also appear:

• rashes;
• enlargement of the liver and spleen.

Jaundice for hepatitis B is uncharacteristic. Liver damage can be extremely severe and, in severe cases, lead to cirrhosis and liver cancer.

Hepatitis B treatment

Treatment of hepatitis B requires an integrated approach and depends on the stage and severity of the disease. In the treatment, immune preparations, hormones, hepatoprotectors, antibiotics are used.

To prevent the disease, vaccination is used, which is carried out, as a rule, in the first year of life. It is believed that the duration of post-vaccination immunity to hepatitis B is at least 7 years.

Hepatitis C

The most severe form of viral hepatitis is hepatitis C or post-transfusion hepatitis. Hepatitis C virus infection can affect anyone and is more common in younger people. The incidence is on the rise.

This disease is called post-transfusion hepatitis due to the fact that infection with viral hepatitis C most often occurs through the blood - during blood transfusion or through non-sterile syringes. Currently, all donated blood must be tested for the hepatitis C virus. Sexual transmission of the virus or vertical transmission from mother to fetus is less common.

How is hepatitis C transmitted?

There are two ways of transmission of the virus (as with viral hepatitis B): hematogenous (i.e. through the blood) and sexual. The most common route is hematogenous.

How infection occurs

At blood transfusion and its components. This used to be the main mode of infection. However, with the advent of the method of laboratory diagnosis of viral hepatitis C and its introduction into the mandatory list of donor examinations, this path has faded into the background.

The most common way at present is infection with tattooing and piercing. The use of poorly sterilized, and sometimes not treated instruments at all, has led to a sharp surge in the incidence.

Often, infection occurs when visiting dentist, manicure rooms.

Using common needles for intravenous drug use. Hepatitis C is extremely common among drug addicts.

Using general with a sick person of toothbrushes, razors, nail scissors.

The virus can be transmitted from mother to child at the time of birth.

At sexual contact: this route is not so relevant for hepatitis C. Only 3-5% of cases of unprotected sex can become infected.

Injection with infected needles: this mode of infection is not uncommon among medical workers.

In about 10% of patients with hepatitis C, the source remains unexplained.

Hepatitis C Symptoms

There are two forms of the course of viral hepatitis C - acute (relatively short period, severe) and chronic (prolonged course of the disease). Most people, even in the acute phase, do not notice any symptoms, however, in 25-35% of cases, signs similar to other acute hepatitis appear.

Symptoms of hepatitis usually appear after 4-12 weeks after infection (however, this period can be within 2-24 weeks).

Symptoms of acute hepatitis C

• Loss of appetite.
• Abdominal pain.
• Dark urine.
• Light chair.

Symptoms of chronic hepatitis C

As with the acute form, people with chronic hepatitis C often do not experience any symptoms in the early or even late stages of the disease. Therefore, it is not uncommon for a person to be surprised to learn that he is sick after a random blood test, for example, when going to the doctor in connection with a common cold.

Important: you can be infected for years and not know it, which is why hepatitis C is sometimes called the "silent killer".

If the symptoms still appear, then they are likely to be as follows:

• Pain, swelling, discomfort in the area of ​​the liver (in the right side).
• Fever.
• Muscle pain, joint pain.
• Decreased appetite.
• Weight loss.
• Depression.
• Jaundice (yellow tint to the skin and sclera of the eyes).
• Chronic fatigue, rapid fatigue.
• Vascular "asterisks" on the skin.

In some cases, as a result of the immune response of the body, damage can develop not only to the liver, but also to other organs. For example, kidney damage called cryoglobulinemia may develop.

In this condition, there are abnormal proteins in the blood that become solid when the temperature drops. Cryoglobulinemia can lead to consequences ranging from skin rashes to severe kidney failure.

Diagnosis of viral hepatitis C

Differential diagnosis is similar to that for hepatitis A and B. It should be borne in mind that the icteric form of hepatitis C, as a rule, occurs with mild intoxication. The only reliable confirmation of hepatitis C is the results of marker diagnostics.

Given the large number of anicteric forms of hepatitis C, it is necessary to carry out marker diagnostics of persons who systematically receive a large number of injections (primarily intravenous drug users).

Laboratory diagnosis of the acute phase of hepatitis C is based on the detection of viral RNA in PCR and specific IgM by various serological methods. If hepatitis C virus RNA is detected, genotyping is desirable.

The detection of serum IgG to antigens of viral hepatitis C indicates either a previous illness or the ongoing persistence of the virus.

Treatment of viral hepatitis C

Despite all the terrible complications that hepatitis C can lead to, in most cases the course of hepatitis C is favorable - for many years, the hepatitis C virus may not show up.

