Hepatitis: all types, signs, transmission, chronic, how to treat, prevention. Types of hepatitis Variety of hepatitis and its treatment

Hepatitis C is an inflammation of the liver of a viral origin, clinical manifestations of which in most cases are significantly delayed in time or so little expressed that the patient himself may not notice that a “gentle” killer virus has settled in his body, as the hepatitis C virus (HCV) is commonly called.

Once upon a time, and this continued until the end of the 80s of the last century, doctors knew about the existence of a special form of hepatitis that did not fit into the concept of "Botkin's disease" or jaundice, but it was obvious that this was hepatitis that affects the liver no less than their own " brethren" (A and B). An unfamiliar species was called hepatitis neither A nor B, since its own markers were still unknown, and the proximity of pathogenesis factors was obvious. It was similar to hepatitis A in that it was transmitted not only parenterally, but suggested other routes of transmission. The similarity with hepatitis B, called serum hepatitis, was that it could also be infected by receiving someone else's blood.

At present, everyone knows that, called neither A nor B hepatitis, is open and well studied. This is hepatitis C, which in its prevalence is not only not inferior to the infamous, but also far exceeds it.

Similarities and differences

Botkin's disease was previously called any inflammatory liver disease associated with a certain pathogen. The understanding that Botkin's disease can represent an independent group of polyetiological pathological conditions, each of which has its own pathogen and the main route of transmission, came later.

Now these diseases are called hepatitis, but a capital letter of the Latin alphabet is added to the name according to the sequence of discovery of the pathogen (A, B, C, D, E, G). Patients often translate everything into Russian and indicate hepatitis C or hepatitis D. At the same time, the diseases assigned to this group are very similar in the sense that the viruses they cause have hepatotropic properties and, if they enter the body, affect the hepatobiliary system , each in its own way violating its functional abilities.

Different types of hepatitis are unequally prone to chronization of the process, which indicates the different behavior of viruses in the body.

Hepatitis C is considered the most interesting in this regard., which remained a mystery for a long time, but even now, being widely known, it leaves secrets and intrigues, since it does not make it possible to give an accurate forecast (it can only be assumed).

Inflammatory processes of the liver caused by various pathogens do not differ in relation to sex, therefore men are equally affected, and women. There was no difference in the course of the disease, however, it should be noted that in women during pregnancy, hepatitis can be more severe. In addition, the penetration of the virus in recent months or the active course of the process can adversely affect the health of the newborn.

If liver diseases of viral origin still have a clear similarity, then considering hepatitis C, it is advisable to touch on other types of hepatitis, otherwise the reader will think that only the “hero” of our article should be afraid. But through sexual contact, you can become infected with almost every species, although this ability is attributed more to hepatitis B and C, and therefore they are often referred to as sexually transmitted diseases. In this regard, other pathological conditions of the liver of viral origin are usually kept silent, since their consequences are not as significant as the consequences of hepatitis B and C, which are recognized as the most dangerous.

In addition, there are hepatitis of non-viral origin (autoimmune, alcoholic, toxic), which should also be touched upon, because one way or another, they are all interconnected and significantly aggravate each other.

How is the virus transmitted?

Depending on which way the virus could "run across" to a person and what things it will start to "do" in the body of a new "host", different types of hepatitis are distinguished. Some are transmitted in everyday life (through dirty hands, food, toys, etc.), appear quickly and pass, basically, without any consequences. Others, called parenteral, having the potential of chronicity, often remain in the body for life, destroying the liver to cirrhosis, and in some cases to primary liver cancer (hepatocarcinoma).

Thus, hepatitis according to the mechanism and routes of infection are divided into two groups:

• Having an oral-fecal transmission mechanism (A and E);
• Hepatitis, for which the blood-contact (hemopercutaneous), or, more simply, the path through the blood, is the main one (B, C, D, G - a group of parenteral hepatitis).

In addition to the transfusion of infected blood or flagrant non-compliance with the rules for medical manipulations associated with damage to the skin (the use of insufficiently processed instruments, for example, for acupuncture), often there is the spread of hepatitis C, B, D, G and in other cases:

1. Various fashionable procedures (tattoos, piercings, ear piercings) performed by a non-professional at home or in any other conditions that do not meet the requirements of the sanitary and epidemiological regime;
2. By using one needle for several people, this method is practiced by syringe addicts;
3. Transmission of the virus through sexual intercourse, which is most likely for hepatitis B, hepatitis C in such situations is transmitted much less frequently;
4. Cases of infection by the "vertical" route (from mother to fetus) are known. Active disease, acute infection in the last trimester, or HIV carriers greatly increase the risk of hepatitis.
5. Unfortunately, up to 40% of patients cannot remember the source that “gifted” the hepatitis B, C, D, G virus.

The hepatitis virus is not transmitted through breast milk, so women with hepatitis B and C can safely feed their baby without fear of infecting him.

We can agree that the fecal-oral mechanism, water, contact-household, being so interconnected, cannot exclude the possibility of transmitting the virus and sexually just as well as other types of hepatitis transmitted through the blood, have the ability to penetrate into another organism during sex.

Signs of an unhealthy liver

After infection, the first clinical signs of different forms of the disease appear at different times. For example, the hepatitis A virus declares itself in two weeks (up to 4), the causative agent of hepatitis B (HBV) is somewhat delayed and manifests itself in the interval from two months to six months. As for hepatitis C, it the pathogen (HCV) can detect itself after 2 weeks, after 6 months, or it can “hide” for years, turning a healthy person into a carrier and source of infection for a rather serious disease.

The fact that something is wrong with the liver can be guessed from the clinical manifestations of hepatitis:

• Temperature. With it and the phenomena of influenza infection, hepatitis A usually begins (headache, pain in the bones and muscles). The onset of HBV activation in the body is accompanied by subfebrile temperature, and with C-hepatitis it may not rise at all;
• Jaundice varying degrees of expression. This symptom appears a few days after the onset of the disease, and if its intensity does not increase, then the patient's condition usually improves. A similar phenomenon is most characteristic of hepatitis A, which cannot be said about hepatitis C, as well as toxic and alcoholic hepatitis. Here, a more saturated color is not attributed to signs of an impending recovery, rather, on the contrary: with a mild form of inflammation of the liver, jaundice may be absent altogether;
• Rashes and itching more characteristic of cholestatic forms of inflammatory processes in the liver, they are caused by the accumulation of bile acids in tissues due to obstructive lesions of the hepatic parenchyma and injury to the bile ducts;
• Decreased appetite;
• Heaviness in the right hypochondrium, possible enlargement of the liver and spleen;
• Nausea and vomiting. These symptoms are more characteristic of severe forms;
• Weakness, malaise;
• Joint pain;
• dark urine, dark beer-like , discolored feces - typical signs of any viral hepatitis;
• Laboratory indicators: liver function tests (AlT, AST, bilirubin), depending on the severity of the course, can increase several times, the number of platelets decreases.

During viral hepatitis, 4 forms are distinguished:

1. Easy, often characteristic of hepatitis C: jaundice is often absent, subfebrile or normal temperature, heaviness in the right hypochondrium, loss of appetite;
2. Medium: the above symptoms are more pronounced, there is pain in the joints, nausea and vomiting, there is practically no appetite;
3. heavy. All symptoms are present in a pronounced form;
4. Lightning (fulminant), which is not found in hepatitis C, but is very characteristic of hepatitis B, especially in the case of coinfection (HDV / HBV), that is, a combination of two viruses B and D that cause superinfection. The fulminant form is the most dangerous, because as a result of the rapid development of massive necrosis of the hepatic parenchyma, the death of the patient occurs.

