Today in the world, viral hepatitis ranks first in the structure of liver diseases. In addition, viral hepatitis most often of all diseases of the hepatobiliary system leads to the development of cirrhosis and liver cancer, which are difficult to treat and in most cases are fatal.

Viral hepatitis is a group of infectious and inflammatory liver diseases, which are based on viral damage to hepatocytes with impairment of their functions.

Depending on the type of pathogen, it is customary to divide all viral hepatitis into A, B, C, D, E, F and G. The last four types are very rare.

Hepatitis C is rightfully considered the most common, and the most insidious and dangerous.

According to the duration of the disease, viral hepatitis can be divided into fulminant, acute, chronic and protracted.

A fulminant or fulminant course occurs with hepatitis A, B, C, D. This is a severe variant of the course of viral hepatitis, in which liver failure, intoxication of the body and disorders of the central nervous system progress.

Fulminate viral hepatitis even with timely treatment has a high mortality rate.

The acute form of viral hepatitis is characterized by intoxication and impaired liver function. Most cases end in recovery, but sometimes chronic viral hepatitis can develop.

Acute viral hepatitis lasts no more than three months. This variant of the course is observed in hepatitis A.

Prolonged viral hepatitis resembles an acute course, but with a longer icteric period. The protracted course takes about six months and also occurs with S.

Chronic viral hepatitis occurs over a long period of time with periods of exacerbation and remission. The severity of the symptoms of the disease depends on the type of pathogen, the state of the patient’s immune system and the presence of concomitant pathology.

Important! The most common chronic viral hepatitis are B, C and D, which often cause liver failure, cirrhosis and liver cancer.

Features of viral hepatitis:

• viral hepatitis belongs to the group of anthroponotic infections;
• viral hepatitis can be transmitted by parenteral, sexual and nutritional routes;
• hepatitis viruses are highly resistant to environmental factors;
• causative agents of viral hepatitis are hepatotropic viruses that multiply in liver cells and damage them;
• viral hepatitis manifests itself with similar laboratory signs;
• The principles of treatment are the same for all types of viral hepatitis.

Hepatitis A virus is a hepatotropic RNA virus with a weak cytopathogenic effect, which belongs to the Picornavirus family. Hepatitis A virus was isolated by Finestone in 1973.

This virus is highly resistant to high and low temperatures, drying, and freezing. It retains its pathogenicity for a long time in water, food, sewage water, as well as on objects and surfaces.

Interesting! The hepatitis A virus can be inactivated by boiling for five minutes and by treating with solutions of bleach, potassium permanganate, chloramine or formaldehyde.

Hepatitis B virus is a representative of DNA viruses of the Orthovirus genus of the Hepadnovirus family. The DNA of the virus looks like a ring of two strands.

On the surface of the protein-lipid shell there is a surface antigen - HBsAg, and inside the viral cell there are three more heart-shaped ones - HBxAg, HBeAg and HBcAg. Antibodies are produced in the patient’s body against the HBsAg and HBcAg antigens, and lifelong immunity is formed.

The causative agent of hepatitis B, like the hepatitis A virus, is resistant to aggressive environmental factors. It can live for several months at room temperature, and several years when frozen.

At a temperature of 120 °C it dies within 45 minutes, and at 180 °C - in an hour. The hepatitis B virus is sensitive to disinfectants based on hydrogen peroxide, chloramine and formaldehyde.

is an RNA virus of the Flavovirus family. Due to the large number of RNA variants, 6 types and more than 90 subtypes of hepatitis C virus are known.

In each region, the disease is caused by a specific type of virus. Cross immunity to different types and virus subtypes are not formed. In addition, the hepatitis virus has the property of long-term persistence in hepatocytes without any signs of disease.

The hepatitis C virus remains active at a temperature of 50°C and is resistant to freezing. At 25-27°C it can live up to 4 days. Inactivation of the virus occurs with ultraviolet irradiation for 9-11 minutes and at a temperature of 100°C for 2-3 minutes.

The hepatitis D virus is resistant to heat and freezing, as well as to acids, nucleases and glycosides.

Mechanisms and routes of transmission of viral hepatitis

The source of the disease in all viral hepatitis is a sick person or a virus carrier.

The fecal-oral transmission mechanism is the spread of pathogens through contaminated hands, vegetables and fruits, and drinking water. This way you can become infected with hepatitis A and E.

The parenteral mechanism of spread is the transmission of the pathogen through blood and other biological fluids. This mechanism is characteristic of hepatitis B, C, D and G viruses.

