Today, viral hepatitis ranks first in the structure of liver diseases in the world. 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 diseases of the liver, which are based on viral damage to hepatocytes with impaired 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 in 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.

Fulminating 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.

Protracted viral hepatitis resembles an acute course, but with a longer icteric period. The protracted course takes about six months and is also found in S.

Chronic viral hepatitis proceeds for a long 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 belong to the group of anthroponotic infections;
• viral hepatitis can be transmitted by parenteral, sexual and alimentary 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 are manifested by 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 Picornaviridae 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, as well as on objects and surfaces.

Interesting! Hepatitis A virus can be inactivated by boiling for five minutes and by treatment with solutions of bleach, potassium permanganate, chloramine or formalin.

Hepatitis B virus is a member of the DNA viruses of the Orthovirus genus of the Hepadnovirus family. The DNA of the virus has the form of a ring of two strands.

On the surface of the protein-lipid shell contains 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 HBsAg and HBcAg antigens, and lifelong immunity is formed.

The causative agent of hepatitis B, as well as the hepatitis A virus, is resistant to aggressive environmental factors. At room temperature, it can live for several months, and frozen - for several years.

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

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

In each region, the disease is caused by a certain 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 retains its activity at a temperature of 50°C, 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 ways 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. In this way, you can become infected with hepatitis A and E.

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

Ways 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 the remains of blood infected with the hepatitis virus;
• sexual way - during sexual intercourse without the use of 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;
• during manicure, pedicure, shaving, hair removal, permanent makeup, if the instruments are not treated with disinfectants.

Clinical course of viral hepatitis

Viral hepatitis can proceed cyclically and acyclically.

Interesting! Asymptomatic forms of the disease are diagnosed randomly when examining 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 due to the fact that there are no signs of viral hepatitis, but it is determined in the blood 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 stage of heat;
• 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, on the type of virus and the state of human immunity.

Prodromal stage (period)

The 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 stools or constipation.

3. Arthralgic syndrome:

• migratory 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;
• skin itching;
• rash.

The peak period of the disease (icteric)

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

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

The stool brightens and becomes completely colorless, since it lacks stercobilinogen, which colors it orange-brown.

convalescence period

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

General blood analysis is prescribed to detect 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 the erythrocyte sedimentation rate.

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

Blood chemistry is the most informative, as it indicates a violation of liver function. Viral hepatitis is characterized by an increase in the activity of hepatic transaminases (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, glutamyl dehydrogenase, lactate dehydrogenase), a 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 causative agents of viral hepatitis. Using this method, markers of viral hepatitis - antibodies to hepatitis viruses and their antigens - are determined quantitatively and qualitatively in the blood.

Polymerase chain reaction is another method of determining the type of virus that caused viral hepatitis. This method consists in 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 is carried out to determine the activity, the prevalence of the process and the presence of complications.

All viral hepatitis are treated according to general principles, among which are the following:

• only essential medications are prescribed so as not to overload the liver;
• the choice of the drug depends on the period of the disease, the presence of concomitant pathology or complications;
• if possible, accompanying chronic pathology treated after the normalization of liver function;
• 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 appointment of drugs that stop the replication of viruses and kill them.

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

Pathogenetic therapy viral hepatitis includes the following items:

• hepatoprotectors to activate the recovery processes of hepatocytes and protect them from negative factors(Gepabene, Heptral, Essentiale, Silibor, Karsil and others);
• enterosorbents to accelerate the excretion of bilirubin and viruses from the body (Enterosgel, Laktofiltrum and others);
• detoxification therapy (5% Glucose, 0.95 sodium chloride, Rheosorbilact, Ringer-Lactate, Disol, Trisol, etc.);
• glucocorticosteroids (Prednisolone, Dexamethasone);
• antispasmodic therapy (No-shpa, Papaverine);
• choleretic therapy (Ursochol, Ursosan, Holesas);
• vitamin preparations (Cyanocobolamin, 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 long, but also expensive.

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

• vaccination 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;
• make tattoos and piercings only in special salons that comply with the relevant anti-epidemic standards;
• use condoms during sexual intercourse;
• do not inject drugs.

The treatment of viral hepatitis is carried out by an infectious disease specialist together with a hepatologist.

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

Hepatitis of viral etiology can be acute and chronic, while each of them has its own incubation period and peculiar signs.

Acute hepatitis in adults, especially with correct therapy at an early stage, amenable to rapid treatment, chronic appearance - only in rare cases can it be cured completely.

There is a group of people who are much more at risk of getting infected than others. These include:

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

In order to avoid infection, there are methods of prevention, the observance of which will reduce the risk.