Hepatitis, dangerous in everyday life (A, E)

In everyday life, first of all, liver diseases that have a predominantly fecal-oral route of transmission can lie in wait, and these are, as you know, hepatitis A and E, so you should dwell a little on their characteristic features:

Hepatitis A

Hepatitis A is a highly contagious infection. Previously, it was simply called infectious hepatitis (when B was serum, and others were not yet known). The causative agent of the disease is a small but incredibly resistant virus containing RNA. Although epidemiologists note susceptibility to the pathogen as universal, it is predominantly children who have stepped over the age of one who are ill. Infectious hepatitis, triggering inflammatory and necrobiotic processes in the hepatic parenchyma, giving symptoms of intoxication (weakness, fever, jaundice, etc.), as a rule, ends with recovery with the development of active immunity. The transition of infectious hepatitis to a chronic form practically does not occur.

Video: hepatitis A in the program “Live healthy!”

Hepatitis E

Its virus also belongs to RNA-containing ones, it “feels good” in the aquatic environment. It is transmitted from a sick person or carrier (in the latent period), there is a high probability of infection through food that has not undergone heat treatment. Mostly young people (15-30 years old) living in the countries of Central Asia and the Middle East get sick. In Russia, the disease is extremely rare. The contact-household route of transmission is not excluded. Cases of chronicity or chronic carriage have not yet been established or described.

Hepatitis B and dependent hepatitis D virus

hepatitis virusB(HBV), or serum hepatitis, is a DNA-containing pathogen with a complex structure that prefers liver tissue for its replication. A tiny dose of infected biological material is enough to transmit the virus, why this form passes so easily not only during medical manipulations, but also during sexual intercourse or in a vertical way.

The course of this viral infection is multivariate. It may be limited to:

• Carrying;
• Give acute liver failure with the development of a fulminant (fulminant) form, often taking the life of the patient;
• When the process is chronic, it can lead to the development of cirrhosis or hepatocarcinoma.

The incubation period of this form of the disease lasts from 2 months to six months, and the acute period in most cases has symptoms characteristic of hepatitis:

1. Fever, headache;
2. Decreased efficiency, general weakness, malaise;
3. Pain in the joints;
4. Disorder of the function of the digestive system (nausea, vomiting);
5. Sometimes rashes and itching;
6. Heaviness in the right hypochondrium;
7. Enlargement of the liver, sometimes - the spleen;
8. Jaundice;
9. A typical sign of liver inflammation is dark urine and discolored feces.

Very dangerous and unpredictable combinations of HBV with the causative agent of hepatitis D (HDD), which was previously called delta infection - a unique virus that is invariably dependent on HBV.

The transmission of two viruses can be simultaneous, which leads to the development co-infections. If the D-causative agent later joined the HBV-infected liver cells (hepatocytes), then we will talk about superinfection. A serious condition, which was the result of such a combination of viruses and the clinical manifestation of the most dangerous type of hepatitis (fulminant form), often threatens to be fatal in a short time.

Video: hepatitis B

The most significant parenteral hepatitis (C)

viruses of various hepatitis

The “famous” C-hepatitis virus (HCV, HCV) is a microorganism with unprecedented heterogeneity. The causative agent contains a single-stranded positively charged RNA encoding 8 proteins (3 structural + 5 non-structural), to each of which corresponding antibodies are produced during the course of the disease.

The hepatitis C virus is quite stable in the external environment, tolerates freezing and drying well, but is not transmitted in negligible doses, which explains the low risk of infection by the vertical route and during sexual intercourse. A low concentration of an infectious agent in the secrets released during sex does not provide the conditions for the transmission of the disease, unless other factors are present that "help" the virus "move". These factors include concomitant bacterial or viral infections (HIV in the first place), which reduce immunity, and a violation of the integrity of the skin.

The behavior of HCV in the body is difficult to predict. Having penetrated into the blood, it can circulate for a long time at a minimum concentration, forming in 80% of cases a chronic process that can eventually lead to severe liver damage: cirrhosis and primary hepatocellular carcinoma (cancer).

The absence of symptoms or a slight manifestation of signs of hepatitis is the main feature of this form of inflammatory liver disease, which remains unrecognized for a long time.

However, if the pathogen nevertheless "decided" to immediately begin damaging the liver tissue, then the first symptoms may already appear after 2-24 weeks and last 14-20 days.

The acute period often proceeds in a mild anicteric form, accompanied by:

• weakness;
• Joint pains;
• indigestion;
• Slight fluctuations in laboratory parameters (liver enzymes, bilirubin).

The patient feels some heaviness on the side of the liver, sees a change in the color of urine and feces, however, pronounced signs of hepatitis, even in the acute phase, are generally not typical for this species and are rare. Diagnosis of C-hepatitis becomes possible when the corresponding antibodies are detected by the method (ELISA) and the RNA of the pathogen by conducting (polymerase chain reaction).

Video: film about hepatitis C

What is Hepatitis G

Hepatitis G is considered the most mysterious today. It is caused by a virus containing single-stranded RNA. The microorganism (HGV) has 5 varieties of genotypes and is structurally very similar to the causative agent of C-hepatitis. One (first) of the genotypes chose the west of the African continent for its habitat and is not found anywhere else, the second has spread throughout the globe, the third and fourth “liked” Southeast Asia, and the fifth settled in southern Africa. Therefore, the inhabitants of the Russian Federation and the entire post-Soviet space have "chance" to meet with a representative of type 2.

For comparison: a map of the spread of hepatitis C

In epidemiological terms (sources of infection and transmission routes), G-hepatitis resembles other parenteral hepatitis. As for the role of HGV in the development of inflammatory diseases of the liver of infectious genesis, it is not defined, the opinions of scientists differ, and the data of the medical literature remain contradictory. Many researchers associate the presence of the pathogen with the fulminant form of the disease, and also tend to think that the virus plays a role in the development of autoimmune hepatitis. In addition, a frequent combination of HGV with hepatitis C (HCV) and B (HBV) viruses was noticed, that is, the presence of coinfection, which, however, does not aggravate the course of monoinfection and does not affect the immune response during treatment with interferon.

HGV monoinfection usually proceeds in subclinical, anicteric forms, however, as the researchers note, in some cases it does not pass without a trace, that is, even in a latent state it can lead to morphological and functional changes in the hepatic parenchyma. There is an opinion that a virus, like HCV, can hide, and then strike no less, that is, transform into cancer or hepatocellular carcinoma.

When does hepatitis become chronic?

Chronic hepatitis is understood as a diffuse-dystrophic process of an inflammatory nature, localized in the hepatobiliary system and caused by various etiological factors (viral or other origin).

The classification of inflammatory processes is complex, however, like other diseases, besides, there is still no universal methodology, therefore, in order not to load the reader with incomprehensible words, we will try to say the main thing.

Given that in the liver, for certain reasons, a mechanism is triggered that causes degeneration of hepatocytes (liver cells), fibrosis, necrosis of the hepatic parenchyma and other morphological changes that lead to a violation of the functional abilities of the organ, they began to distinguish:

1. Autoimmune hepatitis, characterized by extensive damage to the liver, and, therefore, an abundance of symptoms;
2. Cholestatic hepatitis, caused by a violation of the outflow of bile and its stagnation as a result of an inflammatory process affecting the bile ducts;
3. Chronic hepatitis B, C, D;
4. Hepatitis caused by the toxic effects of drugs;
5. Chronic hepatitis of unknown origin.

It is obvious that the classified etiological factors, associations of infections (co-infection, superinfection), phases of the chronic course, do not fully provide a complete picture of inflammatory diseases of the main detoxification organ. There is no information about the reaction of the liver to the damaging effects of adverse factors, toxic substances and new viruses, that is, nothing is said about very significant forms:

• Chronic alcoholic hepatitis, which is the source of alcoholic cirrhosis;
• Nonspecific reactive form of chronic hepatitis;
• Toxic hepatitis;
• Chronic hepatitis G, discovered later than others.

