Viral hepatitis a and e. Hepatitis A - what it is, signs and treatment
Botkin's disease, aka hepatitis A virus affects the liver, causing disruption of its normal functioning. A clear sign of hepatitis is jaundice. It appears as a result of the fact that the substance bilirubin produced by the liver, under the influence of the virus, begins to be released into the blood in large quantities. This is why the skin of patients with hepatitis acquires a yellow tint. The normal level of bilirubin in the blood of a healthy person is 0.6 mg%. In patients, this figure increases to 0.8 mg%. If you use the Hymansvan den Berg method, you can detect up to 20 mg% in the blood of patients, sometimes this figure reaches 30 mg%.
Classification of hepatitis A
1) the typical variant of the development of the disease includes all cases when the patient develops jaundice
2) with an atypical variant, the skin in yellow does not stain, the disease may not even be noticed. In children, for example, only one symptom may appear - temporary bowel dysfunction.
Three forms of the disease:
1) light (the most common);
2) moderate (affects 30% of patients);
3) severe form of hepatitis A (no more than 1-3% of patients).
Hepatitis usually results in complete recovery, with the liver beginning to function normally again. Less commonly, it may still remain enlarged for life, but other symptoms, as a rule, are absent in such patients.
Symptoms of the disease
Symptoms usually appear one month after infection. Incubation period hepatitis A lasts on average 30 days, but can range from 15 to 50 days. Then the symptoms of the disease appear: dyspepsia (heaviness in the stomach and right hypochondrium, nausea, vomiting), fever, weakness, change in the color of urine (it takes on the color of strongly brewed tea and becomes foamy), and then main symptom– jaundice: the sclera becomes yellow, the skin, and feces become discolored. At this point usually general state the infected person improves. Jaundice usually lasts from three to six weeks, but sometimes it lasts longer. The disease itself lasts about 40 days. This also depends on the patient’s age, the state of his immunity, the presence of concomitant diseases, and strict adherence to the doctor’s recommendations. In 15% of patients, the infection becomes chronic, lasting about 6-9 months. Afterwards, as a rule, recovery occurs. Most cases of hepatitis A have a typical course and result in complete recovery, without requiring further special treatment.Children usually tolerate hepatitis relatively easily. The disease is severe in children under one year of age, adults and the elderly. Their infection is characterized by severe jaundice and intoxication, the disease lasts about 3 months.
When should you get vaccinated against hepatitis A?
To assess the risk of the disease and the need for vaccination, you need to conduct a blood test to find out whether it contains antibodies to the hepatitis A virus class A immunoglobulin G (anti-HAV IgG). If there are such antibodies in the blood, it means that contact with the virus has already occurred (either the person has already had hepatitis A, or vaccination has already been carried out). In this case, there is immunity to the virus, and vaccination is not necessary. As a rule, re-infection with the hepatitis A virus is impossible.If there are no antibodies in the blood, there is a risk of disease, therefore, it is necessary to get vaccinated.
Prevention
From early childhood, teach your child to observe basic hygiene rules, tell him that after each visit to the toilet he needs to wash his hands, warn him in an accessible form about possible consequences violation of this mandatory rule.
A child sick with hepatitis A is immediately isolated, and all children who interact with him are examined every day for skin and eyes, and be sure to pay attention to the size of the liver.
Children who have been in contact with a sick child are given immunoprophylaxis (antibodies to the hepatitis A virus are administered). In regions where the incidence rate is high, prevention is carried out as planned: antibodies to the virus are administered in August or September.
For prevention, vaccines are used - preparations containing a weakened virus. Vaccination begins at 12 months of age, the vaccine is re-administered 6 months after the first administration, the third stage of vaccination is carried out a year after the first administration. Children usually tolerate the vaccine easily, although painful sensations at the site of drug administration.
Treatment of hepatitis A
Patients with hepatitis A recover without treatment. Antiviral treatment is not carried out. Used in modern medicine The drugs are not aimed at destroying the virus, but at reducing the concentration and removing from the body harmful substances that appear as a result of disturbances in the liver. Typically, patients are given detoxification solutions, vitamins, glucose, and drugs that protect liver cells (hepatoprotectors). In severe cases, the principles of therapy do not change, but the volume of symptomatic therapy becomes larger.Usually liver function is completely restored.
Children who carry the disease to mild form, it is necessary to limit the motor mode (exclude outdoor games). If the baby is seriously ill, bed rest is necessary. Children who have had hepatitis are exempt from physical education for 3-6 months; they should not engage in sports for 6-12 months.
The diet of patients should be balanced, nutritious and high-calorie.
Products with a high protein content include milk, cottage cheese, kefir, lean meat (chicken, beef, veal), lean fish (cod, pike perch, navaga, pike), low-fat cheese, and omelet. Fats are introduced into the diet in the form of butter and vegetable oil (sunflower, corn, olive). Various porridges contain carbohydrates: rice, semolina, oatmeal, buckwheat; pasta, potatoes, bread, sugar.
The diet must contain sufficient quantities of raw and boiled vegetables: tomatoes, cucumbers, cabbage, carrots, zucchini), herbs, fruits and juices.
It is necessary to exclude from the diet: refractory fats (margarine, lard, shortening), fatty sausages, canned meat, pork, fatty poultry, ham, fatty types fish; spicy food, marinades, smoked meats; legumes, radishes, garlic, radishes; cakes, pastries, chocolate, sweets; mushrooms, nuts, horseradish, products containing extractives, etc.
Among sweets, it is allowed to eat jam, honey, savory cookies, marshmallows, prunes, dried apricots, raisins, jelly, mousses, and jelly. You can eat vinaigrettes, salads, jellied fish, soaked herring.
If you have had Botkin's disease (hepatitis A) write your review about treatment and recovery.
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Comments
They admitted me to the hospital and gave me a drip of Glucose and Sodium Chloride for two weeks. There were also two injections a day, I don’t remember their name. And three weeks later I’m already home, only now I can’t leave the house for 10 days and I need to drink oat tea 2 times a day.
Alexander 12 April 2013 15:59
I spent 15 days in the hospital and was ill at home for a week, the most difficult period. The first two weeks were just terrible, I ate almost nothing, during the first week a banana and a couple of sandwiches, when I turned yellow it seemed to get better. Thanks doctors. True, when they filled the first dropper, 1.5 liters, I thought the sides would burst, the doctor lowered the norm to a liter, then raised it to 1.2. We were treated with phosphoglyph, injections in a dropper for a week, then pills. Now the diet.
Wash your hands and bananas and oranges, and tell your children not to eat bananas on the street.
I got over it very easily. Difficult period at home. First, nausea and heaviness in the stomach appeared, this lasted for 5-7 days, then it turned yellow, and my health improved a lot. I was immediately admitted to the hospital for 5 days, put on a glucose drip and given enterosgel. For the rest of the week I drank Essliver Forte and continued to eat Enterosgel. Overall, I got over the illness very easily. Don't hurt anyone!
