What is Hepatitis? Hepatitis A, B, C, D, E

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With asymptomatic disease and in the absence of timely treatment, hepatitis becomes chronic and eventually leads to cirrhosis and cancer.
When injected into the human body, the hepatitis virus infects the liver tissue, causes inflammation in them, and then there is a gradual replacement of the liver parenchyma with connective tissue. During this period, the main functions of the body are violated. Thus, the liver stops producing the enzymes necessary for blood clotting and the digestive process. In the blood, the level of bilirubin (gall pigment) rises, jaundice appears. Most clearly, it manifests itself on the skin, mucous membrane of the soft palate and sclera.
Due to a violation of blood clotting, at the slightest blows serious hematomas appear, there is a threat of internal bleeding. In the absence of proper treatment or a severe course of the disease, liver cells are increasingly affected, the combination of symptoms becomes brighter, the liver grows in size and completely ceases to perform its functions. Hepatitis in this stage is fatal.

Types of hepatitis

Currently, there are several varieties of viral hepatitis:

    Hepatitis A. This is the most common type of virus that has the most favorable picture of the course of the disease. Its symptoms and signs appear a week or two months after the infection of the body. This form of hepatitis in rare cases becomes chronic, sometimes ends in complete self-healing of the body;
    hepatitis B. This is a dangerous form of hepatitis, which is accompanied by pronounced symptoms. It requires compulsory treatment in the hospital with the use of a full range of drugs, adherence to strict diet, as well as the rejection of bad habits. In 80% percent of cases, hepatitis B ends with a complete cure for a person from the virus. Escape from the disease is possible with the help of vaccination;
    Hepatitis C. This is the most severe form of the disease, which is often joined by viral hepatitis of other groups. An effective hepatitis C vaccine does not exist today. The disease is difficult to treat and in every 7th person infected, it leads to chronic hepatitis, followed by the occurrence of liver cirrhosis and cancer;
    Hepatitis D. This is another form of viral hepatitis, which in the course of the disease is similar to group B hepatitis. The difference in viruses is the presence of a delta agent;
    Hepatitis E. In terms of symptoms, this infection is similar to Hepatitis Form A. The disease can also be completely cured with timely referral to specialists. If it develops into a chronic stage, it affects not only the liver, but also the kidneys. This form is dangerous for women in the last months of pregnancy.

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

    acute hepatitis;
    chronic hepatitis.

Acute hepatitis most often manifests itself as overt symptoms and signs of a disease, a chronic disease is considered when the virus does not respond to treatment for 6 months.

The reasons
The main causes of hepatitis:

    viral infection;
    alcohol addiction;
    drug intoxication.

In more rare cases, other infections, such as cytomegalovirus, herpes, etc., become the cause of the hepatitis virus.
Hepatitis A and E groups most often enter the body through the gastrointestinal tract. This is facilitated by:

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

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

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

It also distinguishes the autoimmune causes of hepatitis of different groups, but what provokes a similar reaction of the body, to date, scientists do not know. In the case of an autoimmune reaction, the body produces antibodies to the cells and tissues of the liver. This provokes the development of the disease and aggravates its further course.

Viral hepatitis: symptoms and signs of the disease

Symptoms and signs of acute hepatitis

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

    fever observed over several weeks;
    headache;
    general fatigue and fatigue;
    decreased appetite;
    nausea, vomiting and diarrhea;
    the appearance of an unpleasant bitter taste in the mouth;
    pain in the right hypochondrium;
    spider veins on the skin;
    frequent nosebleeds, easy formation of hematomas;
    dark urine and fecal discoloration.

Hepatitis: signs of chronic form

During the transition of hepatitis to the chronic form, the symptoms remain the same, but their severity decreases. Also appear:

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

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

Hepatitis: diagnostic methods




As a rule, hepatitis is diagnosed during the patient's treatment to the doctor with complaints or during preventive examinations.
In the framework of the usual reception at the therapist or gastroenterologist specialist palpation of the liver area. With hepatitis, it always increases in size.
In addition to the survey, anamnesis and palpation, taking materials for laboratory research.
The standard diagnostic framework for hepatitis is:

    clinical analysis of blood, urine and feces;
    biochemical blood examination
    PCR diagnosis of viral hepatitis
    FibroTest and Fibromaks (determination of the degree of liver fibrosis).