For this reason, it was determined 3 forms of chronic hepatitis based on morphological features:

1. Chronic persistent hepatitis (CPH), which, as a rule, is inactive, manifests itself clinically for a long time, infiltration is observed only in the portal tracts, and only the penetration of inflammation into the lobule will indicate its transition to the active phase;
2. Chronic active hepatitis (CAH) is characterized by the transition of the inflammatory infiltrate from the portal tracts into the lobule, which is clinically manifested by varying degrees of activity: slight, moderate, pronounced, pronounced;
3. Chronic lobular hepatitis, due to the predominance of the inflammatory process in the lobules. The defeat of several lobules with multibular necrosis indicates a high degree of activity of the pathological process (necrotizing form).

Given the etiological factor

Inflammatory process in the liver refers to polyetiological diseases, as it is caused by a number of reasons:

The classification of hepatitis has been revised many times, but experts have not come to a consensus. Currently, only 5 types of liver damage associated with alcohol have been identified, so it hardly makes sense to list all the options, because not all viruses have been discovered and studied yet, and not all forms of hepatitis have been described. Nevertheless, it may be worthwhile to acquaint the reader with the most understandable and accessible division of chronic inflammatory liver diseases according to etiological grounds:

1. Viral hepatitis, caused by certain microorganisms (B, C, D, G) and uncertain - poorly studied, unconfirmed by clinical data, new forms - F, TiTi;
2. autoimmune hepatitis(types 1, 2, 3);
3. Inflammation of the liver (drug-induced), often detected in "chronics", associated with the long-term use of a large number of drugs or the use of drugs that show severe aggression to hepatocytes for a short time;
4. Toxic hepatitis due to the influence of hepatotropic toxic substances, ionizing radiation, alcohol surrogates and other factors;
5. Alcoholic hepatitis, which, together with the drug-induced one, is classified as a toxic form, but in other cases is considered separately as a social problem;
6. Metabolic that occurs in congenital pathology - disease Konovalov-Wilson. The reason for it lies in the hereditary (autosomal recessive type) violation of copper metabolism. The disease is extremely aggressive, quickly ends with cirrhosis and death of the patient in childhood or young age;
7. Cryptogenic hepatitis, the cause of which, even after a thorough examination, remains unknown. The disease is characterized by progression, requires monitoring and control, as it often leads to severe liver damage (cirrhosis, cancer);
8. Nonspecific reactive hepatitis (secondary). It is often a companion of various pathological conditions: tuberculosis, renal pathology, pancreatitis, Crohn's disease, ulcerative processes in the gastrointestinal tract and other diseases.

Considering that some types of hepatitis are very related, widespread and quite aggressive, it makes sense to give a few examples that are likely to be of interest to readers.

Chronic form of hepatitis C

An important question regarding hepatitis C is how to live with it and how many years they live with this disease. After learning about their diagnosis, people often panic, especially if they receive information from unverified sources. However, this is not necessary. With C-hepatitis they live a normal life, but they have it in mind in terms of some diet (you should not load the liver with alcohol, fatty foods and substances toxic to the organ), increasing the body's defenses, that is, immunity, being careful at home and when sexual contacts. You just need to remember that human blood is contagious.

As for life expectancy, there are many cases when hepatitis, even among lovers of good food and drink, has not shown itself in 20 years, so you should not bury yourself prematurely. The literature describes both cases of recovery and the reactivation phase, which occurs after 25 years, and, of course, a sad outcome - cirrhosis and cancer. Which of the three groups you get into sometimes depends on the patient, given that there is currently a drug - synthetic interferon.

Hepatitis associated with genetics and immune response

Autoimmune hepatitis, which occurs in women 8 times more often than in men, is characterized by rapid progression with a transition to portal hypertension, renal failure, cirrhosis, and ends with the death of the patient. In accordance with the international classification, autoimmune hepatitis can occur in the absence of blood transfusions, liver damage from alcohol, toxic poisons, and drugs.

The cause of autoimmune liver damage is believed to be a genetic factor. Positive associations of the disease with antigens of the major histocompatibility complex (HLA leukocyte system), in particular, HLA-B 8 , which is recognized as an antigen of hyperimmunoreactivity, were revealed. However, many may have a predisposition, but not all get sick. Some drugs (for example, interferon), as well as viruses can provoke an autoimmune lesion of the hepatic parenchyma:

• Epstein-Barra;
• Corey;
• Herpes 1 and 6 types;
• Hepatitis A, B, C.

It should be noted that about 35% of patients who were overtaken by AIH already had other autoimmune diseases.

The vast majority of cases of autoimmune hepatitis begin as an acute inflammatory process (weakness, loss of appetite, severe jaundice, dark urine). After a few months, signs of an autoimmune nature begin to form.

Sometimes AIT develops gradually with a predominance of symptoms of asthenovegetative disorders, malaise, heaviness in the liver, slight jaundice, rarely the onset is manifested by a significant increase in temperature and signs of another (extrahepatic) pathology.

The following manifestations may indicate a detailed clinical picture of AIH:

1. Severe malaise, loss of working capacity;
2. Heaviness and pain on the side of the liver;
3. Nausea;
4. Skin reactions (capillaritis, telangiectasia, purpura, etc.)
5. Itching of the skin;
6. Lymphadenopathy;
7. Jaundice (intermittent);
8. Hepatomegaly (enlargement of the liver);
9. Splenomegaly (enlargement of the spleen);
10. In women, the absence of menstruation (amenorrhea);
11. In men - an increase in the mammary glands (gynecomastia);
12. Systemic manifestations (polyarthritis),

Often AIH is a companion of other diseases: diabetes mellitus, diseases of the blood, heart and kidneys, pathological processes localized in the organs of the digestive system. In a word, autoimmune - it is autoimmune and can manifest itself in any, far from hepatic pathology.

Any liver "does not like" alcohol ...

Alcoholic hepatitis (AH) can be considered as one of the forms of toxic hepatitis, because they have one reason - a negative effect on the liver of irritating substances that have a detrimental effect on hepatocytes. Hepatitis of alcoholic origin is characterized by all the typical signs of inflammation of the liver, which, however, can take place in a sharply progressive acute form or have a persistent chronic course.

Most often, the onset of an acute process is accompanied by signs:

• Intoxication: nausea, vomiting, diarrhea, aversion to food;
• weight loss;
• Jaundice without itching or with itching due to the accumulation of bile acids in the cholestatic form;
• A significant increase in the liver with its compaction and soreness in the right hypochondrium;
• Tremor;
• Hemorrhagic syndrome, renal failure, hepatic encephalopathy with fulminant form. Hepatorenal syndrome and hepatic coma can cause the death of the patient.

Sometimes in the acute course of alcoholic hepatitis, a significant increase in body temperature is observed, bleeding and the addition of bacterial infections are possible, causing inflammation of the respiratory and urinary tract, gastrointestinal tract, etc.

Chronic persistence of hypertension is oligosymptomatic and often reversible if a person manages to stop in time. Otherwise the chronic form becomes progressive with transformation into cirrhosis.

… And other toxic substances

For the development of acute toxic hepatitis a single dose of a small dose of a toxic substrate is sufficient, which has hepatotropic properties, or a large number of substances that are less aggressive towards the liver, for example, alcohol. Acute toxic inflammation of the liver manifests itself by its significant increase and pain in the right hypochondrium. Many people mistakenly believe that the organ itself hurts, but this is not so. Pain is caused by stretching of the liver capsule due to an increase in its size.