She was seriously ill, with cholestasis. 3 months have passed, I’m still treating the gastrointestinal tract. There were a lot of medications and IVs. Perhaps because there was a duodenal ulcer. It’s terrible that it’s also reflected on the skin now: dryness, rashes. Now I take Nolpaza, phosphogliv, bifiform. My muscle tone is very weak, I used to do oriental dancing, but now I can’t. I went to yoga once and my stomach hurt. When will it be possible to do fitness and dance, who knows?
Oi August 17, 2015 00:50
I noticed that I was disgusted by the fried onions. I went to the toilet, and when I saw the picture “they have sailed” there, for some reason, out of fear, I took a bucket of cosmetics with me and rushed to the hospital. I got over the illness easily, no IVs were given, only hepatoprotectors and vitamins. I drank a large amount of rosehip brew or immortelle (a weak brew). She stayed there for 21 days (that’s how it was supposed to be). Afterwards I led a normal lifestyle and got one plus - I lost 10 kg. Well, what does cosmetics have to do with it? - you thought. Yes, despite the fact that I didn’t take anything into my head! She started the morning with makeup, which lasted for hours, leaving no shadow of illness! People who wanted to hang themselves were brought to me on an excursion.... 20 years have passed. Sometimes I undergo an ultrasound, you know, age.
I was sick when I was in the 8th grade, my nephew brought it from kindergarten, just when I was going to the sanatorium, I didn’t notice right away, they told me to eat and I had no appetite, as soon as I ate it all came back, already in the sanatorium we noticed yellowing of the sclera, after admitted to the hospital, 2 weeks on drips of glucose and sodium chloride, then 11 days of injections 3 times a day, a total of 25 days, soon they said no alcohol and sweets for about 6 months, but I ate what I wanted, in general this was the experience , after that, after strong alcoholic drinks, there is always vomiting. Now I’m 22 years old, I’m looking at the recent results of a blood test and noticed that direct bilirubin is 3.0 µmol/l, I wondered if the disease had an effect.
Botkin's disease occurred at the age of 4 years. Infected in kindergarten. She was admitted to the Morozov hospital in serious condition because the local pediatrician was unable to diagnose the disease in time. The consequences, of course, were unpleasant and took a long time to make themselves felt. Fatigue, of course, but it was still impossible to understand what and in what combination could be eaten. Constant nausea and then vomiting, weakness, fever. Only one thing saved me: I stopped eating all meat. Became a different person. Now I eat sour, fried, and spicy, but nothing meat, not even chicken, especially no sausages. I eat legumes, a lot of dairy products, fruits, nuts, cereals, soy products... Now I’m 58 years old, I haven’t eaten meat for almost 18 years. I'm not advocating anything, I'm just sharing my experience.
Veronica P July 15, 2017 00:14
I was ill almost a year ago, in a severe form. She was in the hospital for 1.5 months and received drops all this time, but the liver tests never decreased. They were discharged with indicators 5 times higher than normal, they say, then everything will go away, it just takes time and diet. After 2 weeks, I repeated the tests, they were growing, they prescribed IVs again 5 days after them nothing changed much, on the contrary, only the numbers grew, they were unrealistically high and the doctors were surprised, like this virus doesn’t give such high performance. They sent me to the region to the hepatocenter for stationary treatment and re-tested for all possible viral hepatitis and various viruses such as herpes, etc. nothing, just hep A antibodies and that’s it. They put me in static and then again 5 days of IVs, but in the end everything was again to no avail. Then they prescribed retoxil, atoxil and bicyclol, a drug to lower alt/ast, but that really helped. After 7 months, the pain is again in the right hypochondrium and the same as it was then, I don’t know what it is and why this is happening, I went off the diet after two months and you’re screwed again
I got sick in July '17. It started with a high temperature of up to 39.5 for several days. And there was no appetite. Doctors made all sorts of diagnoses and nearly performed surgery. On the 6th day, the analysis showed antibodies to Hepatitis A. But it didn’t get better, I lost consciousness, at some point I thought I was going to die. They also put in intravenous drips, 3 liters per day. Then it turned yellow, the urine darkened and the stool came out white. I stayed there for about 20 days and was discharged with ALT and AST above 200. I stayed at home for a couple more months; I had very strong weakness, dizziness and periodic fever. Heptor started drinking again. The enzymes dropped and then suddenly rose again. In short, I more or less came to my senses only 4-5 months after discharge. I didn’t really like fatty and fried foods before, so it wasn’t difficult to follow the diet. I lost 8 kg, mostly in muscle mass. That is, he returned to his youthful clothing size “S”. The truth in Lately sat down for sweets and cookies. I'll be back to the doctor soon for tests. In general, you wouldn’t wish it on your enemy. And for some, the skin color just changed and that’s it. In general, depending on your luck, it’s better not to get sick, of course.
Hepatitis A or Botkin's disease– an acute viral disease of the liver that causes damage to organ cells. It is manifested by general intoxication and jaundice. Hepatitis A is transmitted through the fecal-oral route, which is why it is also called “dirty hands disease.”
Compared to other hepatitis (B, C, E), this disease is considered the most benign. In contrast, hepatitis A does not cause chronic damage and has a low mortality rate of less than 0.4%. In an uncomplicated course, the symptoms of the disease disappear within 2 weeks, and liver function is restored within a month and a half.
Both men and women of all ages are equally susceptible to the disease. Children from one to 10 years of age experience a mild form of the disease, while infants and the elderly experience a severe form. After past illness strong immunity remains, so people only get hepatitis A once.
Hepatitis A incidence statistics. According to WHO, 1.5 million people suffer from the disease every year. In fact, the number of cases is many times higher. The fact is that 90% of children and 25% of adults suffer from a hidden asymptomatic form of the disease.
Viral hepatitis A is common in developing countries with poor sanitation^ Egypt, Tunisia, India, countries South-East Asia, South America and the Caribbean. Tourists going on vacation to hot countries should remember this. In some countries, the disease is so widespread that all children are ill before the age of ten. The territory of the CIS belongs to countries with an average risk of infection - 20-50 cases per 100 thousand population. Here, a seasonal increase in incidence is noted in August – early September.
Story. Hepatitis A has been known since antiquity under the name “icteric disease.” Large epidemics broke out during the war, when masses of people found themselves in unsanitary conditions, which is why hepatitis was also called “trench jaundice.” For a long time, doctors associated the disease only with blockage of the bile ducts. In 1888, Botkin hypothesized that the disease was infectious in nature, so it was subsequently named after him.
The hepatitis virus was identified only in the 70s of the twentieth century. At the same time, it became possible to create a vaccine that would protect against infection.
Properties of the hepatitis A virus
Hepatitis A virus or HAV belongs to the family Picornaviruses (Italian for “small”). It really differs from other pathogens in its very small size - 27-30 nm.Structure. The virus has a round, spherical shape and consists of a single strand of RNA enclosed in a protein shell - the capsid.
HAV has 1 serotype (variety). Therefore, after suffering from a disease, antibodies to it remain in the blood and upon re-infection the disease no longer develops.