At this time, hepatitis C does not require special treatment - only careful medical monitoring. It is necessary to check liver function regularly, at the first signs of activation of the disease, it is necessary to carry out antiviral therapy.

Currently, 2 antiviral drugs are used, which are most often combined:

• interferon-alpha;
• ribavirin.

Interferon-alpha is a protein that the body synthesizes on its own in response to a viral infection, i.e. it is actually a component of natural antiviral protection. In addition, interferon-alpha has antitumor activity.

Interferon-alpha has many side effects, especially when administered parenterally, i.e. in the form of injections, as it is usually used in the treatment of hepatitis C. Therefore, treatment should be carried out under mandatory medical supervision with the regular determination of a number of laboratory parameters and the appropriate dosage adjustment of the drug.

Ribavirin as an independent treatment has low efficiency, but when combined with interferon, it significantly increases its effectiveness.

Traditional treatment quite often leads to a complete recovery from chronic and acute forms of hepatitis C, or to a significant slowdown in the progression of the disease.

Approximately 70 to 80% of people with hepatitis C develop the chronic form of the disease, which is the greatest danger, as this disease can lead to the formation of a malignant tumor of the liver (that is, cancer) or cirrhosis of the liver.

When hepatitis C is combined with other forms of viral hepatitis, the patient's condition can deteriorate sharply, the course of the disease can become more complicated and lead to death.

The danger of viral hepatitis C is also in the fact that there is currently no effective vaccine that can protect a healthy person from infection, although scientists are making a lot of efforts in this direction of preventing viral hepatitis.

How long do people live with hepatitis C

Based on medical experience and research in this field, life with hepatitis C is possible and even long enough. A common disease, in other matters, like many others, has two stages of development: remission and exacerbation. Often hepatitis C does not progress, that is, does not lead to cirrhosis of the liver.

It must be said right away that lethal cases, as a rule, are not associated with the manifestation of the virus, but with the consequences of its effects on the body and general disturbances in the functioning of various organs. It is difficult to specify a specific period during which pathological changes incompatible with life occur in the patient's body.

Various factors influence the rate of progression of hepatitis C:

According to the statistics of the World Health Organization, there are more than 500 million people in whose blood a virus or pathogenic antibodies are found. These data will only go up every year. The number of cases of cirrhosis of the liver has increased by 12 percent worldwide over the past decade. The average age category is 50 years.

It should be noted that in 30% of cases the progression of the disease is very slow and lasts about 50 years. In some cases, fibrotic changes in the liver are rather insignificant or absent even if the infection lasts for several decades, so you can live with hepatitis C for quite a long time. So, with complex treatment, patients live 65-70 years.

Important: if appropriate therapy is not carried out, then life expectancy is reduced to an average of 15 years after infection.

Hepatitis D

Hepatitis D or delta hepatitis differs from all other forms of viral hepatitis in that its virus cannot multiply in the human body separately. To do this, he needs a "helper virus", which becomes the hepatitis B virus.

Therefore, delta hepatitis can be considered rather than as an independent disease, but as a complicating course of hepatitis B, a companion disease. When these two viruses coexist in the patient's body, a severe form of the disease occurs, which doctors call superinfection. The course of this disease resembles that of hepatitis B, but the complications characteristic of viral hepatitis B are more common and more severe.

Hepatitis E

Hepatitis E in its characteristics, it is similar to hepatitis A. However, unlike other types of viral hepatitis, in severe hepatitis E, there is a pronounced lesion not only of the liver, but also of the kidneys.

Hepatitis E, like hepatitis A, has a fecal-oral infection mechanism, is common in countries with a hot climate and poor water supply to the population, and the prognosis for recovery is favorable in most cases.

Important: the only group of patients for whom infection with hepatitis E can be fatal is women in the last trimester of pregnancy. In such cases, mortality can reach 9-40% of cases, and the fetus dies in almost all cases of hepatitis E in a pregnant woman.

Prevention of viral hepatitis in this group is similar to the prevention of hepatitis A.

Hepatitis G

Hepatitis G- the last representative of the family of viral hepatitis - in its symptoms and signs resembles viral hepatitis C. However, it is less dangerous, since the progression of the infectious process inherent in hepatitis C with the development of liver cirrhosis and liver cancer is not typical for hepatitis G. However, the combination of hepatitis C and G can lead to cirrhosis.

Medicines for hepatitis

Which doctors to contact with hepatitis

Tests for hepatitis

To confirm the diagnosis of hepatitis A, a biochemical blood test is sufficient to determine the concentration of liver enzymes, protein and bilirubin in the plasma. The concentration of all these fractions will be increased due to the destruction of liver cells.

Biochemical blood tests also help determine the activity of the course of hepatitis. It is by biochemical indicators that one can get an impression of how aggressively the virus behaves in relation to liver cells and how its activity changes over time and after treatment.