With toxic liver damage, the symptoms of alcoholic hepatitis are characteristic, however, depending on the type of poisonous substance, they can be more pronounced, for example:

1. Feverish state;
2. progressive jaundice;
3. Vomiting with an admixture of blood;
4. Nose and gingival bleeding, hemorrhages on the skin due to damage to the vascular walls by toxins;
5. Mental disorders (excitation, lethargy, disorientation in space and time).

Chronic toxic hepatitis develops over a long period of time when small but constant doses of toxic substances are ingested. If the cause of the toxic effect is not eliminated, then after years (or only months) complications can be obtained in the form cirrhosis of the liver and liver failure.

Markers for early diagnosis. How to deal with them?

Viral hepatitis markers

Many have heard that the first step in the diagnosis of inflammatory liver diseases is a study on markers. Having received a piece of paper with the answer to the analysis for hepatitis, the patient is unable to understand the abbreviation if he does not have a special education.

Viral hepatitis markers determined with the help of and, inflammatory processes of non-viral origin are diagnosed by other methods, not excluding ELISA. In addition to these methods, biochemical tests, histological analysis (based on liver biopsy material) and instrumental studies are carried out.

However, we should return to the markers:

• Infectious hepatitis A antigen can be determined only in the incubation period and only in the feces. In the phase of clinical manifestations, class M immunoglobulins (IgM) begin to be produced and appear in the blood. HAV-IgG synthesized somewhat later indicate recovery and the formation of lifelong immunity, which these immunoglobulins will provide;
• The presence or absence of the causative agent of viral hepatitis B determined by the “Australian antigen” - HBsAg (surface antigen) detected from time immemorial (though not by modern methods) and the inner shell antigens - HBcAg and HBeAg, which became possible to identify only with the advent of laboratory diagnostics by ELISA and PCR. HBcAg is not detected in the blood serum, it is determined using antibodies (anti-HBc). To confirm the diagnosis of HBV and monitor the course of the chronic process and the effectiveness of treatment, it is advisable to use PCR diagnostics (detection of HBV DNA). The patient's recovery is evidenced by the circulation of specific antibodies (anti-HBs, total anti-HBC, anti-HBe) in the serum of his blood in the absence of the antigen itselfHBsAg;
• Diagnosis of C-hepatitis without detection of virus RNA (PCR) is difficult. IgG antibodies, having appeared at the initial stage, continue to circulate throughout life. The acute period and the reactivation phase are indicated by class M immunoglobulins (IgM), the titer of which increases. The most reliable criterion for diagnosing, monitoring and controlling the treatment of hepatitis C is the determination of virus RNA by PCR.
• The main marker for the diagnosis of hepatitis D(delta infection) class G immunoglobulins (anti-HDD-IgG) are considered to persist throughout life. In addition, to clarify monoinfection, super (association with HBV) or coinfection, an analysis is carried out that detects class M immunoglobulins, which remain forever with superinfection, and disappear with coinfection in about six months;
• The main laboratory study of hepatitis G is the determination of viral RNA using PCR. In Russia, antibodies to HGV are detected using specially designed ELISA kits that can detect immunoglobulins to the E2 envelope protein, which is a component of the pathogen (anti-HGV E2).

Hepatitis markers of non-viral etiology

Diagnosis of AIH is based on the detection of serological markers (antibodies):

In addition, the diagnosis uses the determination of biochemical parameters: protein fractions (hypergammaglobulinemia), liver enzymes (significant activity of transaminases), as well as the study of the histological material of the liver (biopsy).

Depending on the type and ratio of markers, types of AIH are distinguished:

• The first is more often manifested in adolescents or in adolescence, or “waits” up to 50;
• The second most often affects childhood, has high activity and resistance to immunosuppressors, quickly transforms into cirrhosis;
• The third type used to stand out as a separate form, but now it is no longer considered in this perspective;
• Atypical AIH representing cross-hepatic syndromes (primary biliary cirrhosis, primary sclerosing cholangitis, chronic viral hepatitis).

Direct evidence of the alcoholic origin of liver damage does not exist, therefore, there is no specific analysis for hepatitis associated with the use of ethanol, however, some factors that are very characteristic of this pathology have been noticed. For example, ethyl alcohol, which acts on the hepatic parenchyma, promotes the release of alcoholic hyaline called Mallory bodies, which leads to the appearance of ultrastructural changes in hepatocytes and stellate reticuloepithelial cells, indicating the degree of negative impact of alcohol on the "long-suffering" organ.

In addition, some biochemical indicators (bilirubin, liver enzymes, gamma fraction) indicate alcoholic hepatitis, but their significant increase is characteristic of many pathological conditions of the liver when exposed to other toxic poisons.

Clarification of anamnesis, identification of a toxic substance that affected the liver, biochemical tests and instrumental examination are the main criteria for the diagnosis of toxic hepatitis.

Can hepatitis be cured?

Treatment of hepatitis depends on the etiological factor that caused the inflammatory process in the liver. Of course , hepatitis of alcoholic or autoimmune origin usually requires only symptomatic, detoxification and hepatoprotective treatment .

Viral hepatitis A and E, although of infectious origin, are acute and, as a rule, do not give chronicity. The human body in most cases is able to resist them, therefore it is not customary to treat them, except that sometimes symptomatic therapy is used to eliminate headaches, nausea, vomiting, and diarrhea.

The situation is more complicated with inflammation of the liver caused by viruses B, C, D. However, given that delta infection practically does not occur on its own, but follows HBV obligately, it is necessary to treat B-hepatitis first of all, but with increased doses and lengthened course.

It is not always possible to cure hepatitis C, although the chances of a cure nevertheless appeared with the use of interferons-alpha (a component of the immune defense against viruses). In addition, combined schemes are currently used to enhance the effect of the main drug, involving combinations of prolonged interferons with antiviral drugs, for example, ribavirin or lamivudine.

It should be noted that not every immune system adequately responds to the intervention of immunomodulators introduced from the outside into its work, therefore, interferon, for all its advantages, can produce undesirable effects. In this regard, interferon therapy is carried out under the close supervision of a doctor with regular laboratory control over the behavior of the virus in the body. If it is possible to completely eliminate the virus, then this can be considered a victory over it. Incomplete elimination, but the cessation of replication of the pathogen is also a good result, allowing you to "lull the enemy's vigilance" and delay the likelihood of hepatitis turning into cirrhosis or hepatocellular carcinoma for many years.

How to prevent hepatitis?

The expression “It is easier to prevent a disease than to cure” has long been hackneyed, but not forgotten, since many troubles can really be avoided if preventive measures are not neglected. As for viral hepatitis, special care will not be superfluous here either. Compliance with the rules of personal hygiene, the use of specific protective equipment when in contact with blood (gloves, fingertips, condoms) in other cases may well become an obstacle to the transmission of infection.

Medical workers in the fight against hepatitis specifically develop action plans and follow them every point. Thus, in order to prevent the incidence of hepatitis and the transmission of HIV infection, as well as reduce the risk of occupational infection, the Sanitary and Epidemiological Service recommends adhering to certain prevention rules:

1. Prevent "syringe hepatitis" common among people who use drugs. To this end, organize points for the free distribution of syringes;
2. Prevent any possibility of transmission of viruses during blood transfusions (organization of PCR laboratories at stations for transfusion and quarantine storage of drugs and components obtained from donor blood at ultra-low temperatures);
3. Minimize the likelihood of occupational infection to the maximum, using all available personal protective equipment and complying with the requirements of the sanitary and epidemiological supervision authorities;
4. Pay special attention to departments with an increased risk of infection (hemodialysis, for example).

We should not forget about the precautions for sexual intercourse with an infected person. The chance of sexual transmission of hepatitis C virus is negligible, but for HBV it increases significantly, especially in cases associated with the presence of blood, such as menstruation in women or genital trauma in one of the partners. If you can’t do without sex, then at least you shouldn’t forget about a condom.