The routes of transmission of viral hepatitis can be as follows:

• blood transfusion - with the transfusion of blood and its components;
• injection - through syringes and needles that contain remnants of blood infected with the hepatitis virus;
• sexual intercourse - during sexual intercourse without using a condom;
• vertical - from a sick mother to a child during childbirth or caring for him;
• when performing tattoos, acupuncture, piercing with non-sterile needles;
• for manicure, pedicure, shaving, hair removal, permanent makeup, if the instruments are not treated with disinfectants.

Clinical course of viral hepatitis

Viral hepatitis can occur cyclically and acyclically.

Interesting! Asymptomatic forms of the disease are diagnosed randomly during examination of persons who have been in contact with patients for viral hepatitis, and for other pathologies, as well as in the process of preoperative preparation.

This is explained by the fact that there are no signs of viral hepatitis, but in the blood it is determined increased activity transaminases, the presence of antibodies against hepatitis viruses, their antigens and genetic material.

The course of the cyclic form of viral hepatitis can be divided into the following stages:

• incubation;
• preicteric, or prodromal;
• icteric, or high stage;
• stage of convalescence, or recovery.

Incubation stage (period)

The shortest incubation period for hepatitis A is 2-4 weeks, and the longest for hepatitis C is 2 months, and sometimes 5-20 years. Duration incubation stage depends on the amount of virus that entered the body during infection, the type of virus and the state of the person’s immunity.

Prodromal stage (period)

Prodromal period, which can be manifested by the following syndromes and symptoms:

1. Asthenovegetative syndrome:

• fast fatiguability;
• low performance;
• general weakness;
• drowsiness or insomnia.

2. Dyspeptic syndrome:

• decreased or complete lack of appetite;
• heaviness in the epigastrium;
• flatulence;
• loose stool or constipation.

3. Arthralgic syndrome:

• migrating pain in the joints, without signs of inflammation.

4. Intoxication syndrome:

• body aches;
• muscle pain;
• fever;
• chills;
• increased sweating;
• pain.

5. Allergic syndrome:

• dry skin;
• itchy skin;
• rash.

The period of the height of the disease (icteric)

The patient experiences yellowing of the skin, sclera and other mucous membranes. With the appearance of jaundice, intoxication of the body increases, and the patient’s condition worsens even more.

Also during this period, the urine darkens due to the large amount of urobilinogen in it. Urine resembles strong black tea or dark beer.

The feces lighten and become completely colorless, since it lacks stercobilinogen, which colors it orange-brown.

Convalescence period

The convalescence period is the time from the beginning of the subsidence of the symptoms of the disease to their complete disappearance and normalization of all blood parameters. During this period, patients experience fatigue, general weakness, and biochemical blood parameters are disturbed.

General blood analysis is prescribed to identify an inflammatory process in the body, which is characterized by: an increase in the number of white blood cells, a shift leukocyte formula to the left, acceleration of erythrocyte sedimentation rate.

General urine analysis will indicate excess bilirubin in the body - the presence of a large number of bile pigments, direct bilirubin and urobilin. General stool analysis. Stercobilin, which gives it its natural color, disappears from the feces.

Blood chemistry is the most informative, as it indicates a dysfunction of the liver. Viral hepatitis is characterized by increased activity of liver transaminases (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, glutamyl dehydrogenase, lactate dehydrogenase), decrease in the amount total protein and an imbalance of its fractions, prothrombin, fibrinogen, an increase in the amount of bilirubin, cholesterol.

Linked immunosorbent assay is specific method identification of pathogens of viral hepatitis. Using this method, markers of viral hepatitis are determined quantitatively and qualitatively in the blood - antibodies to hepatitis viruses and their antigens.

Polymerase chain reaction is another method of determining the type of virus that caused viral hepatitis. This method involves identifying the genetic material of the virus (DNA, RNA) in the blood and feces of the patient.

Ultrasound examination of the liver and biliary tract used to diagnose structural changes in the liver, as well as for the differential diagnosis of viral hepatitis with other pathologies of the hepatobiliary system.

Liver biopsy carried out to determine the activity, extent of the process and the presence of complications.

All viral hepatitis is treated by general principles, among which are the following:

• Only extremely necessary medications are prescribed so as not to overload the liver;
• the choice of drug depends on the period of the disease, the presence of concomitant pathology or complications;
• if possible, then accompanying chronic pathology treated after normalization of liver functions;
• appointed bed rest during acute viral hepatitis or exacerbation of chronic;
• diet is a mandatory component of the treatment of viral hepatitis.

Treatment of viral hepatitis consists of etiotropic and pathogenetic therapy.

Etiotropic therapy– this is the prescription of drugs that stop the replication of viruses and kill them.

The basis of antiviral therapy for hepatitis are short- and short-acting interferons. long acting, as well as Ribavirin, Lamivudine, Acyclovir, Retrovir, Zinovudine and others. Depending on the type of viral hepatitis, monotherapy or combination treatment regimens are used. Treatment of acute viral hepatitis lasts on average 1 month, and chronic - 6-12 months.