To determine infection with the other two types of virus, a blood test is performed for antigens and antibodies to hepatitis C and B. Blood tests for hepatitis can be taken quickly, without spending much time, but their results will allow the doctor to obtain detailed information.

By assessing the number and ratio of antigens and antibodies to the hepatitis virus, you can find out about the presence of infection, exacerbation or remission, as well as how the disease responds to treatment.

Based on the data of blood tests in dynamics, the doctor can adjust his appointments and make a forecast for the further development of the disease.

diet for hepatitis

The diet for hepatitis is as sparing as possible, since the liver, which is directly involved in digestion, is damaged. For hepatitis, frequent small meals.

Of course, one diet for the treatment of hepatitis is not enough, drug therapy is also needed, but proper nutrition plays a very important role and favorably affects the well-being of patients.

Thanks to the diet, pain is reduced and the general condition improves. During an exacerbation of the disease, the diet becomes more strict, during periods of remission - more free.

In any case, it is impossible to neglect the diet, because it is the reduction in the load on the liver that can slow down and alleviate the course of the disease.

What can you eat with hepatitis

Foods that can be included in the diet with this diet:

• lean meats and fish;
• low-fat dairy products;
• inedible flour products, lingering cookies, yesterday's bread;
• eggs (only protein);
• cereals;
• boiled vegetables.

What not to eat with hepatitis

The following foods should be excluded from your diet:

• fatty meats, duck, goose, liver, smoked meats, sausages, canned food;
• cream, fermented baked milk, salty and fatty cheeses;
• fresh bread, puff and pastry, fried pies;
• fried and hard-boiled eggs;
• pickled vegetables;
• fresh onions, garlic, radishes, sorrel, tomatoes, cauliflower;
• butter, lard, cooking fats;
• strong tea and coffee, chocolate;
• alcoholic and carbonated drinks.

Prevention of hepatitis

Hepatitis A and hepatitis E, which are transmitted by the fecal-oral route, are quite easy to prevent if basic hygiene rules are followed:

• wash hands before eating and after going to the toilet;
• do not eat unwashed vegetables and fruits;
• do not drink raw water from unknown sources.

For children and adults at risk, there is hepatitis A vaccination, but it is not included in the mandatory vaccination schedule. Vaccination is carried out in case of an epidemic situation in terms of the prevalence of hepatitis A, before traveling to areas unfavorable for hepatitis. It is recommended to vaccinate against hepatitis A for workers of preschool institutions and physicians.

As for hepatitis B, D, C and G, transmitted through the infected blood of a patient, their prevention is somewhat different from the prevention of hepatitis A. First of all, contact with the blood of an infected person should be avoided, and since hepatitis is enough to transmit the hepatitis virus the minimum amount of blood, then infection can occur when using one razor, nail scissors, etc. All these devices must be individual.

As for the sexual transmission of the virus, it is less likely, but still possible, so sexual contact with unverified partners should take place only using a condom. Increases the risk of contracting hepatitis intercourse during menstruation, defloration, or other situations in which sexual contact is associated with the release of blood.

The most effective protection against hepatitis B infection today is considered to be vaccination. In 1997, hepatitis B vaccination was included in the mandatory vaccination schedule. Three vaccinations against hepatitis B are carried out in the first year of a child's life, and the first vaccination is given in the maternity hospital, a few hours after the birth of the baby.

Adolescents and adults are vaccinated against hepatitis B on a voluntary basis, and experts strongly recommend such a vaccination to representatives of the risk group.

Recall that the risk group includes the following categories of citizens:

• employees of medical institutions;
• patients who received blood transfusions;
• drug addicts.

In addition, people who live or travel in areas with a high prevalence of hepatitis B virus, or who have family contact with people with hepatitis B or carriers of the hepatitis B virus.

Unfortunately, vaccines to prevent hepatitis C are currently does not exist. Therefore, its prevention is reduced to the prevention of drug addiction, mandatory testing of donor blood, explanatory work among adolescents and young people, etc.

Questions and answers on the topic "Viral hepatitis"

Question:Hello, what is a healthy carrier of hepatitis C?

Answer: A hepatitis C carrier is a person who has the virus in their blood and does not show any symptoms. This condition can last for years while the immune system keeps the disease at bay. Carriers, being a source of infection, must constantly take care of the safety of their loved ones and, if they wish to become parents, carefully approach the issue of family planning.

Question:How do I know if I have hepatitis?

Answer: Get a blood test for hepatitis.

Question:Hello! I am 18 years old, hepatitis B and C negative, what does this mean?

Answer: The analysis showed the absence of hepatitis B and C.