Stability in the external environment. Despite the fact that the virus does not have an envelope, it persists in the external environment for quite a long time:
- when drying on household items – up to 7 days;
- in a humid environment and on food 3-10 months;
- when heated to 60°C, withstands up to 12 hours;
- When frozen below – 20°C, it is preserved for years.
HAV life cycle. With food, the virus enters the mucous membrane of the mouth and intestines. From there it penetrates the bloodstream and the liver.
From the moment the virus enters the body until the disease manifests itself, it takes from 7 days to 7 weeks. In most cases, the incubation period lasts 14-28 days.
Next, the virus penetrates into liver cells - hepatocytes. How he manages to do this has not yet been established. There it leaves the shell and is integrated into the ribosomes of cells. It rearranges the work of these organelles so that they create new copies of the virus - virions. New viruses enter the intestines with bile and are excreted in the feces. The affected liver cells wear out and die, and the virus moves into neighboring hepatocytes. This process continues until the body produces a sufficient number of antibodies that destroy the viruses.
Causes of hepatitis A
The transmission mechanism is fecal-oral.A sick person releases a huge amount of viruses into the environment with feces. They can get into water, food, and household items. If the pathogen gets into the mouth of a healthy person susceptible to infection, hepatitis will develop.
You can become infected with hepatitis A in such situations
- Swimming in polluted pools and ponds. The virus enters the mouth with fresh and sea water.
- Eating contaminated foods. These are often berries that have been fertilized with human feces.
- Eating raw shellfish and mussels from contaminated water bodies, where the pathogen can persist for a long time.
- When using poorly purified water. Contaminated water is not only dangerous to drink, but also to use for washing hands and dishes.
- When living together with a sick person, infection occurs through household items ( door handles, towels, toys).
- During sexual contact with a patient. This route of transmission is especially common among homosexuals.
- When administering drugs intravenously with a non-sterile syringe. The virus circulates in the blood and is transmitted from one person to another through a needle.
- failure to comply with personal hygiene rules
- staying in crowded places: boarding schools, barracks
- staying in conditions where there is no running water or sewerage: refugee camps, field camps for military personnel
- trips to areas with high level morbidity without prior vaccination
- living with a person with hepatitis A
- lack of access to safe drinking water
Symptoms of hepatitis A
| Symptom | Development mechanism | How it manifests itself externally or during diagnosis |
| The pre-icteric period lasts 3-7 days | ||
| Signs of general intoxication appear at the end of the incubation period | The breakdown products of liver cells poison the patient’s body, including nervous system | Malaise, fatigue, lethargy, loss of appetite |
| Temperature increase. In the first days of illness in 50% of patients | The immune system's response to the presence of a virus in the blood | Chills, fever, temperature rise to 38-39 |
| The icteric period lasts 2-4 weeks | ||
| Jaundice appears on the 5-10th day from the onset of the disease | The bile pigment, bilirubin, accumulates in the blood. It is a product of the breakdown of red blood cells in the liver. Normally, the pigment binds to blood proteins. But when liver function is impaired, it cannot “send” it into bile, and bilirubin returns to the blood | First, the mucous membrane under the tongue and the sclera of the eyes turn yellow, then the skin acquires a yellow, saffron color. This occurs when the concentration of bilirubin in the blood exceeds 200-400 mg/l With the appearance of jaundice, the temperature returns to normal |
| Darkening of urine | Excess bilirubin and urobilin from the blood are excreted through the kidneys in the urine | Urine takes on the color of dark beer and foams |
| Stool discoloration | With hepatitis, the flow of stercobilin with bile into the intestines decreases. It is a pigment from destroyed red blood cells that colors stool. | In the pre-icteric period, stool gradually discolors - it becomes spotted, then becomes completely colorless. |
| Pain in the right hypochondrium | Viruses infect liver cells and cause their death, and edema develops. The liver increases in size and stretches the sensitive capsule | Rubbing sensation, pain and heaviness in the right hypochondrium. The liver is enlarged; when palpated, the patient feels pain |
| Enlarged spleen | Associated with immune response to infection and enhanced clearance of toxins | When palpated, the spleen is enlarged |
| Dyspeptic phenomena | Digestive problems are associated with impaired liver function. Bile stagnates in the gallbladder and does not enter the intestines in sufficient quantities | Nausea, vomiting, heaviness in the stomach, belching, bloating, constipation |
| Pain in muscles and joints | Pain is associated with the accumulation of toxins caused by the death of the virus and liver cells | Body aches, muscle pain |
| Itchy skin | An increase in the level of bile acids in the blood leads to their accumulation in the skin and an allergic reaction. | Dry skin that is accompanied by itching |
| The recovery period lasts from 1 week to six months | ||
| Symptoms gradually subside, liver function is restored | ||
Treatment of hepatitis A
Treatment of hepatitis A with medications
Specific drug treatment hepatitis A does not exist. Therapy is aimed at eliminating symptoms, removing intoxication and quickly restoring normal liver function. | Group of drugs | Mechanism therapeutic effect | Representatives | How to use |
| Vitamins | Reduce vascular permeability, reduce swelling of liver tissue, increase the body's resistance to the virus | Askorutin, Askorutin, Undevit, Aevit | 1 tablet 3 times a day |
| Hepatoprotectors | Accelerate the recovery and division of damaged liver cells. Supply structural elements necessary for the construction of cell membranes of hepatocytes | Essentiale, Karsil, Hepatofalk | 1-2 capsules 3 times a day |
| Enterosorbents | To remove toxins from the intestines and eliminate bloating | Smecta, Polyphepan | 2 hours after each meal |
| Enzyme preparations For moderate and severe forms | Promote the breakdown of proteins, fats and carbohydrates and speedy absorption of food in the intestines | Creon, Mezim-Forte, Pancreatin, Festal, Enzistal, Panzinorm | With each meal, 1-2 tablets |
| Glucocorticoids With a sharp deterioration in condition | They have an anti-inflammatory anti-allergic effect, reduce the attack of immune cells (lymphocytes and leukocytes) on damaged liver cells | Prednisolone, Methylprednisolone | 60 mg/day orally or 120 mg/day intramuscularly for 3 days |
| Immunomodulators | Improves immune function. Stimulates the production of antibodies to fight hepatitis A virus | Timalin, Timogen | Administered intramuscularly at 5-20 mg per day for 3-10 days. |
| T-activin | 1 ml of 0.01% solution is administered subcutaneously for 5-14 days | ||
| Detoxification solutions | Binds toxins circulating in the blood and promotes their rapid elimination in the urine | Gemodez, Geopolyglyukin | Intravenously drip 300-500 ml per day |
| Choleretic agents | Eliminate stagnation of bile in the liver, help cleanse it and improve digestion | Sorbitol Magnesium sulfate | Dilute 1 tsp of the drug in a glass of warm boiled water and drink at night |
Currently, doctors are trying to avoid unnecessary drugs, prescribing only the minimum necessary to eliminate symptoms.
Is hospitalization required for hepatitis A treatment?