Pathogenetic therapy viral hepatitis includes the following items:

• hepatoprotectors to activate the processes of restoration of hepatocytes and protect them from negative factors(Gepabene, Heptral, Essentiale, Silibor, Karsil and others);
• enterosorbents to accelerate the removal of bilirubin and viruses from the body (Enterosgel, Laktofiltrum and others);
• detoxification therapy (5% Glucose, 0.95 Sodium Chloride, Reosorbilact, Ringer-Lactate, Disol, Trisol, etc.);
• glucocorticosteroids (Prednisolone, Dexamethasone);
• antispasmodic therapy (No-shpa, Papaverine);
• choleretic therapy (Ursohol, Ursosan, Cholesas);
• vitamin preparations (cyanocobolamine, A nicotinic acid, Ascorbic acid and others).

Complications of viral hepatitis

• biliary dyskinesia;
• cholecystitis, cholangitis;
• hepatic coma;
• hepatocellular carcinoma.

Prevention of viral hepatitis

Important! Viral hepatitis often leads to serious and dangerous complications, and their treatment is not only lengthy, but also expensive.

Therefore, it is better to carry out simple prevention of viral hepatitis:

• vaccine prevention of hepatitis A and B;
• use of quality drinking water, cleanly washed vegetables and fruits;
• all products must undergo sufficient heat treatment;
• do not use other people’s manicure accessories, scissors, razors, toothbrushes;
• get tattoos and piercings only in special salons that comply with the relevant anti-epidemic standards;
• use condoms during sexual intercourse;
• do not use injection drugs.

Viral hepatitis is treated by an infectious disease specialist together with a hepatologist.

One of the most dangerous diseases infectious etiology, in which an inflammatory process of liver tissue occurs, is viral hepatitis. It can be caused by various known factors, but many of them have not yet been fully studied. Forms of viral hepatitis are designated in Latin letters. Each type has its own characteristics and transmission routes. Hepatitis diseases can be divided into two groups, which have different modes of infection:

Hepatitis of viral etiology can have an acute and chronic form, and each of them has its own incubation period and peculiar symptoms.

Acute hepatitis in adults, especially with proper therapy at an early stage, can be quickly treated, chronic form - only in rare cases can it be cured completely.

There is a group of people whose risk of becoming infected is many times greater than others. These include:

• people who randomly change sexual partners;
• people who use drugs;
• clinic patients exposed to frequent surgical interventions: operations, blood transfusions and other manipulations;
• medical personnel whose work involves contact with sick people and contaminated blood.

To avoid infection, there are prevention methods that, if followed, will reduce the risk.

General symptoms

Despite the fact that each group of viral hepatitis has its own characteristic manifestations, are still available general signs, indicating a virus. Main symptoms of the disease:

The appearance of some of these signs may not indicate the presence of the disease. Therefore, the first thing you need to do is see a doctor for examination.

Hepatitis A

Symptoms of the disease depend on the age of the person. The older the patient, the more severe the disease will be, and complications will occur more often after it. In very young children, hepatitis A can occur without showing any signs, and the risk of complications is minimal.

The incubation period of the disease ranges from 1 week to 1.5 months. During this period the patient may be bothered following symptoms:

• illness characteristic of influenza: chills, high fever and headache;
• there may be aches in the body and joints;
• Gastrointestinal disorders: vomiting, diarrhea, nausea, lack of appetite.

At the end of the period, changes in color appear feces and urine. This suggests that the next period may begin - jaundice. Jaundice occurs when bile is released into the blood, causing the skin and eyes to turn red. yellow. It is bile that changes the color of stool and urine. Worth remembering! Not all types of hepatitis cause jaundice.

After icteric period Often there is an improvement in the person’s condition. Group A viral disease is the most mild form with virtually no consequences.

Such patients receive lifelong immunity to this type of disease.

Hepatitis B

The symptoms of hepatitis B are similar to the group A virus, but have differences in the incubation period. In acute hepatitis B, this period can reach six months and at the initial stage be completely asymptomatic.

The manifestations of symptoms in children and adults are the same. The disease proceeds in the same way as hepatitis A, in several stages:

• nausea and general malaise occur, abdominal pain may occur;
• jaundice appears, the color of stool and urine changes, and sometimes a rash appears;
• When diagnosed, an enlarged liver and spleen is detected.

Hepatitis B, if not treated in a timely manner, affects liver cells, which can lead to irreversible, severe consequences: cancer or liver failure. But there have also been cases of complete recovery and acquisition of immunity to the virus of this group.

Hepatitis C

This form of the disease is the most severe. The most common causes of the disease are blood transfusions, the use of contaminated needles, unprotected sexual intercourse and mother-to-child transmission of the virus.