There is a higher chance of becoming infected in the acute phase of the disease, when the concentration of the virus is especially high, so for such a period it would be better to abstain from sexual relations altogether. Otherwise, carrier people live a normal life, give birth to children, remembering their peculiarities, and be sure to warn doctors (ambulance, dentist, when registering at a antenatal clinic and in other situations that require increased attention) about what is included in risk group for hepatitis.

Increasing resistance to hepatitis

Hepatitis prevention also includes vaccination against a viral infection. Unfortunately, a vaccine against hepatitis C has not yet been developed, but available vaccines against hepatitis A and B have significantly reduced the incidence of these types.

The hepatitis A vaccine is given to children 6-7 years of age (usually before school entry). A single use provides immunity for a year and a half, revaccination (re-vaccination) extends the protection period to 20 years or more.

The HBV vaccine is administered to newborn babies still in the maternity hospital without fail, for children who for some reason have not been vaccinated, or for adults there are no age restrictions. To ensure a full-fledged immune response, the vaccine is administered three times over several months. The vaccine was developed on the basis of the surface ("Australian") HBs antigen.

The liver is a delicate organ

Treating hepatitis on your own means taking full responsibility for the outcome of the inflammatory process in such an important organ, therefore, in the acute period or in the chronic course, it is better to coordinate any of your actions with the doctor. After all, anyone understands: if the residual effects of alcoholic or toxic hepatitis can neutralize folk remedies, then they are unlikely to cope with the rampant virus in the acute phase (meaning HBV and HCV). The liver is a delicate organ, albeit a patient one, so home treatment should be thoughtful and reasonable.

Hepatitis A, for example, does not require anything other than diet, which is necessary, in general, in the acute phase of any inflammatory process. Nutrition should be as sparing as possible, since the liver passes everything through itself. In the hospital, the diet is called the fifth table (No. 5), which is also observed at home for up to six months after the acute period.

In chronic hepatitis, of course, it is not advisable to offer strict adherence to a diet for years, but it would be right to remind the patient that one should not irritate the organ once again. It is advisable to try to eat boiled foods, exclude fried, fatty, pickled, limit salty and sweet. Strong broths, strong and weak alcoholic and carbonated drinks, the liver also does not accept.

Can folk remedies save?

Folk remedies in other cases help the liver cope with the load that has fallen on it, raise natural immunity, and strengthen the body. However they cannot cure hepatitis, therefore, to engage in amateur activities, to treat liver inflammation without a doctor is unlikely to be correct, because each of the types has its own characteristics that must be taken into account in the fight against it.

"Blind" sounding

Often the attending physician himself, when discharging a convalescent from the hospital, recommends simple home procedures for him. For example - "blind" probing, which is done on an empty stomach in the morning. The patient drinks 2 chicken yolks, throwing away the proteins or using them for other purposes, after 5 minutes he drinks it all with a glass of still mineral water (or clean from the tap) and puts it on the right barrel, putting a warm heating pad under it. The procedure takes an hour. You should not be surprised if after it a person runs to the toilet to give away everything unnecessary. Some use magnesium sulphate instead of yolks, however, this is a saline laxative, which does not always provide such comfort to the intestines as, say, eggs.

Horseradish?

Yes, some people use finely grated horseradish (4 tablespoons) as a treatment, diluting it with a glass of milk. Drinking the mixture immediately is not recommended, so it is first heated (almost to a boil, but not boiled), left for 15 minutes so that a reaction occurs in the solution. Use the medicine several times a day. It is clear that such a remedy will have to be prepared every day if a person tolerates a product such as horseradish well.

Soda with lemon

They say that in the same way some people lose weight . But still we have another goal - to treat the disease. Squeeze the juice of one lemon and pour a teaspoon of baking soda into it. After five minutes, the soda will be extinguished and the medicine is ready. Drink for 3 days three times a day, then rest for 3 days and repeat the treatment again. We do not undertake to judge the mechanism of action of the drug, but people do it.

Herbs: sage, mint, milk thistle

Some say that milk thistle, known in such cases, which helps not only with hepatitis, but also with cirrhosis, is absolutely ineffective against hepatitis C, but in return, people offer other recipes:

• 1 tablespoon peppermint;
• Half a liter of boiling water;
• Infused for a day;
• Strained;
• Used throughout the day.

Or another recipe:

• Sage - a tablespoon;
• 200 - 250 grams of boiling water;
• A tablespoon of natural honey;
• Honey is dissolved in sage with water and infused for an hour;
• Drink the mixture on an empty stomach.

However, not everyone adheres to a similar point of view regarding milk thistle and offers a recipe that helps with all inflammatory liver diseases, including C-hepatitis:

1. A fresh plant (root, stem, leaves, flowers) is crushed;
2. Put in the oven for a quarter of an hour to dry;
3. Remove from the oven, lay out on paper and place in a dark place to complete the drying process;
4. Select 2 tablespoons of dry product;
5. Add half a liter of boiling water;
6. Insist 8-12 hours (preferably at night);
7. Drink 3 times a day, 50 ml for 40 days;
8. Arrange a break for two weeks and repeat the treatment.

Video: viral hepatitis in the “School of Dr. Komarovsky”

The liver is a multifunctional organ. It is involved in digestion, hematopoiesis, in the formation of immunity, neutralizes endo- and exotoxins, and even releases hormones. Therefore, it is not surprising that the general condition and life of a person depends on her health.

One of the most common liver pathologies is viral hepatitis. Within this group, there are several varieties that differ in the type of pathogen.

Hepatitis is the general name for inflammatory liver pathologies. Most often, this term is understood as a disease of a viral nature. They can occur in an acute form, but in some cases the disease becomes chronic, which is the cause of the development of such dangerous complications as malignant tumors in the liver and cirrhosis.

To date, several pathogens have been identified that determine the development of such a disease as viral hepatitis. More often, six viral agents are distinguished, their names differ in Latin letters: from A to G.

How does infection spread?

Viral hepatitis differs from each other in the form of transmission. According to this parameter, they can be divided into 2 groups described in the table.

For a long time, the main method of infection with viruses of the second group was the transfusion of donor blood. For this reason, all donors and the material taken from them began to be carefully checked.

Note! It has been proven that viral hepatitis is not transmitted through breast milk.

Hepatitis viruses differ from each other not only in the mode of transmission, but also in clinical manifestations and other features.

Hepatitis A (HAV, or Botkin's disease) often affects children under 14 years of age, adults get sick somewhat less often, but more severely. At a younger age, the disease can even be asymptomatic. The incubation period can range from a week to 50 days.

The classic manifestation of hepatitis caused by the A virus, or HAV, is the icteric type. It proceeds in two stages:

• preicteric period;
• actual jaundice.

The first stage occurs after the end of viral incubation, lasts about 3-7 days and is characterized by acute symptoms:

• the patient's temperature rises sharply to 38–39 degrees, pain in the joints, loss of appetite, fever, pain localized in the head, and other signs of intoxication appear;

  

• on the part of the digestive system, there is nausea, belching, vomiting, constipation or diarrhea, pain and heaviness in the hypochondrium on the right;

  

• in some cases, digestive disorders are preceded or accompanied by unpleasant symptoms from the respiratory tract, for example, pain and sore throat;
• children may experience biliary colic;

  

• sometimes there is itching of the skin.

At the end of the preicteric stage, feces become lighter and urine darkens, which is an important diagnostic sign. An icteric period begins, lasting about 14 days and characterized by two important symptoms:

• improving the general well-being of the patient;
• staining of the skin and sclera of the eyes in yellow.

Sometimes a change in the color of the integument is the first sign of the disease.

Gradually, the condition returns to normal, physical weakness, heaviness in the abdomen when eating can last up to six months.