General symptoms

Despite the fact that each group of viral hepatitis has its own characteristic manifestations, yet there are common signs indicating a virus. The main symptoms of the disease:

The appearance of some of these signs may not indicate the presence of the disease. Therefore, the first step is to consult 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 after it more complications will occur. In very young children, hepatitis A can occur without any symptoms, 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 disturbed the following symptoms:

• flu-like symptoms: chills, 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 stool and urine. This suggests that the next period may begin - icteric. Jaundice occurs when bile is released into the blood, which can cause the skin and eyes to become stained. yellow. It is bile that changes the color of feces and urine. Worth remembering! Not all types of hepatitis cause jaundice.

After icteric period often there is an improvement in the condition of a person. Group A viral disease is the most mild form with almost no consequences.

Such patients receive lifelong immunity to this type of disease.

Hepatitis B

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

Manifestations of signs 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 be noted;
• jaundice appears, the color of feces and urine changes, sometimes a rash appears;
• when diagnosing, an enlarged liver and spleen are found.

Hepatitis B, if not treated promptly, affects the liver cells, which can cause irreversible severe consequences: cancer or liver failure. But there have also been cases of complete cure and the 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 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 damage occurs with little to no symptoms. In the acute course of the disease, the symptoms are similar to group B virus, only without icteric manifestations.

With a disease of this form, the following typical symptoms can be observed:

• pain in the joints;
• 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 written off to patients with acute respiratory viral infections 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 tissues. 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 A viral disease is similar in symptoms to a group B virus. As a rule, there is a simultaneous course of two forms of the disease, since hepatitis D cannot exist on its own. A mixed type of disease can lead to a number of severe complications especially cirrhosis of the liver cells.

Hepatitis E

Symptoms of viral hepatitis E in adults appear almost the same as with hepatitis A - jaundice occurs. But their difference is that after the icteric period with hepatitis E, there is no improvement in the condition. The incubation period can range from 2 weeks to 2 months.

At the initial stage of the development of this form of the disease, there may be a slight malaise or there are 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 the form A in that the virus affects not only the tissues of the liver, but also the kidneys.

Mild hepatitis E usually clears up within a month. The exception is pregnancy.

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

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 the manifestations of the group C virus, but there are still differences.

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

If any signs appear, you should immediately consult a doctor and do 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 the liver tissue they cause is also called jaundice or Botkin's disease. To date, the sixth species has become known - "G".

The essence of viral hepatitis

What 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 embedded 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. The lightest and most common form. Infection occurs due to non-compliance with hygiene measures, through the things of an infected person. History shows that the transferred hepatitis A creates a strong immunity in the body to the disease.
2. It has a more severe course. Infection - through blood, sexual intercourse, childbirth. Causes severe liver damage.
3. Referred to as HCV. It tends to transform into a chronic form. Infection occurs through blood, sexual intercourse, medical instruments.
4. Characterized acute course, resulting in mass defeat liver cells. Virus reproduction depends on the presence of type B virus. The only way get infected is blood.
5. Type A virus modification. You can get infected through water, from infected people.
6. Weaker version of type C.

According to the 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, medicinal etiology. But with a cryptogenic and autoimmune type of disease, the cause cannot be found out. According to the path of infection, the hepatitis disease is divided into two groups:

• enteral (A, E), resulting from infection through the mouth;
• parenteral (B, C, D, G), transmitted through the 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 falls into the soil. Poor hygiene, contaminated drinking water sources all contribute to the spread of the virus. Hepatitis A and E are the most common.
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 contact, due to non-sterile medical instruments. This is how hepatitis B, C, D, G is transmitted. The incidence is especially widespread among drug addicts, transmitted through common tools.

Virus classification

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

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

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

• manifest, proceeding with the manifestation or absence of a sign of jaundice;
• asymptomatic.

Symptoms and signs of viral hepatitis

Acute forms arise due to different viruses, their subspecies 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 SARS;
• dark urine, colorless feces.

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

Methods for diagnosing a virus

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

Tests for the disease

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

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

There is a search for viral antigens in special laboratories through various tests.

The particles of viruses and antibodies found in the patient's blood contribute to:

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

PCR method

Used to detect hepatitis C PCR method. Another milestone diagnostics is a biochemical analysis of blood composition. There is a determination of liver enzymes in the blood, as well as bilirubin fractions. To detect the presence of morphological changes in the structure of the liver, an ultrasound examination (ultrasound) is used. If a diagnosis of viral hepatitis is made, then treatment is prescribed immediately.