For hepatitis A, hospitalization in the infectious diseases department is required in the following cases:- for complicated forms of hepatitis A
- with the co-occurrence of Botkin's disease and other hepatitis
- with alcoholic liver damage
- in elderly patients and children under 1 year of age
- in weakened patients with severe concomitant diseases
Diet for hepatitis A
Diet 5 is recommended for the treatment of hepatitis A. In the fight against infection, therapeutic nutrition plays an important role. It reduces the load on the liver and protects its cells. It is recommended to eat small meals 4-6 times a day. - dairy products: low-fat cottage cheese, kefir, yogurt, low-fat sour cream for dressing
- lean meat: beef, chicken, rabbit
- meat products: steamed dumplings, meatballs, meatballs, sausages and boiled beef sausages
- Not fatty fish : pike perch, pike, carp, hake, pollock
- vegetables: potatoes, zucchini, cauliflower, cucumbers, beets, carrots, cabbage, tomatoes
- side dishes: cereals (except legumes and pearl barley), pasta
- soups low-fat vegetables, dairy with added cereals
- bread yesterday's, crackers
- eggs: white omelette, 1 soft-boiled egg per day
- Dessert: mousses, jelly, jelly, marshmallows, marmalade, pastille, hard biscuits, honey, homemade jam, dried fruits
- fats: butter 5-10 g, vegetable oils up to 30-40 g
- beverages: black tea, herbal tea, compotes, juices, uzvar, rose hip decoction, coffee with milk, alkaline mineral waters, 5% glucose solution.
- rehydration medications recovery electrolyte balance Rehydron, Humana electrolyte, Gidrovit forte are recommended.
- fried smoked dishes
- canned food fish, meat, vegetables
- fatty meats: pork, goose, duck
- fatty fish: sturgeon, gobies, spicy herring, caviar
- fats: lard, lard, margarine
- bakery from butter and puff pastry, fresh bread
- full fat dairy products: whole milk, cream, full-fat cottage cheese, salty cheese
- soups on concentrated meat, fish broth, sour cabbage soup
- vegetables: radish, radish, sauerkraut, sorrel, onion, parsley, pickled vegetables, mushrooms
- Dessert: ice cream, chocolate, products with cream, sweets, steamed
- beverages: strong coffee, cocoa, carbonated drinks, alcohol
It is very important to adhere to the drinking regime. To remove toxins, you need to consume at least 2 liters clean water without gas.
Can Hepatitis A be treated at home?
If the disease is mild, hepatitis can be treated at home. This requires several conditions: - the patient has been examined, taken tests, and will regularly visit the doctor
- the disease occurs in a mild, uncomplicated form
- It is possible to isolate the patient in a separate room
- diet and bed rest
Restrictions. It is not advisable to involve the patient in cooking. All family members must strictly observe personal hygiene rules and wash their hands thoroughly after using the toilet.
Mode. Pre-icteric period - bed rest is required. The patient experiences severe weakness and excess energy expenditure can lead to additional stress on the liver. And in a horizontal position, the diseased organ receives more blood, which promotes a speedy recovery.
Jaundice period– Semi-bed rest is allowed. Once the symptoms of the disease have subsided, you can gradually increase your activity. This helps restore physical and emotional well-being.
Consequences of hepatitis A
Complications are not typical for hepatitis A. Consequences occur in only 2% of cases. At risk are people who violate their diet, do not follow doctor’s prescriptions, abuse alcohol, or suffer from liver pathology.The most common complications of hepatitis A
- Biliary dyskinesia– impaired motility of the biliary tract, resulting in stagnation of bile. Symptoms: pain in the right hypochondrium, radiating to the right shoulder, occurs after eating and physical activity. diabetes mellitus
Prevention of hepatitis A
Prevention of hepatitis A includes several areas.- Disinfection in the area of hepatitis A
Disinfection is carried out in the apartment of the sick person. Medical personnel teach family members how to handle objects that the sick person has come into contact with.
- Bed sheets and clothes are boiled in a 2% soap solution (20g of any washing powder per liter of water) for 15 minutes, and then washed as usual.
- After eating, the dishes are boiled for 15 minutes in a 2% soda solution.
- Carpets are cleaned with a brush soaked in a 1% chloramine solution.
- Floors and other surfaces are washed with hot 2% soap or soda solution. The door handles of the toilet and flush cistern are treated in the same way.
- Vaccination against hepatitis A
Vaccination is aimed at reducing susceptibility to the virus.
- Human immunoglobulin is normal. The drug is administered intravenously to people living in the same apartment as the sick person. The drug contains ready-made donor antibodies against hepatitis A and other infections. Its use reduces the risk of getting sick several times.
- Hepatitis A vaccine– a mixture of neutralized purified viruses. In response to the vaccine, the body produces specific antibodies. Therefore, if infection occurs, the disease does not develop - antibodies quickly neutralize the viruses.
- Travelers departing to countries with poor hygiene levels
- Military personnel, long time staying in field conditions
- People in refugee camps and other places where hygiene is impossible due to lack of running water and sewerage
- medical staff
- food industry workers
- Hygiene rules
- wash your hands thoroughly after using the toilet
- drink only boiled water
- wash vegetables, fruits and herbs
- do not swim in bodies of water that may have received sewage
- thoroughly boil and fry foods when cooking
- Measures regarding contact persons
To prevent the spread of infection, health workers monitor people who have been in contact with the patient:
- Quarantine in groups and children's groups for a period of 35 days from the moment of isolation of the last sick person
- Monitoring of all contacts. Check to see if there is jaundice on the mucous membranes and sclera, and if the liver is enlarged. If flu-like symptoms appear, they should be isolated
- Blood test for the presence of specific antibodies to the hepatitis A virus (IgG)
Viral hepatitis A is an acute viral liver disease. This pathology is characterized by: yellowness (hyperbilirubinemia) of the skin and mucous membranes, darkening of urine, lightening of stool, chills, weakness, increased body temperature.
It is known that every disease has an incubation period. At this time there are no clinical manifestations, but the person is already considered sick. The incubation period of hepatitis A differs from a similar period of time for other diseases in that during it a person can infect others.
The disease is caused by the hepatitis A virus. People most often through water infected with the pathogen. The virus can enter the body when using poorly washed dishes, household items, or eating unwashed fruits and vegetables.
What is the incubation period?
The incubation period of hepatitis A and other viral diseases is, in other words, an interval without any symptoms, which lasts from the moment the pathogen enters the body until the onset of clinical manifestations.
U various diseases its duration varies. It can last from several hours to decades.
There are no symptoms due to the fact that the harm caused to the body is still small, since the amount of the pathogenic agent is still small. Gradually, there are more microorganisms, and the immune system stops dealing with them. From now on they appear clinical manifestations, and the asymptomatic interval ends. This principle is typical for all diseases, but hepatitis A has its own characteristics.
- The virus leads to the destruction of liver cells (hepatocytes), but this organ can regenerate and perform its functions, even if a third of it remains.
- does not appear until the liver can cope with its tasks.
- In the case of this disease, it is not the amount of virus in the body that is decisive, but the number of damaged organ cells.