In some cases, the disease is severe, which usually occurs in adults who abuse alcohol and drugs. Very rarely there is a hepatic coma.

The anicteric variant of Botkin's disease occurs quite often, but it is rarely recorded, only with a special examination of population groups in the event of an epidemic. There is also an erased or asymptomatic form of HAV.

Features of hepatitis B and D (HBV and HDD)

Inflammation of the liver caused by the hepatitis B virus (HBV) can be acute or chronic.

Hepatitis B - features

In the first case, the symptoms are similar to hepatitis A, but there are some differences.

1. HBV has longer periods of incubation (up to six months), jaundice (up to one and a half months) and recovery (about six months). The preicteric stage can last from 1 to 5 weeks.
2. A frequent manifestation of the disease is insomnia.
3. Almost a third of patients experience joint pain and a rash like urticaria.
4. Developing jaundice is accompanied by increased weakness, refusal to eat, persistent nausea and bitterness in the oral cavity, but the temperature and fever subside.
5. In the icteric variant, there is often a violation of the flow of bile into the intestines. This is accompanied by mild intoxication, itching and a yellow-green color of the skin, which persists for a long time.

Viral hepatitis D - features

Acute inflammation may resolve without jaundice, with blurred manifestations, or asymptomatically.

The signs of chronic inflammation are not pronounced:

• weakness and fatigue;
• irritability;
• disruptions in digestion, manifested in the form of heaviness, nausea, belching;
• vascular disorders of the type of stars and "liver" palms (redness that disappears with pressure, and then returns);
• sometimes - subfebrile temperature, increased sweating, insomnia;
• minor bleeding - in every second patient (subcutaneous hemorrhages mainly on the limbs, blood flow from the nose).

But the main, and sometimes the only manifestation of chronic hepatitis B is a strong increase in the liver.

Hepatitis D has an identical course. This virus does not develop on its own. Usually there is a simultaneous infection with HBV and HDV, which is very dangerous for human life, since this combination is the cause of cirrhosis.

Signs of hepatitis C and G

Viruses B and C cause similar symptoms. But jaundice is less common with HCV. Carriage of the virus without active symptoms, but with liver-destroying effects, is common.

Hepatitis C virus (HCV) incubation can last up to 26 weeks.

In almost 80% of cases, the disease becomes chronic, which often causes cancer and cirrhosis.

Hepatitis G is called the younger brother of HCV. However, VGG itself occurs more often in a mild form. Self-recovery may occur, or the disease becomes a carrier or becomes chronic. The combination of HCV and HGV is more dangerous.

How does hepatitis E manifest itself?

Hepatitis E virus has not only transmission methods similar to HAV, but also symptoms. But it also has a number of specific manifestations.

1. HEV mainly affects adolescents and young adults. In children, it often occurs without obvious symptoms.
2. The anicteric type of hepatitis E is much more common than in the case of the A virus.
3. The incubation period is from 2 weeks to 2 months.
4. Fever is not so intense, high temperature is recorded in about a fifth of patients.
5. A change in the color of feces, skin and sclera is not accompanied by an improvement, but by a deterioration in well-being.
6. The severe form is rare and affects mainly women in the late stages of pregnancy. This is a very dangerous condition for the mother and fetus. Even full-term babies do not survive half the time. The disease is difficult in those who have just given birth and are breastfeeding. A severe complication is severe bleeding in the intestines, uterus and other organs.

Also, hepatitis E is not characterized by a chronic form. However, it has been reported in some patients who have undergone immunosuppression due to organ transplantation.

Treatment of viral hepatitis

Therapy of viral inflammation of the liver depends on the form of the course of the disease and the virus that caused it.

Therapy for Botkin's disease

Hepatitis A has no specific treatment, no antiviral drugs are used.

In mild cases, hospitalization is usually not carried out, but the patient must be quarantined to prevent the spread of the virus. In other cases, the patient is sent to the infectious department.

1. The main therapy includes a special diet according to table number 5, a sparing daily regimen and plenty of fluids.
2. Enterosorbents are often prescribed to relieve intoxication.

   

3. With vomiting and refusal of food, glucose or Ringer's solution is administered through a dropper.

   

4. Since defecation is essential for a cure, laxatives, such as lactulose syrup, are indicated for delayed stools.

   

5. In difficult cases, plasmapheresis may be prescribed.
6. If it is impossible to obtain vitamins in their natural form, it is recommended to take multivitamin complexes.
7. In case of violation of the outflow of bile (cholestatic syndrome), ursodeoxycholic acid (Ursofalk), vitamins A and E are prescribed.

   

How is HEV treated?

With hepatitis E, hospitalization is carried out. Mild to moderate disease is treated similarly to inflammation caused by HAV. The treatment of seriously ill patients is carried out in the conditions of the intensive care unit and intensive care and is directed to the prevention and relief of hemorrhagic syndrome. Infusion detoxification is also carried out.

The tactics of managing pregnant women with hepatitis E is aimed at timely determination of the risk of abortion and blocking it, since childbirth intensifies the manifestations of the disease. With the onset of the birth process, anesthesia and the maximum acceleration of delivery are necessary.

Note! Artificial termination of pregnancy with hepatitis E is prohibited.

Treatment methods for hepatitis B and D

In the acute period, inflammation of the liver caused by HBV has no specific treatment and includes the removal of intoxication, sparing regimen and diet.

Therapy for the chronic form includes taking antiviral drugs. The World Health Organization recommends drugs such as Tenofovir and Entecavir. They do not destroy viruses, but block their reproduction, so taking these drugs is often lifelong. Such therapy helps to prevent the development of complications.

Hepatitis D is treated together with HBV.

Therapy for hepatitis C and G

To date, HCV is considered a curable disease. The therapy protocol is changing as more and more new drugs are released with better effects and fewer side effects.

Until recently, the combination of drugs such as Interferon and Ribavirin was considered the best method, which made it possible to get rid of the disease in about 50% of cases. But the consequences of taking these medications are sometimes life threatening.

There are already more effective and safe antiviral drugs for oral use. But while they are inaccessible due to unreasonably high prices.

HCV is usually treated together and in the same way as HCV hepatitis.

Note! Treatment of all forms of hepatitis, especially with the use of antiviral drugs, should be carried out only by a doctor and under his supervision.

Prevention of viral inflammation of the liver

Preventive measures for infection with hepatitis viruses can be divided into two groups:

• non-specific;
• specific.

The second group includes vaccination. To date, they have been successfully vaccinated against HAV and HBV, and a vaccine against HEV is under development.

Non-specific prophylaxis involves the exclusion of risk factors and depends on the form of transmission of the disease.

Prevention of fecal-oral infection includes:

• compliance with the rules of personal hygiene;
• quarantine for a patient with hepatitis A or E;
• providing people with clean water;
• complete wastewater treatment;
• thorough washing of products and compliance with sanitary and hygienic rules during cooking.

To exclude infection with HBV, HCV, HDV and HGV, the following rules must be followed:

Preventive measures for chronic hepatitis and the development of complications include preventive medical examinations.

Important! Viral hepatitis is a rather dangerous disease, which is easier to prevent than to treat. Therapy should be carried out only by a doctor.

Video - Hepatitis. Kinds

Video - Viral hepatitis. Types, treatment, prevention

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 increase;
• 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 a 20-minute boil 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

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 regularly check liver function, at the first signs of activation of the disease should be carried 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 70-80% 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 quite 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 parameters 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 carried out 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 calendar. 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, it is necessary to avoid contact with the blood of an infected person, 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 manipulations, 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 manipulations, 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 for a long time there are vaccines, vaccinations with which give a 100% guarantee against the occurrence 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 diagnosed 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. Thank you. 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 hygienic, 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 yellow coloration 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.