Question:Hello! My husband has hepatitis B. I recently had my last hepatitis B vaccine. A week ago, my husband's lip cracked, now it doesn't bleed, but the crack hasn't healed yet. Is it better to stop kissing until it heals completely?

Answer: Hello! It is better to cancel, and you to pass anti-hbs, hbcorab total, PCR quality for him.

Question:Hello! I did a trimmed manicure in the salon, my skin was injured, now I’m worried, after what time should I be tested for all infections?

Answer: Hello! Contact an infectious disease specialist to decide on an emergency vaccination. After 14 days, you can take a blood test for RNA and DNA of hepatitis C and B viruses.

Question:Hello, please help: I ​​was recently diagnosed with chronic hepatitis b with low activity (hbsag +; dna pcr +; dna 1.8 * 10 in 3 tbsp. IU / ml; alt and ast are normal, other indicators in the biochemical analysis are normal ; hbeag - ; anti-hbeag +). The doctor said that no treatment is required, no diet is needed, however, I have repeatedly come across information on various sites that all chronic hepatitis is treated, and there is even a small percentage of complete recovery. So maybe you should start treatment? And yet, for more than a year I have been using a hormonal drug prescribed by a doctor. This drug adversely affects the liver. But it is impossible to cancel it, what to do in this case?

Answer: Hello! Observe regularly, follow a diet, exclude alcohol, it is possible to prescribe hepatoprotectors. HTP is currently not required.

Question:Hello, I am 23 years old. Recently, I had to take tests for a medical examination, and this is what was found out: the analysis for hepatitis B is deviating from the norm. Do I have a chance to pass a medical examination for contract service with such results? I was vaccinated against hepatitis B in 2007. I have never observed any symptoms related to the liver. Jaundice did not hurt. Nothing bothered. Last year, for six months I took SOTRET 20 mg per day (there were problems with the skin of the face), nothing more special.

Answer: Hello! Probably transferred viral hepatitis B with recovery. The chance depends on the diagnosis made by the hepatological commission.

Question:Maybe the question is in the wrong place, tell me who to contact. The child is 1 year and 3 months old. We want to vaccinate him against infectious hepatitis. How can this be done and are there any contraindications.

Answer:

Question:What should other family members do if the father has hepatitis C?

Answer: Viral hepatitis C refers to the "blood infections" of a person with a parenteral mechanism of infection - during medical procedures, blood transfusions, during sexual intercourse. Therefore, at the household level in family foci for other family members, there is no danger of infection.

Question:Maybe the question is in the wrong place, tell me who to contact. baby is 1 year and 3 months old. We want to vaccinate him against infectious hepatitis. How can this be done and are there any contraindications.

Answer: Today it is possible to vaccinate a child (as well as an adult) against viral hepatitis A (infectious), against viral hepatitis B (parenteral or "blood") or by a combined vaccination (hepatitis A + hepatitis B). Vaccination against hepatitis A is single, against hepatitis B - three times at intervals of 1 and 5 months. Contraindications are standard.

Question:I have a son (25 years old) and a daughter-in-law (22 years old) with hepatitis G, they live with me. In addition to the eldest son, I have two more sons of 16 years old. Is hepatitis ji contagious to others? Can they have children and how this infection will affect the health of the child.

Answer: Viral hepatitis G is not transmitted by contact and is not dangerous for your younger sons. A woman infected with hepatitis G can give birth to a healthy child in 70-75% of cases. Since this is generally a fairly rare type of hepatitis, and even more so - in two spouses at the same time, to exclude a laboratory error, I recommend repeating this analysis again, but in a different laboratory.

Question:How effective is the hepatitis B vaccine? What are the side effects of this vaccine? What should be the vaccination plan if a woman is going to become pregnant in a year? What are the contraindications?

Answer: Vaccination against viral hepatitis B (performed three times - 0, 1 and 6 months) is highly effective, cannot lead to jaundice on its own and has no side effects. There are practically no contraindications. Women who are planning a pregnancy and have not had rubella and chickenpox, in addition to hepatitis B, must also be vaccinated against rubella and chickenpox, but no later than 3 months before pregnancy.

Question:What to do about hepatitis C? To treat or not to treat?

Answer: Viral hepatitis C should be treated in the presence of three main indicators: 1) the presence of cytolysis syndrome - elevated levels of ALT in whole and diluted 1:10 blood serum; 2) a positive test result for antibodies of the immunoglobulin M class to the core antigen of the hepatitis C virus (anti-HCVcor-Ig M) and 3) detection of hepatitis C virus RNA in the blood by polymerase chain reaction (PCR). Although the final decision should still be made by the attending physician.

Question:Hepatitis A (jaundice) was diagnosed in our office. What should we do? 1. Should the office be disinfected? 2. When does it make sense for us to get tested for jaundice? 3. Should we limit contact with families now?