The incubation period of this form of the disease lasts from 14 to 180 days. If the virus initiates a passive process, liver destruction occurs with virtually no symptoms. In the acute course of the disease, the symptoms are similar to the group B virus, only without icteric manifestations.

When this form of disease occurs, the following typical symptoms may occur:

• joint pain;
• weakness;
• nausea and vomiting;
• digestive tract disorders.

Viral hepatitis C is dangerous because it may not manifest itself for a long time, minor disorders and ailments are attributed to patients with ARVI or poisoning. The acute form in 80% of cases can become chronic, which in most cases leads to serious complications - cirrhosis or cancer of the liver tissue. Often, hepatitis C can be combined with other types of viral diseases, which can subsequently lead to death.

Hepatitis D

The incubation period of the disease ranges from 45 days to six months. This form The symptoms of a viral disease are similar to those of group B virus. As a rule, two forms of the disease occur simultaneously, since hepatitis D cannot exist independently. A mixed type of disease can lead to a number of severe complications, in particular cirrhosis of liver cells.

Hepatitis E

Symptoms of viral hepatitis E in adults manifest themselves in almost the same way as with hepatitis A - jaundice occurs. But they differ in that after the icteric period with hepatitis E, the condition does not improve. The incubation period can range from 2 weeks to 2 months.

At the initial stage of development of this form of the disease, there may be a slight malaise or no signs at all. Gradually, the symptoms increase - the state of health worsens and the temperature rises. The form of the group E virus differs from form A in that the virus affects not only the liver tissue, but also the kidneys.

Mild forms of hepatitis E usually go away within a month. The exception is pregnancy.

Starting from the 2nd trimester of pregnancy, the disease can lead to death of the mother. Fetal death always occurs at any stage.

A distinctive feature of hepatitis E from other manifestations of a viral disease is the absence of a chronic course of the disease in adults.

Hepatitis G

The symptoms of this form of the disease are similar to those of the group C virus, but there are still differences.

Hepatitis G is milder, without severe manifestations infectious period. This type The virus rarely leads to serious consequences, but when combined with other forms it can become dangerous. When occurring simultaneously with hepatitis C, it leads to cirrhosis of liver cells. With a single course of hepatitis G, recovery can occur independently, without flowing into chronic course in adults.

If any signs appear, you should immediately consult a doctor and not self-medicate, since at the initial stage there is a chance to stop infectious process and not become a carrier of the virus.

• "A";
• "B";
• "C";
• "D";
• "E".

They are a group of infectious diseases.

The pathology of liver tissue they cause is also called jaundice or Botkin's disease. By now, a sixth species has become known - “G”.

The essence of viral hepatitis

Which hepatitis is viral? Pathogens spread in the body through the blood, affecting the liver tissue of an infected person. The hepatitis virus has the ability to bind to the CD81 receptor protein. After it enters the cell, the RNA of the virus is integrated into its genetic apparatus. Its reproduction begins, after which the cell dies, releasing them outside. The infection spreads further. The course of the disease manifests itself in several forms:

1. Botkin's disease. Lightest and most common form. Infection occurs due to non-compliance with hygiene measures through the belongings of an infected person. History shows that hepatitis A creates lasting immunity in the body to the disease.
2. It has a more severe course. Infection is through blood, sexual intercourse, childbirth. Causes severe liver damage.
3. Referred to as HCV. Has the ability to transform into a chronic form. Infection occurs through blood, sexual intercourse, and medical instruments.
4. Characterized by acute course, as a result it is observed mass destruction liver cells. Replication of the virus depends on the presence of type B virus. The only way infected is the blood.
5. Modification of type A virus. You can become infected through water from infected people.
6. A weaker variety of type C.

According to ICD 10 code, all types of viral hepatitis are designated as B15-B19.

Causes of viral hepatitis

The causes of viral hepatitis are infectious, alcoholic, and drug etiologies. But with the cryptogenic and autoimmune type of the disease, the cause cannot be found out. According to the route of infection, hepatitis disease is divided into two groups:

• enteral (A, E), resulting from infection through the mouth;
• parenteral (B, C, D, G), transmitted through blood.

Infection and transmission of the causative agent of viral hepatitis

Infection and transmission of the causative agent of viral hepatitis occurs in two ways:

1. Oral-fecal. The excrement of a sick person ends up in the soil. Poor hygiene and contaminated drinking water sources all contribute to the spread of the virus. This is how hepatitis A and E are most often spread.
2. Through blood. The causative agents of other varieties of the disease enter the body after contact with infected blood. This occurs after a blood transfusion, during sexual intercourse, and due to unsterile medical instruments. This is how hepatitis B, C, D, G is transmitted. The incidence of the disease is especially widespread among drug addicts, transmitted through shared instruments.