• Main symptoms
• Classification of hepatitis: forms of hepatitis
• Characteristics of hepatitis

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Hepatitis is a general term for acute, inflammatory, and chronic liver diseases. Types of hepatitis differ in symptoms, methods of infection, rates of development, drug therapy. These pathologies are characterized by specific signs, which, depending on the type of disease, may be more pronounced than others.

Main symptoms

Signs of the disease:

1. Jaundice is the most common symptom of hepatitis. It got its name for giving nails, skin and mucous membranes of organs a yellowish tint. For example, a patient may have yellow eye sclera. This happens due to an increase in bilirubin in the blood, which causes a violation of liver function. Bilirubin is excreted mainly in the urine.
2. Pain in the right hypochondrium. It may be dull and prolonged or paroxysmal. The increase in size causes inflammation of the liver, stretching the membrane and thereby causing pain.
3. Deterioration of general well-being, impotence, temperature, discoloration of feces and urine.

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Classification of hepatitis: forms of hepatitis

There are two types of hepatitis: acute and chronic. In most cases, the acute form appears with viral or toxic liver damage. In the acute form, the patient's well-being deteriorates sharply, and the symptoms worsen. With the exception of those circumstances when the acute form flows into the chronic phase, then the outcome is always favorable. The acute form is easier to diagnose and treat.

The chronic form is an inflammation of the liver that has arisen due to poisoning during alcoholism, or the progression of acute hepatitis. In this form, healthy liver cells are gradually replaced by fibrous tissue. In this phase, minor symptoms appear that are invisible to the patient and others. It is usually diagnosed at the stage of cirrhosis of the liver, which is practically untreatable and entails serious consequences.

Hepatitis A, B, C, D, E, F, G are considered viral. Parenteral link independent inflammation of the liver with hepatitis B, C, D, G. These are pathologies associated with acute infectious diseases, which are accompanied by damage not only to the liver, but also to other organs. Parenteral viral hepatitis is prone to chronicity, the development of cirrhosis and liver cancer.

This pathology is similar to HIV infection in terms of the infection system, but the threat of infection is much higher. It is transmitted through blood, sexually, personal hygiene items. For example, through syringes, in the salon during tattooing or piercing, manicure kit, razors, etc. Most often, healthcare workers and people who often come into contact with blood and body fluids are at risk of infection.

Parenteral hepatitis is very dangerous, as in 80% of cases it becomes chronic. In order not to get parenteral viral hepatitis, it is necessary to carry out prophylaxis:

• ensure that medical facilities use disposable sterile instruments;
• disinfect personal hygiene items;
• avoid casual sexual contact;
• do not use drugs.

To protect children, get all the necessary vaccinations and mandatory booster vaccinations.

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Characteristics of hepatitis

Hepatitis A. The most common form of all. The latency period can last from 7 to 50 days. It is transmitted through food, dishes, etc. It is manifested by an increase in body temperature, sometimes the symptoms are similar to the flu. Most often, the cure occurs spontaneously and does not require dynamic treatment.

In severe cases, droppers are prescribed to relieve intoxication. This type of hepatitis usually takes place in an acute form, the duration of the disease is 30 days. Special antiviral therapy is not required, the treatment is symptomatic, bed rest and the necessary diet are observed. The diet consists in the exclusion from the diet of fried, spicy, smoked, the use of alcoholic beverages is prohibited.

Hepatitis B. Passes in an acute or chronic form. There is no complete cure, but with the observance of prescriptions, diet, and the use of drugs that accelerate movement in the liver tissues, a favorable course of the disease is observed. The disease, which is asymptomatic, most often becomes chronic. The chronic form leads to the formation of cirrhosis or liver cancer. Infection occurs through the blood, sexually. Treatment is long-term (with the use of interferons), takes place under the supervision of a physician. If necessary, a second course is prescribed.

Hepatitis C. It is transmitted in the same way as hepatitis B, without appropriate treatment it becomes chronic and ends with cirrhosis of the liver. Inflammation of the liver caused by hepatitis C may be asymptomatic for up to 20 years. Currently, there is no vaccine against hepatitis C. Among the types of hepatitis, the most dangerous type is fatal. Treatment depends on the duration of the disease, the genotype of the virus, the age and sex of the patient. For the accuracy of the diagnosis, fibroscanning and liver biopsy, ultrasound, general and biochemical blood tests are performed.

Hepatitis D. Infection with this type is spontaneously impossible, since this type can occur against the background of hepatitis B. Inflammation of the liver occurs in an acute or chronic form. Timely treatment and adherence to the recommendations of the doctor most often lead to a favorable outcome. In hepatitis D, inpatient therapeutic treatment is carried out in combination with antiviral drugs.

Hepatitis E. In terms of manifestations and system of infection, it is similar to hepatitis A. Most often it proceeds safely and does not require specific treatment. It has the greatest danger for pregnant women, as it proceeds in a severe form of fulminant hepatitis, causes encephalopathy and intravascular coagulation, and leads to death. Patients with chronic liver pathology are also at risk.

Hepatitis F. This type, unlike other types, has not yet been fully studied. Causes and causative agents are not currently determined, but there are suggestions that species F is caused by two viruses, not one. The symptoms are similar to those of other types of hepatitis. The exact treatment has not been established, since the source is unknown, therefore, only symptomatic treatment is carried out.

Hepatitis G. Insufficiently studied, like its predecessors, types of ABC. The source and causes of occurrence are not exactly known. According to some reports, this species is caused by three viruses. Treatment is aimed at preventing inflammation of the liver and infection of healthy tissues with the help of interferons.

The use of interferons does not guarantee complete healing, but may prevent the development of cirrhosis or liver cancer.

Interferon is most effective in combination with ribavirin.

Hepatitis of the liver appears not only due to tissue damage by viruses, but also for other reasons. They are classified as non-viral. These include hepatitis in combination with cytomegalovirus, rubella, AIDS, etc.

Inflammation caused by syphilis, leptospirosis, sepsis is called bacterial hepatitis. Toxic appears when poisoned by alcohol, poisons and chemistry. Radiation occurs when irradiation and a high dose of radiation. Autoimmune manifests itself in autoimmune diseases.

The determination of the conclusion is carried out according to the results of blood tests for antibodies to hepatitis viruses, indicators of liver function, PCR. Based on the data obtained, an appropriate treatment is selected.

Among all known liver diseases, hepatitis and its types are considered the most common. About 2 million people die from them every year around the world.

Hepatitis is an acute or chronic inflammation of the liver, which in most cases occurs as a result of damage to the organ by a virus.

The main forms and types of hepatitis

Answering the question about what types of hepatitis are, experts note that in modern medicine there are several classifications of the disease.

There are two main forms of hepatitis - acute and chronic.

The acute form is characterized by a bright and clearly expressed clinical picture, in which there is a sharp deterioration in the patient's condition, severe intoxication of the body, yellowness of the sclera of the eyes and skin, and a violation of the basic functions of the liver. The acute form is most characteristic of the pathology of viral etymology.

Chronic (inactive) form It is characterized by an erased clinical picture and in many cases is asymptomatic. It can develop both independently and become a complication of the acute form of the disease. In chronic forms, there is a significant increase in the size of the liver, noticeable even with palpation of the diseased organ, dull pain in the right hypochondrium, nausea. With untimely treatment, chronic forms of the disease lead to dangerous complications, in particular, to cirrhosis and liver cancer.

Depending on the cause of hepatitis, there are:

• viral;
• toxic;
• autoimmune.

Conventionally, all of the listed species can be combined into two groups - infectious and non-infectious species.

Viral

This is the most common cause of liver inflammation.