Treatment of viral hepatitis

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

• antihistamines and antiviral drugs;
• interferons.

The severe course of hepatitis is accompanied by the use of Reamberin, hormonal drugs. Sometimes they can be treated with antibiotics.

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

• Hemodeza;
• Poliglukin;
• 5% Glucose.

Hepatitis C is not treatable. The methods used by doctors can only suppress its reproduction. Stopping the progression of the disease allows the infected person to continue living normally.

Medicines to treat the virus

The most commonly prescribed drugs:

• Ademetionine;
• Ursodeoxycholic acid;
• Silymarin;
• Katergen;
• Hepanorm;
• cyanidanol;
• Velferon;
• Intron-A;
• lamivudine;
• Adefovir;
• Entecavir.

Diet and Nutrition in Viral Hepatitis

In a special place in viral hepatitis is a change in the patient's diet. The diet developed by doctors involves the use of only easily digestible products that do not put a load on the damaged organ.

Forbidden foods

1. Fatty meat and dairy foods.
2. Fried, marinated, 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 below.
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 a predominant lesion of the hepatobiliary system with the development of general toxic, dyspeptic and hepatolienal syndromes, impaired liver function and often jaundice.

According to the mechanisms and routes of transmission, two groups of viral hepatitis are distinguished:

• with the 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, which is 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 with feces, after which, with water or food, it enters the intestines of other people. Characteristic for hepatitis A and E viruses.
2. Human contact with infected blood . It is characteristic of hepatitis B, C, D, G viruses. The greatest danger, due to the prevalence and severe consequences infections are hepatitis B and C viruses.

Using one needle different people greatly increases the risk of contracting 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 commonly transmitted sexually. It is believed that the likelihood of contracting hepatitis C in spouses is low.

The path of infection from mother to child (doctors call it "vertical") is not so common. The risk is increased if the woman has an active form of the virus or recent months pregnancy suffered acute hepatitis. The probability of infection of the fetus increases dramatically if the mother, in addition to the hepatitis virus, has an HIV infection. Hepatitis virus is not transmitted through mother's milk.

Hepatitis B, C, D, G viruses are transmitted by tattooing, acupuncture, ear piercing with non-sterile 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, a different time passes: 2-4 weeks for hepatitis A, 2-6 months for hepatitis B.

Hepatitis A before jaundice resembles the flu and begins with fever, headache, general malaise, 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 a slight temperature, joint pain, and sometimes rashes.

Initial manifestations of hepatitis C may be limited to weakness and decreased appetite. After a few days, the picture begins to change: appetite disappears, pains appear in the right hypochondrium, nausea, vomiting, urine darkens and feces become discolored. There is an increase in the liver and less often - the spleen. Specific markers of viruses are found in the blood, bilirubin increases, liver tests increase by 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 severity: mild, moderate, severe and fulminant (that is, fulminant) forms. The last 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 by the end of the day, the inability to perform previous physical activity. These symptoms are not permanent.

Signs of hepatitis are also nausea, abdominal pain, joint and muscle pain, upset stool.

With jaundice at an advanced stage of chronic hepatitis, darkening of the urine is detected, pruritus, bleeding, weight loss, enlargement of the 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 severe consequences. Most often, children get sick with hepatitis A: the disease is transmitted through dirty hands. The disease is widespread mainly in underdeveloped countries with a low level of hygiene.

Most cases end spontaneously 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 bed rest during the height of the disease, 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, by injection with non-sterile syringes from drug addicts, from mother to fetus.

Hepatitis B is characterized by liver damage and occurs in different ways: 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 there are rashes. There is an increase in the liver and spleen. 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 fell ill 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 in the event that a virus carrier 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, eventually leading to a liver tumor. In the case of an acute onset of the disease, the initial period lasts 2-3 weeks, and, as with hepatitis B, it is accompanied by joint pain, weakness, and indigestion. Unlike hepatitis B, fever is rare. Jaundice is also uncommon for hepatitis C.

The greatest danger is chronic form disease, which often turns into cirrhosis and liver cancer.

Hepatitis C and sex

Sexual transmission of the virus occurs when an infected secretion (any substance that is shed human body) or infected blood enters healthy body partner through the mucosa. However, the infected secretion alone is not sufficient for infection to occur. The so-called predisposing factors must be present: a large number of virus in the body's secretions, the integrity of the mucosa with which it comes into contact, the presence of other sexual 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 found in them and is contained in a low titer, which is probably the basis for the low incidence of sexually transmitted infection.

Hepatitis D

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

From the moment of infection to the development of the disease takes 1.5-6 months. 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 cirrhosis of the liver. The prognosis for this disease is often poor.