Answer: Disinfection in the office should be done. Analyzes can be taken immediately (blood for ALT, antibodies to HAV - hepatitis A virus classes of immunoglobulins M and G). It is desirable to limit contacts with children (before testing or up to 45 days after the discovery of a case of the disease). After clarifying the situation of healthy non-immune employees (negative test results for IgG antibodies to HAV), it is advisable to vaccinate against viral hepatitis A, as well as hepatitis B - in order to prevent similar crises in the future.

Question:How is the hepatitis virus transmitted? And how not to get sick.

Answer: Hepatitis A and E viruses are transmitted with food and drink (the so-called fecal-oral route of transmission). Hepatitis B, C, D, G, TTV are transmitted through medical procedures, injections (for example, among injecting drug users using one syringe, one needle and a common “shirk”), blood transfusions, during surgical operations with reusable instruments, as well as during sexual contacts (the so-called parenteral, blood transfusion and sexual transmission). Knowing the ways of transmission of viral hepatitis, a person can control the situation to a certain extent and reduce the risk of the disease. From hepatitis A and B in Ukraine, there have long been vaccines, vaccinations with which give a 100% guarantee against the onset of the disease.

Question:I have hepatitis C, genotype 1B. He was treated with reaferon + ursosan - without result. What drugs to take to prevent cirrhosis of the liver.

Answer: In hepatitis C, combined antiviral therapy is most effective: recombinant alpha 2-interferon (3 million per day) + ribavirin (or in combination with other drugs - nucleoside analogues). The treatment process is long, sometimes more than 12 months under the control of ELISA, PCR and indicators of cytolysis syndrome (AlT in whole and diluted 1:10 blood serum), as well as at the final stage - puncture liver biopsy. Therefore, it is desirable to be observed and undergo a laboratory examination by one attending physician - it is necessary to understand the definition of “no result” (dosages, duration of the first course, laboratory results in the dynamics of the use of drugs, etc.).

Question:Hepatitis C! A 9-year-old child has had a fever for all 9 years. How to treat? What's new in this area? Will the right way be found soon? Thank you in advance.

Answer: Temperature is not the main sign of chronic hepatitis C. Therefore: 1) it is necessary to exclude other causes of fever; 2) determine the activity of viral hepatitis C according to three main criteria: a) ALT activity in whole and diluted 1:10 blood serum; b) serological profile - Ig G antibodies to HCV proteins of classes NS4, NS5 and Ig M to the HCV nuclear antigen; 3) test the presence or absence of HCV RNA in the blood by polymerase chain reaction (PCR), and determine the genotype of the detected virus. Only after that it will be possible to talk about the need to treat hepatitis C. There are quite advanced drugs in this area today.

Question:Is it possible to breastfeed a child if the mother has hepatitis C?

Answer: It is necessary to test the mother's milk and blood for hepatitis C virus RNA. If the result is negative, you can breastfeed the baby.

Question:My brother is 20 years old. Hepatitis B was discovered in 1999. He is now diagnosed with hepatitis C. I have a question. Does one virus pass into another? Can it be cured? Is it possible to have sex and have children? He also has 2 lymph nodes on the back of his head, can he be tested for HIV? Didn't take drugs. Please, please answer me. Thanks. Tanya

Answer: You know, Tanya, with a high degree of probability, infection with two viruses (HBV and HCV) occurs precisely when injecting drugs. Therefore, first of all, it is necessary to clarify this situation with the brother and, if necessary, recover from drug addiction. Drugs are a cofactor that accelerates the adverse course of hepatitis. It is advisable to be tested for HIV. One virus does not pass into another. Chronic viral hepatitis B and C are treated today and sometimes quite successfully. Sex life - with a condom. You can have children after treatment.

Question:How is the hepatitis A virus transmitted?

Answer: The hepatitis A virus is transmitted from person to person by the fecal-oral route. This means that a person with hepatitis A is shedding viruses in their stool that, if not properly maintained, can get into food or water and infect another person. Hepatitis A is often referred to as "dirty hand disease".

Question:What are the symptoms of viral hepatitis A?

Answer: Often, viral hepatitis A is asymptomatic, or under the guise of another disease (for example, gastroenteritis, flu, colds), but, as a rule, some of the following symptoms may indicate the presence of hepatitis: weakness, fatigue, drowsiness, tearfulness and irritability in children; decreased or lack of appetite, nausea, vomiting, bitter belching; discolored feces; fever up to 39°C, chills, sweating; pain, feeling of heaviness, discomfort in the right hypochondrium; darkening of urine - occurs a few days after the first signs of hepatitis appear; jaundice (the appearance of a yellow color of the sclera of the eyes, body skin, oral mucosa), as a rule, appears a week after the onset of the disease, bringing some relief to the patient's condition. Often there are no signs of jaundice in hepatitis A at all.

