The diagnosis of "viral hepatitis" is by no means a rarity in our country and around the world, and it can be quite unexpected for an unsuspecting patient. This is due to the fact that the infection is able to exist for a long time in the body, destroying the liver, outwardly not showing itself.
Classification of viral hepatitis
Viral hepatitis is not one disease, but a whole group of pathologies, the causative agents of which are different types of viruses, differing in molecular and biochemical characteristics. They are transmitted in different ways, they do not have the same degree of aggression. Common to these pathogens is that they all cause inflammation of the liver tissue, disrupting its functioning.
Currently, about a dozen types of viruses are known, when infected with which hepatitis develops. Not all of them have been fully studied. In addition, there are still unidentified hepatitis viruses. Viral hepatitis is classified not only by type of virus, but also by other criteria:
1. On the clinical course:
- acute cyclic (up to 90 days);
- acute lingering (up to 6 months);
- chronic (over six months).
2. On the severity of the current:
- light degree;
- average;
- heavy.
3. On the clinical form:
- Manifist (icteric typical, icteric atypical, without jaundice);
- latent (subclinical, inna-parental).
Viral hepatitis A
The disease, provoked by type A viruses, is acute viral hepatitis, characterized by epidemic spread and a high degree of infectiousness. The causative agent of the infection is also known as enterovirus-72, and the pathology itself is called Botkin's disease. Transmitted by fecal-oral route, a person of any age can get sick, after which he develops a permanent immunity.
The incubation period of infection varies between 7 and 45 days. The virus that penetrates the intestinal mucosa accumulates in its epithelium and moves to the liver, where it begins to destroy cellular structures. As a rule, the disease proceeds in mild form, and if the clinical picture is expressed, it is observed:
- a feeling of heaviness in the abdomen associated with an increase in the liver;
- nausea;
- the urge to vomit;
- darkening of urine;
- clarification of feces, its clayiness;
- elevated body temperature (within 2-3 days);
- headache and muscle pain;
- dry mouth;
- yellowing of the skin and sclera;
- skin itching and the like
Viral hepatitis B
Disease of this type can occur in acute, chronic, chronic forms. The pathogen, which excites the disease, is characterized by extreme survival at freezing, boiling, acid exposure, for a long time can be in an active state in the external environment. In patients with a diagnosis of hepatitis B, infectious agents are found in the blood and other biological fluids - saliva, urine, vaginal discharge, etc. Therefore, you can get infected by contact-household, parenteral, sexual and other ways.
Viral hepatitis of this type is characterized by an incubation period lasting from 45 days to six months. At this time, penetrated pathogens through the blood enter the liver, where they multiply and accumulate. After accumulating a certain amount, the first clinical signs may appear:
- general weakness and malaise (without fever);
- a constant sensation of heaviness in the abdomen, becoming intense after a meal;
- nausea;
- change of color of urine;
- pain in the joints, etc.
Further, the viral hepatitis passes into the icteric phase, in which all manifestations increase, and new ones also appear:
- discoloration of stool;
- yellowing of the skin and sclera;
- decreased urine output;
- indigestion;
- sleep disturbance, etc.
The acute form either ends with recovery and remaining stable immunity (with the liver functioning resumed in a few months, and the residual phenomena may be present throughout life), or passes into a chronic form with a wave-like course and parallel developing pathologies of other organs.
Viral hepatitis C
This disease begins with an acute process, which is often chronic. Infection mainly occurs from sick people or virus carriers in contact with their blood, sexually, from the mother to the nurtured child. Because of the fact that chronic viral hepatitis C in most cases proceeds secretly and is detected even when the lesion is irreversible, it is called a "gentle killer."
On average, the incubation period takes 60 days. With the course of this type of disease is similar to hepatitis B and can be characterized by the following manifestations:
- general weakness;
- joint pain;
- indigestion disorder;
- nausea;
- darkening of urine;
- yellowing of the skin, etc.
Viral hepatitis C is accompanied by many extrahepatic signs, masking the underlying pathology: skin rashes, vitiligo, anemia, kidney damage, thyroid gland, etc. After an acute phase, the patient can recover, or the disease goes to a chronic stage. The majority, in the absence of timely treatment, still develops a chronic process that may not manifest itself for decades. Damaged liver tissue gradually changes to fatty and fibrous, sometimes the process becomes malignant.
Viral hepatitis D
This disease is also referred to as delta infection. Hepatitis D is characterized by such a feature as the need to keep the virus type B in cells for its reproduction and development. Therefore, delta infection is detected only against a background of chronically developing hepatitis B and acquires the same clinical manifestations, only in a more pronounced form. In addition, such a complex of infections increases the risk of serious complications. Infection occurs through the blood.