Virus classification

There are different forms of viral hepatitis, the classification divides them into three types according to the duration of their course:

• acute in nature, lasting about 3 months (A);
• protracted, up to six months (B, C);
• chronic, occurring independently, lasting more than 6 months (B, C, D).

The severity of clinical manifestations classifies the disease into two forms:

• manifest, occurring with or without the appearance of jaundice;
• asymptomatic.

Symptoms and signs of viral hepatitis

Acute forms arise from different viruses; their subtypes have their own clinical picture. In general, viral hepatitis has the following symptoms and signs of infection:

• fatigue, weakness, bad dream;
• dyspeptic disorders (nausea, vomiting, lack of appetite);
• itching of the skin;
• joint pain;
• yellowness of the mucous membranes and skin, but may be absent;
• signs of ARVI;
• dark urine, colorless feces.

The clinical picture lasts from 2 to 4 weeks. Delay in treatment threatens fatal.
Photo: Types

Methods for diagnosing the virus

Diagnosis of viral hepatitis is carried out in several stages. Initially, anamnestic data is collected, clinical examination patient.

Tests for the disease

It is necessary to seek help at the initial stage of the disease (prodromal). Then tests are done for viral hepatitis. The basis of diagnostic measures are:

• epidemiological history data;
• indicators of biochemical and clinical research.

Viral antigens are searched for in special laboratories using various tests.

Particles of viruses and antibodies to them found in the patient’s blood contribute to:

• establishing the type of infectious agent;
• activity of the disease.

PCR method

Used to detect hepatitis C PCR method. One more important stage diagnostics is a biochemical analysis of blood composition. Liver enzymes in the blood are determined, as well as bilirubin fractions. To identify the presence of morphological changes in the structure of the liver, ultrasound examination is used. If a diagnosis of viral hepatitis is made, treatment is prescribed immediately.

Treatment of viral hepatitis

After identifying the markers of viral hepatitis and determining the type of virus, appropriate therapy is prescribed. The main drugs for treatment are:

• antihistamines and antiviral drugs;
• interferons.

Severe hepatitis is accompanied by taking Reamberin and hormonal drugs. Sometimes they can be treated with antibiotics.

Vitamin therapy is prescribed to stop inflammatory processes. Detoxification is also carried out using:

• Hemodesa;
• Poliglyukina;
• 5% Glucose.

Hepatitis C has no cure. The methods used by doctors can only suppress its reproduction. Stopping the progression of the disease allows the infected person to continue living normally.

Drugs to treat the virus

Most commonly prescribed drugs:

• Ademetionine;
• Ursodeoxycholic acid;
• Silymarin;
• Katergen;
• Hepanorm;
• Cyanidanol;
• Welferon;
• Intron-A;
• Lamivudine;
• Adefovir;
• Entecavir.

Diet and nutrition for viral hepatitis

A special place for viral hepatitis is changing the patient’s diet. The diet developed by doctors involves the use of only easily digestible foods that do not put stress on the damaged organ.

Prohibited foods

1. Fatty meat and dairy foods.
2. Fried, pickled, baked dishes are also excluded from the menu.
3. Prohibited spicy food, alcohol, soda.

You can read more about food products that are harmful to human health at the link provided.
Life cycle of viral hepatitis

Viral hepatitis this is a group of etiologically heterogeneous anthroponotic diseases caused by hepatotropic viruses, which have different mechanisms of infection and are characterized by predominant damage to the hepatobiliary system with the development of general toxic, dyspeptic and hepatolienal syndromes, impaired liver function and often jaundice.

Based on the mechanisms and routes of transmission, there are two groups of viral hepatitis:

• with a fecal-oral mechanism of infection - viral hepatitis A and E;
• with a hemopercutaneous (blood contact) mechanism, forming a group of so-called parenteral hepatitis B, D, C, G.

Viruses that cause parenteral hepatitis have a chroniogenic potential, especially pronounced in the hepatitis C virus. In addition to chronic hepatitis, they cause the development of liver cirrhosis and primary hepatocarcinoma.

Hepatitis infection

Hepatitis viruses enter the human body in two main ways.

1. Fecal-oral mechanism of infection. A sick person can excrete the virus in their feces, after which it enters the intestines of other people with water or food. Characteristic of hepatitis A and E viruses.
2. Human contact with infected blood . It is characteristic of hepatitis viruses B, C, D, G. The greatest danger, due to the prevalence and severe consequences infections are represented by hepatitis B and C viruses.

Single needle use different people greatly increases the risk of infection with hepatitis B, C, D, G. This is the most common route of infection among drug addicts.