Hepatitis is an inflammatory disease of the liver, due to damage to the liver tissues, a significant aggravation of the general condition of the body occurs. With an asymptomatic course of the disease and in the absence of timely treatment, hepatitis becomes chronic and eventually leads to cirrhosis of the liver and cancer.

When it enters the human body, the hepatitis virus infects the liver tissues, causes inflammation in them, and then there is a gradual replacement of the liver parenchyma with connective tissue. During this period, the main functions of the body are violated. Thus, the liver ceases to produce enzymes necessary for blood clotting and the digestive process. In the blood, the level of bilirubin (bile pigment) rises, jaundice appears. Most clearly, it manifests itself on the skin, mucous membrane of the soft palate and sclera.

Due to a violation of blood clotting, with the slightest blows, serious hematomas appear, there is a threat of internal bleeding. In the absence of proper treatment or a severe course of the disease, liver cells are affected more and more, the set of symptoms becomes brighter, the liver increases in size and completely ceases to perform its functions. Hepatitis in this stage is fatal.

Types of hepatitis

Currently, there are several types of viral hepatitis:

• hepatitis A. This is the most common type of virus, which has the most favorable picture of the course of the disease. Its symptoms and signs appear a week to two months after infection of the body. This form of hepatitis in rare cases becomes chronic, sometimes ends with a complete self-healing of the body;
• hepatitis b. This is a dangerous form of hepatitis, which is accompanied by severe symptoms. It requires mandatory treatment in a hospital with the use of a full range of drugs, adherence to a strict diet, as well as the abandonment of bad habits. In 80% of cases, hepatitis B ends with a complete cure of a person from the virus. It is possible to protect yourself from the disease with the help of vaccination;
• hepatitis C. This is the most severe form of the disease, which is often accompanied by viral hepatitis of other groups. There is currently no effective vaccine for hepatitis C. The disease is difficult to treat and in every 7th infected, it leads to chronic hepatitis with subsequent occurrence of cirrhosis of the liver and cancer;
• hepatitis D. This is another form of viral hepatitis that is similar in course to group B hepatitis. The difference in viruses is the presence of a delta agent;
• hepatitis E. In terms of the totality of symptoms, this infection is similar to hepatitis form A. The disease can also be completely cured with timely access to specialists. If it develops into a chronic stage, it affects not only the liver, but also the kidneys. This form is dangerous for women in the last months of pregnancy.

Also, viral hepatitis differs in the form of the course of the disease:

• acute hepatitis;
• chronic hepatitis.

Acute hepatitis most often manifests itself as obvious symptoms and signs of the disease, chronic disease is considered when the virus is not treatable for 6 months.

Causes

The main causes of hepatitis:

• viral infection;
• alcohol addiction;
• drug intoxication.

In more rare cases, hepatitis virus is caused by other infections, such as cytomegalovirus, herpes, etc.

Hepatitis groups A and E most often enters the body through the gastrointestinal tract. This is facilitated by:

• unprocessed fruits and vegetables;
• unwashed hands;
• contaminated water or food.

Viruses of other groups enter the human body mainly through the blood. The disease is transmitted:

• during childbirth from mother to child;
• during sexual intercourse;
• during transfusion of infected blood and its products;
• when using non-sterile syringes and medical instruments;
• during the use of non-sterile needles in tattoo parlors and untreated manicure tools.

Autoimmune causes of hepatitis of different groups are also distinguished, but what provokes such a reaction of the body is currently unknown by scientists. In the case of an autoimmune reaction, the body produces antibodies to the cells and tissues of the liver. This provokes the development of the disease and aggravates its further course.

Viral hepatitis: symptoms and signs of the disease

Symptoms and signs of acute hepatitis

The most obvious manifestations of hepatitis are jaundice of the skin, eyeballs and mucous membrane of the upper palate. In rare cases, the skin, as well as the sclera, may not change its color, but jaundice always affects the soft palate.

In addition, the patient may observe:

• an increase in body temperature observed for several weeks;
• headache;
• general fatigue and fatigue;
• loss of appetite;
• nausea, vomiting and diarrhea;
• the appearance of an unpleasant bitter taste in the mouth;
• pain in the right hypochondrium;
• spider veins on the skin;
• frequent nosebleeds, easy bruising;
• darkening of urine and discoloration of feces.

Hepatitis: signs of a chronic form

During the transition of hepatitis to a chronic form, the symptoms remain the same, but their severity decreases. In addition, there are:

• nausea;
• loss of appetite;
• periodic vomiting and diarrhea;
• general fatigue and decreased performance;
• gradual weight loss.