With a good immune response and a decent ability of the liver to regenerate, they do not occur. However, in this case, a person releases the pathogen into the environment (with feces), and if basic sanitary and hygienic rules are not followed, people in contact with a sick person can potentially become infected.
Despite the absence of symptoms during the incubation period for hepatitis A, in most cases it is already possible to detect the pathogen, and therefore to begin treatment in a timely manner.
How long is the viral incubation period?
The incubation period for hepatitis A lasts on average 35 days. In some cases, it can be shortened - up to 15 days or lengthened - up to 50. At this time, the virus penetrates the bloodstream and spreads throughout the patient’s body.
The patient's condition is not impaired. He may not even be aware that he is infected. When a person feels worse and develops symptoms, the asymptomatic period ends.
Routes of transmission of hepatitis A virus
In adults and children, viral hepatitis A manifests itself almost identically: 
- the skin and all mucous membranes acquire an intense yellow color;
- temperature rises;
- symptoms of intoxication appear;
- the patient is chilling;
- he complains about nagging pain in muscles;
- stool becomes lighter;
- urine becomes dark.
This is how hepatitis A begins; the incubation period in adults and children lasts on average about 35 days.
In children, due to an insufficiently trained immune system, the disease can begin acutely. But the majority of infected people of all ages are asymptomatic. Often the onset of the pathological process is similar to ARVI: the patient sneezes, coughs, and the temperature rises to low-grade levels. That is why in children's groups, where at least one patient is found, if he has confirmed hepatitis A, the incubation period of which does not affect the well-being, all contacts are examined. They are under medical supervision.
Viral hepatitis A, which can have a long incubation period in children and adults, is not considered severe liver damage, but it is better to take all precautions. There is no need to rely on the fact that this is a disease of dirty hands and only dysfunctional families suffer from it. We all travel in public transport, go to work, our children attend school, classes and kindergartens, and you can get infected anywhere, especially if your immune system is weakened. The virus is very resistant to environment, and when boiled it dies only after five minutes. Therefore, it is very important to comply with everything necessary rules hygiene, wash vegetables and fruits, carefully handle dishes and children's toys.
Maximum infectiousness of hepatitis A
The source of infection for this pathology is a person infected with the hepatitis A virus. With most infectious diseases, the patient is not contagious at this time. This does not apply to hepatitis A, which remains contagious during the incubation period. During this period, a person can already infect others.
The most dangerous in terms of infectiousness are the last five days of the icteric-free period and the first five of the icteric period. At this time, the patient excretes billions of pathogens with feces, and for a person to become infected, a much smaller number of viruses is sufficient.
Useful video
For more information about viral hepatitis A, watch this video:
Conclusion
- In viral hepatitis A average duration The asymptomatic interval averages 35 days.
- Unlike most infectious diseases, at this time a person is dangerous to others. Hyperbilirubinemia appears after the liver can no longer cope with the virus.
- Infection occurs through household contact, so a serious attitude to sanitary and hygienic standards can protect against infection.
Viral hepatitis- this is a group of common and dangerous infectious diseases for humans, which differ quite significantly from each other, are caused by different viruses, but still have common feature is a disease that primarily affects the human liver and causes its inflammation. Therefore, viral hepatitis of different types is often combined under the name “jaundice” - one of the most common symptoms of hepatitis.
Epidemics of jaundice were described as early as the 5th century BC. Hippocrates, but the causative agents of hepatitis were discovered only in the middle of the last century. In addition, it should be noted that the concept of hepatitis in modern medicine can mean not only independent diseases, but also one of the components of a generalized, that is, affecting the body as a whole, pathological process.
Hepatitis (a, b, c, d), that is inflammatory liver disease, is possible as a symptom of yellow fever, rubella, herpes, AIDS and some other diseases. There is also toxic hepatitis, which includes, for example, liver damage due to alcoholism.
We will talk about independent infections - viral hepatitis. They differ in origin (etiology) and course, but some symptoms various types of this disease somewhat similar to each other.
Classification of viral hepatitis
Classification of viral hepatitis is possible according to many criteria:
The danger of viral hepatitis
Particularly dangerous for human health hepatitis viruses B and C. The ability to exist in the body for a long time without noticeable manifestations leads to severe complications due to the gradual destruction of liver cells.
Another one characteristic feature viral hepatitis is what Anyone can become infected with them. Of course, in the presence of factors such as blood transfusion or working with blood, drug addiction, promiscuity, the risk of contracting not only hepatitis, but also HIV increases. Therefore, for example, healthcare workers should regularly test their blood for markers of hepatitis.
But you can also become infected after a blood transfusion, an injection with a non-sterile syringe, after surgery, a visit to the dentist, a beauty salon or a manicure. Therefore, a blood test for viral hepatitis is recommended for anyone who is exposed to any of these risk factors.
Hepatitis C can also cause extrahepatic manifestations, such as autoimmune diseases. The constant fight against the virus can lead to a perverted immune response to the body’s own tissues, resulting in glomerulonephritis, skin lesions, etc.
Important: In no case should the disease be left untreated, since in this case there is a higher risk of it becoming chronic or rapidly damaging the liver.
Therefore the only one affordable way to protect yourself from the consequences of hepatitis infection is to rely on early diagnosis through tests and subsequent consultation with a doctor.
Forms of hepatitis
Acute hepatitis
The acute form of the disease is the most typical for all viral hepatitis. Patients experience:
- deterioration of health;
- severe intoxication of the body;
- liver dysfunction;
- development of jaundice;
- an increase in the amount of bilirubin and transaminase in the blood.
With adequate and timely treatment acute hepatitis ends complete recovery of the patient.
Chronic hepatitis
If the disease lasts more than 6 months, the patient is diagnosed with chronic hepatitis. This form is accompanied by severe symptoms (asthenovegetative disorders, enlarged liver and spleen, disorders metabolic processes) and often leads to liver cirrhosis and the development of malignant tumors.
Human life is at risk when chronic hepatitis, the symptoms of which indicate damage to vital organs, is aggravated by improper treatment, reduced immunity, and alcohol addiction.
General symptoms of hepatitis
Jaundice appears in hepatitis as a result of the entry into the blood of the enzyme bilirubin, which is not processed in the liver. But cases of the absence of this symptom in hepatitis are not uncommon.
Typically, hepatitis in the initial period of the disease manifests flu symptoms. The following are noted:
- temperature increase;
- body aches;
- headache;
- general malaise.
As a result inflammatory process The patient’s liver enlarges and its membrane stretches; at the same time, a pathological process may occur in the gallbladder and pancreas. All this is accompanied pain in the right hypochondrium. The pain often lasts for a long time, aching or dull in nature. But they can be sharp, intense, paroxysmal and give in right shoulder blade or shoulder.
Descriptions of symptoms of viral hepatitis
Hepatitis A
Hepatitis A or Botkin's disease is the most common form of viral hepatitis. Its incubation period (from the moment of infection to the appearance of the first signs of the disease) ranges from 7 to 50 days.