The group of viruses that provoke this disease is so vast and diverse that it is impossible to accurately answer the question of how many types of hepatitis exist. To date, seven main types of viral hepatitis are distinguished, which differ from each other in the structural features of the virus, the mechanisms of transmission and the degree of damage to liver cells.

The classification of viral hepatitis allows us to distinguish two main groups of the disease - with enteral and parenteral infection mechanisms. The first group can include hepatitis A and E, which can be infected "through the mouth", i.e. through contaminated food, dirty water or unwashed hands. The second group includes hepatitis B, C, D, G, which are transmitted through the blood.

Hepatitis A, popularly known as Botkin's disease, is one of the milder forms of the disease. It is essentially a foodborne infection that attacks the liver without affecting the digestive tract. The causative agent of the infection is an RNA virus that enters the human body with contaminated food and water, as well as when using infected household items.

There are three main forms of the disease:

• icteric (acute);
• anicteric;
• subclinical (asymptomatic).

The main diagnostic method is a blood test, which determines antibodies of the lgM class.

People who once had hepatitis A develop lifelong immunity to this form of the disease.

Hepatitis B has a viral nature and is one of the most common and contagious diseases. It has two forms:

• acute, which in 10% of cases develops into chronic;
• chronic, which leads to numerous complications.

There are two main ways of transmission of the virus - artificial and natural. In the first case, the transmission of the virus is possible through infected blood that enters the body of a healthy person during various manipulations (blood transfusion, transplantation of donor organs), when visiting a dental office, a beauty salon, and also when using unsterilized syringes and needles. Among the natural ways of transmission of infection, the most common is the sexual way. Also possible is the so-called vertical infection, which occurs during childbirth from a sick mother to her child.

Scheme "The main symptoms and signs of hepatitis B"

Treatment of the disease is complex and requires an integrated approach, which depends on the stage and form of the disease. However, it is almost impossible to achieve a complete recovery.

Timely vaccination will help protect yourself and prevent hepatitis B infection.

Hepatitis C is known in medical circles as HCV infection.

Answering the question which hepatitis is the most dangerous, infectious disease doctors note that this is hepatitis C.

Currently, 11 genotypes of the HCV virus are known, but they all have one feature in common - they are transmitted only through infected blood.

It has a similar clinical picture with hepatitis B. It manifests itself in both acute and chronic forms. At the same time, according to statistics, the chronic form in 20% of cases ends with cirrhosis or liver cancer. A particularly high risk of such complications is typical for patients who come into contact with hepatitis A and B.

Unfortunately, there is no vaccine for hepatitis C.

The duration of treatment and its outcome depend on the genotype, form and stage of hepatitis, as well as on the age of the patient and his lifestyle. The most effective way to treat the disease is antiviral therapy with new generation drugs, among which the most effective is Interferon alfa. As modern studies show, a positive result is achieved in 40-60% of cases.

If left untreated for hepatitis C, in most cases it leads to the complete death of liver cells and death.

Hepatitis D, also known as delta hepatitis, occurs when a person becomes infected with the HDV virus. It is characterized by acute, all-consuming liver damage and is difficult to treat. Therefore, many experts classify it as the most dangerous hepatitis.

Unlike all types of hepatitis, the HDV virus does not have its own envelope and cannot develop in the human body on its own. A necessary condition for its reproduction in the human body is the presence of the hepatitis B virus. That is why only people with hepatitis B can become infected with delta hepatitis.

There are two forms of delta hepatitis - acute and chronic. The acute form of the disease is characterized by the presence of such symptoms:

• pain in the right hypochondrium;
• fever;
• darkening of the color of urine;
• nausea and vomiting;
• nosebleeds;
• ascites

In the chronic form of the disease, symptoms may be absent or not appear for a long time.

Unfortunately, at present there are no medications that can completely and permanently destroy the HDV virus, however, modern antiviral therapy in combination with the use of hepatoprotectors and immunostimulants can achieve positive results, prevent pathological processes in the liver and avoid dangerous complications.

Hepatitis E is a viral infection of the liver that occurs through the fecal-oral route. Like Botkin's disease, this liver lesion is transmitted mainly with contaminated water and food. You can also get infected through blood.

Dirty water is the main cause of hepatitis E, so epidemics of the disease mainly occur in hot countries with poor water supply.

The symptoms of the disease are similar to the signs of Botkin's disease. The disease begins with a disorder of the digestive system and an increase in body temperature, after which yellowing of the skin and sclera of the eyes occurs.

In most cases, the prognosis for patients is quite favorable. However, in the case of infection in the third trimester of pregnancy, the disease is very difficult and ends in the death of the fetus, and sometimes the death of the mother.

The main difference between hepatitis E and other types of the disease is that this virus affects not only the liver, but also the kidneys.

Hepatitis F is a poorly understood type of disease. All over the world, laboratory studies are still being carried out to study the etymology of the virus and the main methods of its transmission. Since the clinical picture of the virus is not fully understood, it is very difficult to make an accurate diagnosis.

However, it is known for certain that this infection is transmitted through the blood and has the following phases:

• incubation period;
• preicteric phase;
• icteric phase;
• convalescence;
• residual period.

To date, there is no cure for hepatitis F.

Hepatitis G was recently discovered in a patient infected with hepatitis C. That is why the concept of such an infection often means one of the varieties of hepatitis C.

Currently, this type of hepatitis is poorly understood, but there are known ways of infection with hepatitis G: it has been established that it is transmitted through blood during sexual contact, as well as from mother to child during childbirth.

toxic

They arise as a result of the negative impact on the human liver of chemicals, industrial poisons, as well as poisons of plant origin, alcohol and certain drugs.

Depending on the source of infection, the following types of toxic inflammation of the liver are distinguished:

• Alcoholic - occurs as a result of the toxic effect of alcohol on the liver, leads to metabolic disorders in hepatocytes and their replacement with adipose tissue.
• Medication - appears when taking hepatotoxic medications (Ibuprofen, Ftivazid, Biseptol, Azathioprine, Methyldopa, etc.).
• Professional - occurs when the human body is exposed to industrial poisons (phenols, aldehydes, pesticides, arsenic, etc.) and other harmful substances.

Liver disorders in toxic hepatitis

You can get infected with toxic hepatitis through the respiratory system, the gastrointestinal tract, as well as in a tactile way.

Autoimmune

Considered one of the rarest diseases. According to statistics, they occur in 50-100 cases per 1 million people, while they are predominantly affected by women at a young age.

The causes of the development of the disease are not known for certain, however, it has been established that it occurs against the background of a dysfunction of the immune system, is characterized by extensive damage to the liver and some other organs (for example, the pancreas).

This disease is characterized by a number of specific and nonspecific symptoms. In particular:

• severe jaundice;
• darkening of the color of urine;
• pronounced weakness and malaise;
• pain in the right hypochondrium;
• skin itching;
• ascites;
• fever;
• polyarthritis.

In the absence of timely treatment, autoimmune hepatitis leads to cirrhosis of the liver and liver failure, resulting in the need for a donor liver transplant.

It is impossible to diagnose hepatitis and its types solely by external signs. Answering questions about whether hepatitis is visible on ultrasound and whether there is an accurate analysis, experts note that in order to formulate a diagnosis, it is necessary to conduct a whole range of studies. In particular, we are talking about biochemical blood tests, ultrasound of the abdominal organs, computed tomography and liver biopsy.

It is difficult to answer the question of which hepatitis is the most terrible for a person, since each of the known types of the disease can cause irreversible processes in the liver and lead to death. And although many types of hepatitis are known today, new subspecies are being discovered every year, which can be even more dangerous for humans. Therefore, in order to prevent infection with the virus of one of the most dangerous diseases in the world, one should adhere to the rules of personal hygiene, avoid casual sexual contact and carry out timely vaccination.