In the absence of proper treatment of hepatitis of different groups, signs of oncological diseases and cirrhosis of the liver are added to these symptoms.

Hepatitis: diagnostic methods

As a rule, hepatitis is diagnosed during the patient's visit to the doctor with complaints or during preventive examinations.

As part of a regular appointment with a therapist or gastroenterologist, a specialist performs palpation of the liver area. With hepatitis, it always increases in size.

In addition to the survey, history taking and palpation, materials are taken for laboratory tests.

The standard framework for diagnosing hepatitis involves:

• clinical analysis of blood, urine and feces;
• biochemical blood test
• PCR diagnostics of viral hepatitis
• Fibrotest and Fibromax (determination of the degree of liver fibrosis).

In the course of research, the belonging of the virus to one of the groups of hepatitis and its amount (viral load) is determined.

An ultrasound examination of the abdominal organs is also mandatory.

In some cases, you may need:

• study of the hepatic ducts and bile ducts (cholegraphy);
• puncture biopsy of the liver.

Hepatitis: courses of treatment

Treatment of acute forms

Acute hepatitis should be treated immediately. The sooner it is started, the greater the likelihood of a full recovery.

Treatment of any form of hepatitis in the acute period is always carried out within the hospital. The main functions of drug treatment:

• body detoxification;
• the fight against the virus that provoked the development of the disease;
• relief or complete suppression of inflammatory processes in the liver.

The drugs are prescribed both intravenously and orally. Also, vitamin complexes are prescribed for patients with hepatitis, which necessarily include: calcium, potassium, manganese. At the discretion of the doctor, oxygen therapy may be included in the course of treatment of hepatitis of different groups.

During treatment, diet No. 5A is mandatory (to reduce the load on the liver).

Treatment of viral forms of hepatitis involves hospitalization of the patient in the infectious diseases department, in case of a toxic form of hepatitis, treatment is carried out in the toxicology department.

Treatment of chronic hepatitis

Chronic hepatitis involves constant monitoring of the state of the body throughout life. To do this, it is necessary to regularly perform a number of laboratory and instrumental diagnostic procedures.

Treatment of hepatitis of different groups is carried out in courses with mandatory breaks. When drugs are not taken, the patient is prescribed a mandatory diet No. 5. During periods of exacerbation of hepatitis, diet No. 5A is prescribed.

Chronic hepatitis, depending on the causes of the disease, involves taking the following drugs:

• hepatoprotectors that have a beneficial effect on liver cells - hepatocytes;
• vitamin complexes;
• antiviral drugs;
• immunosuppressants and corticosteroids, in case of autoimmune hepatitis.

It is mandatory to carry out the procedure of detoxification of the body.

The patient must give up alcohol and smoking, which only aggravate the condition of the liver tissues. Physical activity during the period of normalization of the state is allowed, but moderate, so as not to cause overwork of the body.

In the practice of treating hepatitis of various forms, cases when the disease develops rapidly (from the moment of infection and the onset of symptoms to global liver damage, there is little time) are quite rare.

Hepatitis: disease prevention

Compliance with preventive measures can partially protect the body from hepatitis, as well as prevent periods of exacerbation in those who are already sick. Disease prevention includes:

• observance of hygiene rules, it is necessary to wash hands with soap before each meal;
• proper processing of food products;
• giving up alcohol and smoking.

Preventive measures also include vaccination. To date, during the first years of life, children are subject to mandatory vaccination against hepatitis B. This allows you to protect the body from damage to the liver by this virus.

It would seem how much information accumulates around modern man. Including in the field of his health, potential risks, personal safety rules and the use of drugs. Nevertheless, not all people know that the types of hepatitis are far from being limited to all known A, B and C. Further alphabetically, the literation of the virus continues. Another thing is that these forms of hepatitis are much less common, and do not carry such dangerous and even fatal complications as the first ones. Nevertheless, to have information about the variability of this disease is simply necessary. It is a personal and community culture of hygiene and health.

Viral hepatitis E - what is it? Such a virus from the genus Calicivirus is one of the varieties of infectious diseases that destroy liver cells, the causative agent of which is considered to be an RNA-containing virus. Compared with other types of hepatitis, this virus is less resistant to environmental conditions, easily tolerates low temperatures up to 20 degrees, but when exposed to temperatures below zero, it dies. It can also be neutralized with solutions containing iodine and chlorine.

According to statistical centers, the disease has a progressive spread in countries where the availability of clean drinking water is a major problem. These include India, Tajikistan, Uzbekistan, Bolivia, Mexico and other tropical regions where hepatitis E can spread.

How is the pathogen transmitted?