In the course of the research, the affiliation of the virus to one of the groups of hepatitis and its quantity (viral load) is determined.
An ultrasound examination of the abdominal cavity organs is also mandatory.
In some cases, you may need:

    examination of the hepatic ducts and biliary ducts (holegraphy);
    needle biopsy of the liver.

Hepatitis treatment

Treatment of acute forms

Treatment of acute hepatitis should be promptly. The sooner it is started, the greater the likelihood of complete recovery.
Treatment of any form of hepatitis in the acute period is always carried out within the hospital. The main functions of drug treatment:

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

Reception of drugs is prescribed both intravenously and orally. Vitamin complexes are also prescribed to patients with hepatitis, and they must include calcium, potassium, manganese. At the discretion of the physician, oxygen therapy may be included in the scope of treatment for hepatitis of different groups.
When treating, compliance with diet No. 5A is required (to reduce the load on the liver).
Patients with hepatitis B is absolutely contraindicated for the use of alcohol and drugs that have a toxic effect on the liver.

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

Treatment of chronic hepatitis

Chronic hepatitis involves continuous monitoring of the state of the body throughout life. To do this, you must regularly perform a number of laboratory and instrumental diagnostic procedures.
Treatment of hepatitis of different groups is carried out courses with mandatory breaks. When drugs are not taken, the patient is prescribed mandatory compliance with diet number 5. During periods of exacerbation of hepatitis, diet number 5A is prescribed.
Chronic hepatitis, depending on the causes of the disease, involves taking the following drugs:

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

The procedure of detoxification of the body is mandatory.
The patient must refuse alcohol and tobacco, which only aggravate the condition of the liver tissue. Exercise during the period of normalization of the state are allowed, but moderate, so as not to cause overwork of the body.
Subject to all recommendations, the patient is able to live a long full life.
In the practice of treating hepatitis of various forms, the cases when the disease develops rapidly (from the moment of infection and the onset of symptoms to global liver damage takes a little time) are quite rare.

Hepatitis: disease prevention

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

    hygiene, wash hands with soap and water before each meal;
    proper processing of food products;
    avoiding alcohol and smoking.

Vaccination is also a preventive measure. Today, during the first years of the life of children, compulsory vaccination against group B hepatitis is carried out. This allows the body to be protected from liver damage by this virus.

Pathogenesis

Acute hepatitis develops either as a result of direct liver damage by hepatotoxic factors or a viral infection, or as a result of the development of an autoimmune reaction — the production of antibodies to the body’s own tissues. In both cases, acute inflammation develops in the liver tissue, damage and destruction of hepatocytes, inflammatory edema and a decrease in the functional activity of the organ. The lack of bile-liver function is the root cause of bilirubinemia and, as a consequence, jaundice. Since there are no pain receptor zones in the liver tissues, pain syndrome is rarely pronounced and is associated with an enlarged liver, stretching its well innervated capsule and inflammatory processes in the gallbladder.
Chronic inflammation usually develops as a result of untreated or insufficiently healed acute hepatitis. Often, anicteric and asymptomatic forms of hepatitis are not detected on time, and the inflammatory process becomes chronic, there are pockets of dystrophy and degeneration of the liver tissue. The decrease in the functional activity of the liver is aggravated. Often, chronic hepatitis gradually turns into cirrhosis.

Classification

Hepatitis classified:

    due to development - viral, alcoholic, medicinal, autoimmune hepatitis, specific hepatitis (tuberculosis, opisthorchosis, echinococcal, etc.), secondary hepatitis (as complications of other pathologies), cryptogenic hepatitis (of unclear etiology);
    with the flow (acute, chronic);
    by clinical signs (icteric, anicteric, subclinical forms).

Viral hepatitis is acute (hepatitis A and B viruses) and chronic (hepatitis B, D, C). Hepatitis can also be caused by viral and virus-like infections that are not specific for the liver - mononucleosis, cytomegalovirus, herpes, yellow fever. Autoimmune hepatitis varies in type depending on the target of antibodies (type 1, type 2, type 3).