Viral hepatitis E
The pathogen causing hepatitis E is similar to rotavirus and is transmitted by the fecal-oral route. This virus is unstable in the external environment, quickly kills by boiling and under the influence of antiseptics, but can persist for a long time in fresh water. The clinical picture resembles an easy course of Botkin's disease, in most cases ends with recovery. Adverse effects of this pathogen on pregnant women: pregnancy often ends in miscarriage, a woman can quickly develop liver failure.
Viral hepatitis F
The causative agent of this type, similar in its properties to adenovirus, was discovered recently and has been little studied. It is transmitted by fecal-oral route either through blood, from mother to fetus. Hepatitis F has the following main symptoms:
- general weakness;
- easy raising of temperature;
- headache;
- pain in the liver;
- jaundice ;
- stool disorder;
- nausea;
- bleeding gums.
How is viral hepatitis transmitted?
The main ways of transmission of viral hepatitis are:
- Fecal-oral (enteral) - with water and food due to poor hygiene, poor sanitary conditions).
- In contact with blood and other biological fluids of an infected person (parenterally) - with therapeutic and diagnostic manipulations, through injection equipment, dental, manicure instruments, with piercing, tattooing, etc.);
- At sexual contacts.
- During pregnancy from mother to future child.
To enteral types of illness carry subspecies A and E. More dangerous parenteral viral hepatitis - B, C, D, F, they pose a threat to life. The main sources of infection are people with asymptomatic and clinically expressed forms of the disease. To infect a microscopic droplet of contaminated biological fluid, imperceptible to the naked eye.
Viral Hepatitis - Diagnosis
The performed diagnostics of viral hepatitis, in addition to clinical examination, involves the detection of the type of pathogen, the form of the disease, the degree of impairment of organ functions and the presence of complications. For this, laboratory and instrumental techniques are used. So, ultrasound is assigned to establish morphological changes in hepatic tissue. In some cases, in order to obtain a complete picture of the inflammatory process, a histological examination of a sample of affected tissues is required.
Analyzes for viral hepatitis
An important diagnostic method is a blood test for markers of viral hepatitis. There are 2 main ways to detect pathogens:
- Immunological - the definition of antibodies produced in the body in response to the penetration of microorganisms, or particles of the virus itself.
- Genetic is a polymerase chain reaction method in which viruses are identified by their DNA or RNA in the blood.
Signs of viral hepatitis are revealed, in addition, through hepatic tests:
- determination of the level of hepatic enzymes;
- determination of bilirubin fractions.
Viral hepatitis - symptoms and treatment
Since with the disease "viral hepatitis" the symptoms do not always manifest themselves at an early stage, a full recovery is not always guaranteed. In most cases, as noted above, the pathology proceeds chronically with erased symptoms that can occur in many other ailments:
- lethargy;
- headache;
- abdominal pain;
- nausea;
- digestive disorders, etc.
Much more dangerous is the so-called lightning current, in which mass death of liver tissues is observed. As a rule, such a form is inherent in hepatitis A. In this case, the symptoms are pronounced clearly and the violations from the central nervous system are put first, which is associated with the accumulation of toxic substances. Thus, patients may have confusion, movement disorders, convulsions, etc. This requires immediate medical intervention.
Treatment of viral hepatitis C, A, B and other types of hepatitis has much in common and includes:
- adherence to bed or half-bed regime, restriction of physical activity;
- diet compliance;
- taking medications (specific antiviral drugs, detoxification agents, interferons, enterosorbents, enzyme preparations, hepatoprotectors, antispasmodics, etc.);
- sometimes - surgical treatment (organ transplantation).
Patients are shown frequent fractional food with the exception of products that stimulate the production of intestinal juice and activate the work of the liver. It is necessary to drink more liquid, to limit the use of salt. Products you can use:
- low-fat meat, fish;
- low-fat dairy products;
- egg white;
- boiled vegetables;
- porridge;
- biscuit cookies, yesterday's bread.
Forbidden:
- fatty meat, smoked products, canned food;
- marinades, pickles;
- fresh baking;
- fried food;
- raw onion, garlic, radish, radish, cabbage;
- chocolate.
In recent years, drugs with immunomodulating action from the group of thiopoetins, which selectively influence the hepatic cells, are used as part of the medicinal treatment of viral hepatitis. Such drugs include Glutoxim. Interferon inductors and immunomodulators are more recommended for acute processes. These are such medicines as:
- Cycloferon;
- Immunophane;
- Polyoxidonium;
- Amiksin and others.
Prevention of viral hepatitis
Regardless of the type of viral hepatitis, prevention is based on a number of rules, compliance with which reduces the risk of infection:
- Drinking boiled water, washed fruit and vegetables, thermally processed foods.
- Avoid contact with other people's body fluids (using only personal hygiene items, disposable syringes, sterilized instruments for manicure, piercing, etc.).
- Avoidance of casual intimate contacts, use of means of protection.
- Vaccination against hepatitis A and B.