Viruses B, C, D, G can be transmitted through sexual contact. Hepatitis B is most often transmitted through sexual contact. It is believed that the likelihood of contracting hepatitis C in spouses is low.

The route of infection from mother to child (doctors call it “vertical”) is not observed so often. The risk increases if the woman has an active form of the virus or recent months suffered acute hepatitis during pregnancy. The likelihood of infection of the fetus increases sharply if the mother, in addition to the hepatitis virus, has HIV infection. The hepatitis virus is not transmitted through mother's milk.

Hepatitis viruses B, C, D, G are transmitted through tattooing, acupuncture, and ear piercing with unsterile needles. In 40% of cases, the source of infection remains unknown.

Symptoms of hepatitis

From the moment of infection to the appearance of the first signs of the disease, different times pass: 2-4 weeks for hepatitis A, 2-6 months for hepatitis B.

Hepatitis A, before the appearance of jaundice, resembles the flu and begins with fever, headache, general malaise, and body aches.

With hepatitis B and C, the onset is usually more gradual, without a sharp rise in temperature.

The hepatitis B virus manifests itself as mild fever, joint pain, and sometimes rashes.

The initial manifestations of hepatitis C may be limited to weakness and loss of appetite. After a few days, the picture begins to change: appetite disappears, pain appears in the right hypochondrium, nausea, vomiting, urine darkens and feces become discolored. There is an enlargement of the liver and, less commonly, the spleen. Specific markers of viruses are detected in the blood, bilirubin increases, liver tests increase 8-10 times.

Usually, after the appearance of jaundice, the condition of patients improves. However, this does not happen with hepatitis C, as well as in chronic alcoholics and drug addicts, regardless of the type of virus.

The clinical course of hepatitis can be of varying degrees of severity: mild, moderate, severe and fulminant (that is, lightning-fast) forms. The last and most severe type of hepatitis, in which massive liver necrosis develops, usually ends in the death of the patient.

The greatest danger is the chronic course of hepatitis. Chronization is typical only for hepatitis B, C, D. The most characteristic signs of chronic hepatitis are malaise and increased fatigue towards the end of the day, and the inability to perform previous physical activities. These symptoms are not permanent.

Signs of hepatitis also include nausea, abdominal pain, joint and muscle pain, and upset bowel movements.

With jaundice at an advanced stage of chronic hepatitis, dark urine is detected, itchy skin, bleeding, weight loss, enlarged liver and spleen, spider veins.

Hepatitis A

Hepatitis A is also called Botkin's disease. It is considered the most favorable form of hepatitis, as it does not have serious consequences. Most often, children get hepatitis A: the disease is transmitted through dirty hands. The disease is widespread mainly in underdeveloped countries with low levels of hygiene.

Most cases result in spontaneous recovery and do not require active treatment. In severe cases, droppers are prescribed to eliminate the toxic effect of the virus on the liver. All patients are recommended to rest in bed during the height of their illness. special diet and drugs that protect the liver (hepatoprotectors).

Hepatitis B

Hepatitis B is also called serum hepatitis. This name is due to the fact that infection with the hepatitis B virus can occur through the blood, and through an extremely small dose. The hepatitis B virus can be transmitted sexually, through injections with non-sterile syringes from drug addicts, and from mother to fetus.

Hepatitis B is characterized by liver damage and occurs in different variants: from carriage to acute liver failure, cirrhosis and liver cancer. From the moment of infection to the onset of the disease, 50-180 days pass. In typical cases, the disease begins with fever, weakness, joint pain, nausea and vomiting. Sometimes rashes appear. The liver and spleen become enlarged. There may also be darkening of the urine and discoloration of the stool.

Hepatitis C

The most severe form of viral hepatitis, which is also called post-transfusion hepatitis. This means that they contracted it after a blood transfusion. Sexual transmission is possible, as well as from mother to fetus, but they occur less frequently.

From the moment of infection to clinical manifestations, it takes from 2 to 26 weeks.

This is the case if virus carriage is not diagnosed, a condition when the virus has been in the body for many years and the person is the source of infection. In this case, the virus can directly act on liver cells, leading over time to liver tumors. In the case of acute onset of the disease, the initial period lasts 2-3 weeks, and, as with hepatitis B, is accompanied by joint pain, weakness, and indigestion. Unlike hepatitis B, fever is rare. Jaundice is also not typical for hepatitis C.

The greatest danger is chronic form a disease that often progresses to cirrhosis and liver cancer.

Hepatitis C and sex

Sexual transmission of the virus occurs when an infected secretion (any substance that is secreted) human body) or infected blood enters healthy body partner through the mucous membrane. However, infected secretions alone are not enough for infection to occur. The so-called predisposing factors must be present: a large number of virus in the secretion secreted by the body, the integrity of the mucous membrane with which it comes into contact, the presence of other sexually transmitted infections (viral or bacterial).