Consider common cases of transmission of the pathogen. It is important to know that the virus can be transmitted exclusively by the oral-fecal route, so it is necessary to pay special attention to the water consumed and raw shellfish from infected water bodies on vacation. It is worth noting that pregnant women most often face especially severe consequences of the disease, and it is they who are much more easily prone to immune openness to the E virus than other categories. This can cause transmission of the virus to the baby. In childhood, this disease usually does not occur.

The disease can be caught from infected dishes and other household items, but these cases are quite rare. The source and custodian of the virus in all cases are sick patients.

Symptoms and consequences

The duration of the disease can be about one and a half to two months. This is similar to the hepatitis A virus and hepatitis E. Symptoms may not appear immediately, so their knowledge is a particularly important factor for treatment and diagnosis. Headache, dizziness, loss of appetite and general weakness of the body for a week and a half are signs of a preicteric period. The danger here is that symptoms such as nausea and various intestinal disorders are usually perceived by patients as temporary inconveniences, which subsequently leads to complications of the disease.

The development of the disease proceeds gradually and the next stage after the preicteric period is the decline in the general condition of the patient's body. At the same time, there is no increase in body temperature and heaviness in the liver, which characterizes its damage. Signs will be itching, nausea, pain, discoloration of urine and feces, yellowing of the sclera. Typically, the presence of such symptoms lasts an average of 21 days, after which the recovery phase of the body begins within two months.

Complications of the virus can cause kidney failure, internal bleeding, and hemoglobinuria. In a low percentage are cases, the outcome of which is the progressive development of cirrhosis of the liver.

Particularly dangerous cases of infection occur in the last trimester of pregnancy, often the symptoms worsen immediately before labor, this can provoke intrauterine death of the baby. The fact is that childbirth can be dangerous due to violations of the liver and kidneys of the mother, as well as heavy uterine bleeding. In most of these cases, all this can lead to sad consequences - the death of the mother and baby.

Diagnostics

As with any viral disease, its diagnosis occupies the most important place in further treatment. When the first symptoms appear, often a person does not seek medical help due to the absence of clear signs of infection in the first days. The virus can be determined by a medical examination, which involves blood donation, in some cases an ultrasound and magnetic resonance imaging of the liver and a coagulogram are required.

In the presence of traces of the virus in the biochemistry of the patient's blood, a high level of bilirubin and the activity of liver transaminases are monitored. Using the PCR technique, doctors can detect IgM antibodies in the blood serum, which is a confirmation of the presence of the virus in a patient. Liver damage in this case is characterized by a clear increase in liver volume by an average of 3 centimeters.

Hepatitis E treatment

Treatment is carried out on the territory of isolated hospitals only for the group of patients who are at risk of complications of the virus - women in the 3rd trimester of pregnancy and patients with serious illnesses. Here, their treatment will primarily be aimed at preventing all kinds of consequences. For patients with a mild form, it is enough to adhere to a special diet and observe a rest and proper sleep regimen.

The diet in this case is the observance of a five-time diet and plenty of drinking in an amount of at least two liters per day. It is also worth excluding chocolate, cocoa, coffee, egg yolks, lard, it is necessary to avoid the use of various flavorings in the form of pepper, mustard, horseradish, onion and garlic. Mushroom broth and mushrooms will burden the normal functioning of the intestines, and alcohol consumption is necessarily reduced to zero.

In cases of a small degree of complication of the disease, the attending physician prescribes Enterosgel, Enterodez and other analogues. With frequent urge to vomit, a dropper with a glucose solution is placed, and with alcohol exposure to the liver, a dropper with the drug Heptral is placed. Cholestatic syndrome involves the appointment of Ursosan, Ursodex, as well as the vitamin complex A and E.

Treatment of severe hepatitis E involves being in a specialized department. Prevention of decreased liver and kidney function, as well as internal bleeding, involves the introduction of cryoplasma, the appointment of oxygen therapy and the use of protease inhibitors. In cases of severe complications in the form of internal hemorrhages, therapy with Trental and Dicinon is prescribed.

If a virus is detected in the blood of a pregnant woman at the initial stage of fetal development, medicine in this case, unfortunately, offers future parents to interrupt gestation. This primarily prevents further death of the fetus in utero and preserves the health of the woman. If a decision is made about labor, then doctors try as much as possible to make the process of giving birth to a baby as quick and painless as possible.

After treatment, with a favorable biochemical blood test, the patient can return to normal life at home, but for several months be monitored by a hepatologist and infectious disease specialist. It is worth noting that due to weakened immunity, patients undergoing therapy are contraindicated in all kinds of vaccinations and surgical intervention for six months. If there is an increased work of liver enzymes in the blood, the patient is prescribed Phosphogliv or Silimar, which are hepatoprotectors. An important factor for people suffering from the disease is its positive prognosis after undergoing appropriate therapy.