Causes of hepatitis A
Hepatitis A is most widespread in third world countries with their low sanitary and hygienic standards of living, but isolated cases or outbreaks of hepatitis A are possible even in the most developed countries of Europe and America.
The most common route of transmission of the virus is through close household contact between people and the consumption of food or water contaminated with fecal material. Hepatitis A is also transmitted through dirty hands, so children most often get it.
Symptoms of Hepatitis A
The duration of hepatitis A disease can vary from 1 week to 1.5-2 months, and the recovery period following the disease sometimes stretches up to six months.
The diagnosis of viral hepatitis A is made taking into account the symptoms of the disease, medical history (that is, the possibility of the disease occurring due to contact with patients with hepatitis A is taken into account), as well as diagnostic data.
Hepatitis A treatment
Of all forms, viral hepatitis A is considered the most favorable in terms of prognosis; it does not cause severe consequences and often ends spontaneously, without requiring active treatment.
If necessary, hepatitis A treatment is carried out successfully, usually in a hospital setting. During illness, patients are recommended bed rest, prescribed a special diet and hepatoprotectors - drugs that protect the liver.
Prevention of hepatitis A
The main measure to prevent hepatitis A is compliance with hygiene standards. In addition, children are recommended to be vaccinated against this type of viral hepatitis.
Hepatitis B
Hepatitis B or serum hepatitis - this is much more dangerous disease, characterized by severe liver damage. The causative agent of hepatitis B is a virus containing DNA. The outer shell of the virus contains a surface antigen - HbsAg, which causes the formation of antibodies to it in the body. Diagnosis of viral hepatitis B is based on the detection of specific antibodies in the blood serum.
Viral hepatitis b remains infectious in blood serum at 30–32 degrees Celsius for 6 months, at minus 20 degrees Celsius for 15 years, after warming up to plus 60 degrees Celsius for an hour, and only with 20 minutes of boiling it completely disappears. This is why viral hepatitis B is so common in nature.
How is hepatitis B transmitted?
Infection with hepatitis B can occur through blood, as well as through sexual contact and vertically - from mother to fetus.
Symptoms of hepatitis B
In typical cases, hepatitis B, like Botkin's disease, begins with the following symptoms:
- temperature rise;
- weaknesses;
- joint pain;
- nausea and vomiting.
Symptoms such as dark urine and discolored stool are also possible.
Other symptoms of viral hepatitis B may also appear:
- rashes;
- enlarged liver and spleen.
Jaundice is uncommon for hepatitis B. Liver damage can be extremely severe and in severe cases lead to cirrhosis and liver cancer.
Treatment of hepatitis B
Treatment for hepatitis B requires integrated approach and depends on the stage and severity of the disease. Immune drugs, hormones, hepatoprotectors, and antibiotics are used in treatment.
To prevent the disease, vaccination is used, which is usually carried out in the first year of life. It is believed that the duration of post-vaccination immunity to hepatitis B is at least 7 years.
Hepatitis C
The most severe form of viral hepatitis is considered hepatitis C or post-transfusion hepatitis. Hepatitis C virus infection can develop in anyone and is more common in young people. The incidence is growing.
This disease is called post-transfusion hepatitis because infection with viral hepatitis C most often occurs through blood - through blood transfusion or through unsterile syringes. Currently, all donated blood must be tested for the hepatitis C virus. Less commonly, sexual transmission of the virus or vertical transmission from mother to fetus is possible.
How is hepatitis C transmitted?
There are two ways of transmission of the virus (as with viral hepatitis B): hematogenous (i.e. through the blood) and sexual. Most frequent path– hematogenous.
How does infection occur?
| At blood transfusion and its components. Previously, this was the main method of infection. However, with the advent of the method of laboratory diagnosis of viral hepatitis C and its introduction into the mandatory list of donor examinations, this path faded into the background. |
| The most common method currently is infection by tattooing and piercing. The use of poorly sterilized and sometimes not sanitized instruments has led to a sharp surge in morbidity. |
| Infection often occurs when visiting dentist, manicure salons. |
| Using shared needles for intravenous drug administration. Hepatitis C is extremely common among drug addicts. |
| Using general with a sick man holding toothbrushes, razors, nail scissors. |
| The virus can be transmitted from mother to child at the time of birth. |
| At sexual contact: This route is not as relevant for hepatitis C. Only in 3-5% of cases unprotected sex infection may occur. |
| Injections from infected needles: this method of infection is not uncommon among medical workers. |
In approximately 10% of patients with hepatitis C, the source remains unclear.
Symptoms of hepatitis C
There are two forms of viral hepatitis C: acute (a relatively short period, severe course) and chronic (prolonged course of the disease). Most people, even in the acute phase, do not notice any symptoms, but in 25-35% of cases, signs similar to other acute hepatitis appear.
Symptoms of hepatitis usually appear in 4-12 weeks after infection (however, this period can be within 2-24 weeks).
Symptoms of acute hepatitis C
- Loss of appetite.
- Abdominal pain.
- Dark urine.
- Light chair.
Symptoms of chronic hepatitis C
As with the acute form, people with chronic hepatitis C often experience no symptoms early on or even after late stages diseases. Therefore, it is not uncommon for a person to be surprised to learn that he is sick after random analysis blood, for example when going to the doctor for a common cold.
Important: You can be infected for years and not know it, which is why hepatitis C is sometimes called the “silent killer.”
If symptoms do appear, they will most likely be as follows:
- Pain, bloating, discomfort in the liver area (on the right side).
- Fever.
- Muscle pain, joint pain.
- Decreased appetite.
- Weight loss.
- Depression.
- Jaundice (yellow discoloration of the skin and sclera of the eyes).
- Chronic fatigue, fast fatiguability.
- Spider veins on the skin.
In some cases, as a result of the body's immune response, damage may develop not only to the liver, but also to other organs. For example, kidney damage called cryoglobulinemia may develop.
In this condition, there are abnormal proteins in the blood that become solid when the temperature drops. Cryoglobulinemia can lead to various consequences from skin rashes to severe renal failure.
Diagnosis of viral hepatitis C
Differential diagnosis is similar to that for hepatitis A and B. It should be taken into account that the icteric form of hepatitis C, as a rule, occurs with mild intoxication. The only reliable confirmation of hepatitis C is the results of marker diagnostics.
Considering the large number of anicteric forms of hepatitis C, it is necessary to carry out marker diagnostics of people who systematically receive a large number of injections (primarily people who use drugs intravenously).
Laboratory diagnosis of the acute phase of hepatitis C is based on the detection of viral RNA by PCR and specific IgM by various serological methods. If hepatitis C virus RNA is detected, genotyping is advisable.
The detection of serum IgG to viral hepatitis C antigens indicates either a previous illness or the ongoing persistence of the virus.
Treatment of viral hepatitis C
Despite all the dangerous complications that hepatitis C can lead to, in most cases the course of hepatitis C is favorable - for many years the hepatitis C virus may not manifest itself.
At this time, hepatitis C does not require special treatment - only careful medical monitoring. It is necessary to regularly check liver function; at the first sign of activation of the disease, it should be carried out antiviral therapy.