Studies on the content of the hepatitis C virus in male semen, vaginal secretions, and saliva indicate that the virus is rarely detected in them and is contained in a low titer, which probably underlies the low frequency of sexually transmitted infections.

Hepatitis D

The causative agent is delta hepatitis virus. The virus cannot reproduce on its own in the human body; it requires the participation of a helper virus. This helper is the hepatitis B virus. This tandem gives rise to a rather serious disease. Most often, infection occurs through blood transfusions, through syringes from drug addicts. Sexual transmission is possible from mother to fetus. All the faces infected with virus hepatitis B, are susceptible to hepatitis D. The risk group includes hemophiliacs, drug addicts, and homosexuals.

From the moment of infection to the development of the disease, 1.5-6 months pass. The clinical picture and laboratory data are the same as for hepatitis B. However, with mixed infection Severe forms of the disease predominate, often leading to liver cirrhosis. The prognosis for this disease is often unfavorable.

Hepatitis E

The mechanism of infection, like that of hepatitis A, is fecal-oral. Infection often occurs through water. As with hepatitis A, the prognosis is favorable in most cases. The exception is women in the last three months of pregnancy, in whom mortality reaches 9-40% of cases. Susceptibility to viral hepatitis E is universal. Mostly young people aged 15-29 years old become ill.

From the moment of infection to the onset of the disease, 14 to 50 days pass. Hepatitis E begins gradually with indigestion, deterioration in general health, and less often with a short rise in temperature. Unlike hepatitis A, the appearance of jaundice does not improve the health of patients. After 2-4 weeks from the onset of the disease, it is observed reverse development symptoms and recovery.

At severe form hepatitis E causes severe damage to the liver and kidneys. With hepatitis E, moderate and severe forms of the disease are more common than with hepatitis A. Distinguished by hepatitis E severe course in pregnant women in the second half of pregnancy with a high number deaths. Fetal death occurs in almost all cases. Hepatitis E is not characterized by a chronic course and viral carriage.

Hepatitis G

Hepatitis G is widespread. Hepatitis G is transmitted through blood. This is reflected in the widespread prevalence of the disease among drug addicts. Infection also occurs during blood transfusions and parenteral interventions. Sexual transmission and vertical transmission from an infected mother to a child are possible.

In clinical manifestations, hepatitis G also resembles hepatitis C. However, it is not characterized by the progression of the infectious process with the development of cirrhosis and cancer inherent in hepatitis C. As a rule, the acute infectious process is mild and asymptomatic. The main marker for diagnosing hepatitis G is the PCR (polymerase chain reaction) method.

The outcomes of acute hepatitis G can be: recovery, the formation of chronic hepatitis or prolonged carriage of the virus. Combination with hepatitis C can lead to cirrhosis.

Diagnosis of hepatitis

Diagnosis of hepatitis A

The diagnosis of hepatitis A is established on the basis of:

• interviewing the patient and epidemiological data;
• symptoms of illness;
• laboratory data.

Diagnosis of hepatitis B

In the diagnosis of hepatitis B, indications of manipulations that have taken place associated with violation of the integrity of the skin or mucous membranes, casual sexual intercourse, close contact with carriers of the hepatitis B virus or with patients with chronic liver diseases in the period from 6 weeks to 6 months before the onset of the disease help.

Hepatitis B is characterized by a gradual onset, a long pre-icteric period with severe weakness and indigestion, joint pain and rashes, lack of improvement in health or its deterioration with the appearance of jaundice, and enlarged liver. Special meaning to diagnose hepatitis B virus have specific reactions.

Diagnosis of hepatitis C

To make a diagnosis of viral hepatitis C, it is necessary to conduct laboratory and instrumental examinations.

Positive test results for hepatitis C virus may mean the following:

1. Chronic infection. This means that there is an infectious viral process that has caused mild liver damage.
2. Previous infection. (You have encountered this virus, but the body's natural defense reaction helped you overcome the infection.)
3. False positive result. During the first blood test, some patients may have a positive result, which is not confirmed by a more in-depth examination. This reaction may be due to causes other than the hepatitis C virus.

Diagnosis of hepatitis E

The basis for the assumption of the presence of hepatitis E is the combination of symptoms of acute hepatitis with the characteristics of infection (stay 2-8 weeks before the disease in a region specific for hepatitis E, consumption there raw water, the presence of similar diseases among others).

A specific marker confirming the diagnosis of hepatitis E is antibodies to the hepatitis E virus class IgM (anti-HEV IgM), detected using enzyme immunoassay ELISA in blood serum in the acute period of the disease.