Hepatitis E

The mechanism of infection, as in hepatitis A, is fecal-oral. Often, infection occurs through water. As with hepatitis A, the prognosis is good in most cases. The exception is women in the last three months of pregnancy, in which mortality reaches 9-40% of cases. Susceptibility to viral hepatitis E is universal. Mostly young people aged 15-29 get sick.

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

At severe form hepatitis E is characterized by severe damage to the liver and kidneys. In hepatitis E, more often than in hepatitis A, moderate and severe forms of the disease are noted. Distinguishes 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 virus carrying.

Hepatitis G

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

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

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

Diagnosis of hepatitis

Diagnosis of hepatitis A

Hepatitis A is diagnosed based on:

• questioning the patient and epidemiological data;
• disease symptoms;
• laboratory data.

Diagnosis of hepatitis B

In the diagnosis of hepatitis B, indications of manipulations that have taken place associated with a violation of the integrity of the skin or mucous membranes, casual sex, 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 preicteric period with severe weakness and indigestion, joint pain and rashes, lack of improvement in well-being or its deterioration with the appearance of jaundice, liver enlargement. Special meaning for the diagnosis of 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.

A positive test result for the hepatitis C virus can mean the following:

1. chronic infection. This means that there is an infectious viral process that caused a mild liver damage.
2. Past infection. (You have been exposed to this virus, but the body's natural defenses helped you overcome the infection.)
3. False positive result. At 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 other causes 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, use 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 of the IgM class (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 parameters: markers of hepatitis viruses, changes in blood biochemical parameters.

Hepatitis treatment

Hepatitis A treatment

Most people infected with hepatitis A are "acutely ill". The infection lasts less than six months (often a month). The human body gets rid of the virus without the help of treatment. However, it is necessary to undergo a complete examination and monitor liver function within six months after recovery.

Hepatitis B treatment

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

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

Preserve liver function and prevent the development of cirrhosis allows lymphotropic therapy. See Endolymphatic Therapy for Diseases of the Liver and Biliary Tracts.

Hepatitis C treatment

Hepatitis C is the most serious type of hepatitis. The development of the 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. In order to enhance the effectiveness of interferon, a process called pegylation has been applied in recent years. Pegylated interferon is sufficient to be administered once a week to maintain the required therapeutic concentration in the blood. After the end of 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 reduce the time of treatment of hepatitis C is lymphotropic therapy.

Hepatitis D treatment

People do not get hepatitis D separately, this infection can only accompany hepatitis B. Therefore, with hepatitis D, which complicates B, the dose of drugs is slightly increased, the course of treatment is lengthened. Even if therapy does not lead to the removal of 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

Hepatitis E is not cured. The human body is strong enough to get rid of the virus without the help of treatment. In a month and a half comes a complete recovery. Sometimes assigned symptomatic therapy to eliminate headaches, nausea and other unpleasant symptoms.

Complications of hepatitis

Functional and inflammatory diseases of the biliary tract and hepatic coma can become complications of viral hepatitis, and if a violation in the work of the biliary tract can be treated, then hepatic coma is a formidable sign of a fulminant form of hepatitis, ending in death in almost 90% of cases.

In 80% of cases, the fulminant course is due to the combined action of hepatitis B and D viruses. Hepatic coma occurs due to massive necrosis (necrosis) of liver cells. The decay 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 in 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 disease may or may not exist.

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 explicit clinical manifestations diseases are detected already at the stage of cirrhosis.

Cirrhosis occurs in approximately 20% of patients with viral hepatitis C. Hepatitis B, with or without hepatitis D, can also lead to this complication. The presence of cirrhosis creates obstacles to normal blood flow in the liver. Another problem associated with the development of cirrhosis of the liver 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 can be treated with drugs or surgery in the early stages. If liver cirrhosis has formed, it cannot be eliminated, even if inflammation of the liver has already passed. Therefore, treatment of viral hepatitis should be started as early as possible!

Prevention of hepatitis

1. Do not drink unboiled water, wash fruits, vegetables, hands.
2. Avoid contact with biological fluids other people. For protection against hepatitis B and C - primarily with blood.
3. Do not use other people's razors, toothbrushes, nail scissors.
4. Never share syringes and needles for taking drugs. Never use non-sterile piercings and tattoos.
5. Especially carefully it is 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, during breastfeeding. With proper medical support, you can try to avoid infection of the baby - this will require careful adherence to hygiene rules and medication.
7. The route of infection with hepatitis very often remains unknown. To be completely calm, it is necessary to vaccinate.