There are currently 2 in use antiviral drugs which are most often combined:
- interferon-alpha;
- ribavirin.
Interferon-alpha is a protein that the body synthesizes independently in response to a viral infection, i.e. it is actually a component of natural antiviral defense. In addition, interferon-alpha has antitumor activity.
Interferon-alpha has many side effects, especially when administered parenterally, i.e. in the form of injections, as is usually used in the treatment of hepatitis C. Therefore, treatment should be carried out under mandatory medical supervision with regular determination of a number of laboratory parameters and appropriate adjustment of the dosage of the drug.
Ribavirin as a stand-alone treatment is low in effectiveness, but when combined with interferon it significantly increases its effectiveness.
Traditional treatment quite often leads to complete recovery from chronic and acute forms hepatitis C, or to a significant slowdown in the progression of the disease.
Approximately 70–80% of people with hepatitis C develop the chronic form of the disease, which is the most dangerous because the disease can lead to the formation of a malignant liver tumor (that is, cancer) or cirrhosis of the liver.
When hepatitis C is combined with other forms of viral hepatitis, the patient's condition can deteriorate sharply, the course of the disease can become more complicated and lead to death.
The danger of viral hepatitis C also lies in the fact that there is currently no effective vaccine that can protect a healthy person from infection, although scientists are making a lot of efforts in this direction to prevent viral hepatitis.
How long do people live with hepatitis C?
Based on medical experience and research conducted in this area, life with hepatitis C is possible and even quite long. A common disease, like many others, has two stages of development: remission and exacerbation. Often, hepatitis C does not progress, that is, it does not lead to cirrhosis of the liver.
It must be said right away that fatal cases, as a rule, are associated not with the manifestation of the virus, but with the consequences of its impact on the body and general disruptions in the functioning of various organs. It is difficult to indicate a specific period during which the patient’s body develops pathological changes, incompatible with life.
The rate of progression of hepatitis C is influenced by various factors:
According to statistical data World Organization There are more than 500 million people in whose blood a virus or pathogen antibodies are detected. These data will only go up every year. The number of cases of liver cirrhosis has increased by 12 percent worldwide over the past decade. The average age category is 50 years.
It should be noted that in 30% of cases The progression of the disease is very slow and lasts about 50 years. In some cases fibrotic changes in the liver are quite insignificant or absent even if the infection lasts several decades, so you can live with hepatitis C for quite a long time. Yes, when complex treatment patients live 65-70 years.
Important: If appropriate therapy is not carried out, life expectancy is reduced to an average of 15 years after infection.
Hepatitis D
Hepatitis D or delta hepatitis differs from all other forms of viral hepatitis in that its virus cannot multiply in the human body separately. To do this, he needs a “helper virus,” which is the hepatitis B virus.
Therefore, delta hepatitis can be considered not as an independent disease, but as a companion disease complicating the course of hepatitis B. When these two viruses coexist in a patient's body, a severe form of the disease occurs, which doctors call superinfection. The course of this disease resembles that of hepatitis B, but complications characteristic of viral hepatitis B are more common and more severe.
Hepatitis E
Hepatitis E its symptoms are similar to hepatitis A. However, unlike other types of viral hepatitis, with severe form Hepatitis E causes severe damage not only to the liver, but also to the kidneys.
Hepatitis E, like hepatitis A, has a fecal-oral mechanism of infection, is common in countries with a hot climate and poor water supply, and the prognosis for recovery in most cases is favorable.
Important: the only group of patients for whom infection with hepatitis E can be fatal are women in the last trimester of pregnancy. In such cases, mortality can reach 9–40% of cases, and the fetus dies in almost all cases of hepatitis E in a pregnant woman.
Prevention of viral hepatitis of this group is similar to prevention of hepatitis A.
Hepatitis G
Hepatitis G- the last representative of the family of viral hepatitis - in its symptoms and signs it resembles viral hepatitis C. However, it is less dangerous, since the progression of the infectious process inherent in hepatitis C with the development of cirrhosis and liver cancer is not typical for hepatitis G. However, the combination of hepatitis C and G can lead to cirrhosis.
Medicines for hepatitis
Which doctors should I contact if I have hepatitis?
Tests for hepatitis
To confirm the diagnosis of hepatitis A, a biochemical blood test is sufficient to determine the concentration of liver enzymes, protein and bilirubin in the plasma. The concentration of all these fractions will be increased due to the destruction of liver cells.
Biochemical blood tests also help determine the activity of hepatitis. It is by biochemical indicators that one can get an impression of how aggressive the virus behaves towards liver cells and how its activity changes over time and after treatment.
To determine infection with two other types of virus, a blood test is performed for antigens and antibodies to hepatitis C and B. You can take blood tests for hepatitis quickly, without spending a lot of time, but their results will allow the doctor to obtain detailed information.
By assessing the number and ratio of antigens and antibodies to the hepatitis virus, you can find out about the presence of infection, exacerbation or remission, as well as how the disease responds to treatment.
Based on dynamic blood test data, the doctor can adjust his prescriptions and make a prognosis for further development diseases.
Diet for hepatitis
The diet for hepatitis is as gentle as possible, since the liver, which is directly involved in digestion, is damaged. For hepatitis it is necessary frequent split meals.
Of course, diet alone is not enough to treat hepatitis; you also need drug therapy, but proper nutrition plays a very important role and has a beneficial effect on the well-being of patients.
Thanks to the diet, pain decreases and general condition improves. During an exacerbation of the disease, the diet becomes more strict, during periods of remission - more free.
In any case, you cannot neglect your diet, because it is precisely reducing the load on the liver that allows you to slow down and alleviate the course of the disease.
What can you eat if you have hepatitis?
Products that can be included in the diet with this diet:
- lean meats and fish;
- low-fat dairy products;
- inconvenient flour products, lingering cookies, yesterday's bread;
- eggs (whites only);
- cereals;
- boiled vegetables.
What not to eat if you have hepatitis
You should exclude the following foods from your diet:
- fatty meats, duck, goose, liver, smoked meats, sausages, canned food;
- cream, fermented baked milk, salty and fatty cheeses;
- fresh bread, puff pastry and pastry, fried pies;
- fried and hard-boiled eggs;
- pickled vegetables;
- fresh onions, garlic, radishes, sorrel, tomatoes, cauliflower;
- butter, lard, cooking fats;
- strong tea and coffee, chocolate;
- alcoholic and carbonated drinks.
Prevention of hepatitis
Hepatitis A and hepatitis E, transmitted by the fecal-oral route, are quite easy to prevent if you follow basic rules hygiene:
- wash your hands before eating and after using the toilet;
- do not eat unwashed vegetables and fruits;
- not to drink raw water from unknown sources.
For children and adults at risk, there is vaccination against hepatitis A, but it is not included in the compulsory vaccination calendar. Vaccination is carried out in case of an epidemic situation regarding the prevalence of hepatitis A, before traveling to areas unfavorable for hepatitis. It is recommended that employees be vaccinated against hepatitis A preschool institutions and doctors.