Thus, the main criterion for making a diagnosis are various clinical and laboratory indicators: markers of hepatitis viruses, changes in biochemical blood parameters.

Hepatitis treatment

Hepatitis A treatment

Most people infected with hepatitis A develop an “acute” illness. The infection lasts less than six months (often a month). The human body gets rid of the virus without treatment. However, it is necessary to undergo a full examination and monitor liver function for six months after recovery.

Hepatitis B treatment

Most adults can resist hepatitis B infection without treatment, but treatment with interferon alfa may be prescribed.

In 45% of patients treated with recombinant interferon alpha-2a, hepatitis B virus is not detected at the end of treatment. Even if interferon alpha treatment does not clear the virus from the body, there is significant improvement in liver tissue, which prevents fast development liver cirrhosis.

Preserves liver function and prevents the development of cirrhosis lymphotropic therapy. See Endolymphatic therapy for diseases of the liver and biliary tract.

Hepatitis C treatment

Hepatitis C is the most serious type of hepatitis. The development of a chronic form is observed in at least every seventh patient. These patients are at high risk of developing cirrhosis and liver cancer.

The basis of all hepatitis C treatment regimens is interferon-alpha. To enhance the effectiveness of interferon, in recent years a process called pegylation has been used. It is enough to administer pegylated interferon once a week to maintain the required therapeutic concentration in the blood. After completing the course of treatment, it is important to continue monitoring blood tests for several more months, since in some patients, when interferon injections are stopped, signs of liver inflammation reappear.

The most progressive method to shorten the treatment time for hepatitis C is lymphotropic therapy.

Treatment of hepatitis D

People do not get hepatitis D separately; this infection can only accompany hepatitis B. Therefore, for hepatitis D, which complicates B, the dose of medication is slightly increased and the course of treatment is lengthened. Even if the treatment does not remove the virus from the body, there is a significant improvement in the liver tissue, which prevents the rapid development of cirrhosis of the liver.

Hepatitis E treatment

There is no cure for hepatitis E. The human body is strong enough to get rid of the virus without treatment. After a month and a half, complete recovery occurs. Sometimes prescribed symptomatic therapy to eliminate headaches, nausea and other unpleasant symptoms.

Complications of hepatitis

Complications of viral hepatitis can include functional and inflammatory diseases of the biliary tract and hepatic coma, and if disruption of the biliary tract can be treated, then hepatic coma is a formidable sign of the fulminant form of hepatitis, ending in death in almost 90% of cases.

In 80% of cases, the fulminant course is caused by the combined effect of hepatitis B and D viruses. Hepatic coma occurs due to massive necrosis (necrosis) of liver cells. The breakdown products of the liver tissue enter the blood, causing damage to the central nervous system and the extinction of all vital functions.

An unfavorable outcome of acute hepatitis is its transition to the chronic stage, mainly with hepatitis C.

Chronic hepatitis is dangerous because the lack of adequate treatment often leads to cirrhosis and sometimes liver cancer. In this regard, doctors consider hepatitis C to be the most serious disease. In 70-80% of cases, its acute form becomes chronic, although external signs there may not be a disease.

The most severe course of hepatitis is caused by a combination of two or more viruses. In this case, the prognosis is extremely unfavorable. Often, the signs of chronic viral hepatitis are mild, which allows a person to ignore the disease for the time being. Often obvious clinical manifestations diseases are detected already at the stage of cirrhosis.

Cirrhosis occurs in approximately 20% of people with hepatitis C. Hepatitis B with or without hepatitis D can also cause this complication. The presence of cirrhosis creates obstacles to normal blood flow in the liver. Another problem associated with the development of liver cirrhosis is ascites (accumulation of fluid in the abdominal cavity), which is externally manifested by an increase in the size of the abdomen.

Sometimes people with cirrhosis develop liver cancer, which in the early stages can be treated with medications or surgery. If cirrhosis of the liver has formed, it cannot be eliminated, even if the inflammation of the liver has already passed. Therefore, treatment for viral hepatitis should be started as early as possible!

Prevention of hepatitis

1. Do not drink unboiled water, wash fruits, vegetables, and hands.
2. Avoid contact with biological fluids other people. To protect against hepatitis B and C - primarily with blood.
3. Do not use other people's razors, toothbrushes, or nail scissors.
4. Never share syringes and needles when taking drugs. Never perform piercings or tattoos with non-sterile equipment.
5. It is especially necessary to take precautions during sex during menstruation and anal intercourse. Oral sex can also be dangerous.
6. Hepatitis is transmitted from mother to child during pregnancy, childbirth, and breastfeeding. With proper medical support, you can try to avoid infection of the baby - this will require careful adherence to hygiene rules and taking medications.
7. The route of infection with hepatitis often remains unknown. To be completely calm, you need to get vaccinated.