As for hepatitis B, D, C and G, transmitted through the infected blood of a patient, their prevention is somewhat different from the prevention of hepatitis A. First of all, it is necessary to avoid contact with blood infected person, and since it is enough to transmit the hepatitis virus minimum amount of blood, then infection can occur when using one razor, nail scissors, etc. All these devices must be individual.
As for the sexual route of transmission of the virus, it is less likely, but still possible, therefore sexual contacts with untested partners should be only using a condom. Intercourse during menstruation, defloration, or other situations in which sexual contact involves the release of blood increases the risk of contracting hepatitis.
Most effective protection from infection with hepatitis B is currently considered vaccination. In 1997, vaccination against hepatitis B was included in the compulsory vaccination schedule. Three vaccinations against hepatitis B are carried out in the first year of a child’s life, and the first vaccination is done in the maternity hospital, a few hours after the baby is born.
Teenagers and adults are vaccinated against hepatitis B on a voluntary basis, and experts strongly recommend that representatives of the risk group receive such a vaccination.
Let us remind you that the risk group includes the following categories of citizens:
- workers of medical institutions;
- patients who received blood transfusions;
- drug addicts.
In addition, persons living or traveling in areas with widespread hepatitis B virus transmission, or having family contact with hepatitis B patients or carriers of hepatitis B virus.
Unfortunately, vaccines to prevent hepatitis C are not available currently does not exist. Therefore, its prevention comes down to the prevention of drug addiction, mandatory testing of donor blood, educational work among adolescents and young people, etc.
Questions and answers on the topic "Viral hepatitis"
Question:Hello, what is a healthy carrier of hepatitis C?
Answer: A carrier of hepatitis C is a person who has the virus in his blood but does not experience any painful symptoms. This condition can last for years while the immune system controls the disease. Carriers, being a source of infection, must constantly take care of the safety of their loved ones and, if they wish to become parents, carefully approach the issue of family planning.
Question:How do I know if I have hepatitis?
Answer: Do a blood test for hepatitis.
Question:Hello! I am 18 years old, hepatitis B and C negative, what does this mean?
Answer: The analysis showed the absence of hepatitis B and C.
Question:Hello! My husband has hepatitis B. I recently had my last hepatitis B vaccine. A week ago my husband’s lip was cracked; now it’s not bleeding, but the crack hasn’t healed yet. Is it better to stop kissing until it heals completely?
Answer: Hello! It’s better to cancel and give you anti-hbs, hbcorab total, PCR test for him.
Question:Hello! I had a trimmed manicure done at the salon, my skin was injured, now I’m worried, how long will it take to get tested for all infections?
Answer: Hello! Contact an infectious disease specialist to decide on emergency vaccination. After 14 days, you can take a blood test for RNA and DNA of hepatitis C and B viruses.
Question:Hello, please help: I was recently diagnosed with chronic hepatitis B with low activity (hbsag +; DNA PCR +; DNA 1.8*10 in 3 st. IU/ml; alt and ast are normal, other indicators are normal biochemical analysis fine; hbeag - ; anti-hbeag+). The doctor said that no treatment is required, no diet is needed, however, I have repeatedly come across information on various websites that all chronic hepatitis can be treated, and there is even a small percentage of complete recovery. So maybe it’s worth starting treatment? And yet, I’ve been using it for several years now. hormonal drug, which was prescribed by the doctor. This drug has a negative effect on the liver. But it is impossible to cancel it, what should you do in this case?
Answer: Hello! Observe regularly, follow a diet, eliminate alcohol, and possibly prescribe hepatoprotectors. HTP is not required at this time.
Question:Hello, I'm 23 years old. Recently I had to take tests for a medical examination and this is what was discovered: the test for hepatitis B deviates from the norm. Do I have a chance to pass a medical examination for contract service with such results? I was vaccinated against hepatitis B in 2007. I have never observed any symptoms related to the liver. I didn't have jaundice. Nothing bothered me. Last year, I took SOTRET 20 mg per day for six months (I had problems with my facial skin), nothing special.
Answer: Hello! Possibly a history of viral hepatitis B with recovery. The chance depends on the diagnosis made by the hepatology commission.
Question:Maybe the question is in the wrong place, tell me who to contact. The child is 1 year and 3 months old. We want to vaccinate him against infectious hepatitis. How can this be done and are there any contraindications?
Answer:
Question:What should other family members do if the father has hepatitis C?
Answer: Viral hepatitis C refers to “blood infections” of a person with a parenteral mechanism of infection - during medical procedures, blood transfusions, during sexual contacts. Therefore, at the household level in family settings, there is no danger of infection for other family members.
Question:Maybe the question is in the wrong place, tell me who to contact. The child is 1 year and 3 months old. We want to vaccinate him against infectious hepatitis. How can this be done and are there any contraindications?
Answer: Today you can vaccinate a child (as well as an adult) against viral hepatitis A (infectious), against viral hepatitis B (parenteral or “blood”) or with a combined vaccination (hepatitis A + hepatitis B). Vaccination against hepatitis A is one-time, against hepatitis B - three times at intervals of 1 and 5 months. Contraindications are standard.
Question:My son (25 years old) and daughter-in-law (22 years old) are sick with hepatitis G and they live with me. In addition to my eldest son, I have two more sons, 16 years old. Is hepatitis G contagious to others? Can they have children and how will this infection affect the child’s health?
Answer: Viral hepatitis G is not transmitted through household contact and to your younger sons not dangerous. A woman infected with hepatitis G can give birth in 70-75% of cases healthy child. Since this is generally a fairly rare type of hepatitis, and even more so in two spouses at the same time, to exclude a laboratory error, I recommend repeating this analysis again, but in a different laboratory.
Question:How effective is the hepatitis B vaccine? What side effects does this vaccine have? What should be the vaccination plan if a woman plans to become pregnant in a year? What are the contraindications?
Answer: Vaccination against viral hepatitis B (carried out three times - 0, 1 and 6 months) is highly effective, cannot in itself lead to jaundice and has no side effects. It has practically no contraindications. Women planning pregnancy and who have not had rubella or chickenpox should mandatory In addition to hepatitis B, you should also get vaccinated against rubella and chickenpox, but no later than 3 months before pregnancy.
Question:What to do about hepatitis C? To treat or not to treat?
Answer: Viral hepatitis C should be treated in the presence of three main indicators: 1) the presence of cytolysis syndrome - increased performance ALT in whole and 1:10 diluted blood serum; 2) a positive test result for antibodies of the immunoglobulin M class to the nuclear antigen of the hepatitis C virus (anti-HCVcor-Ig M) and 3) detection of hepatitis C virus RNA in the blood by the chain method polymerase reaction(PCR). Although the final decision should still be made by the attending physician.
Question:In our office, an employee was diagnosed with hepatitis A (jaundice). What should we do? 1. Should the office be disinfected? 2. When does it make sense for us to test for jaundice? 3. Should we limit contact with families now?
Answer: The office should be disinfected. Tests can be taken immediately (blood for AlT, antibodies to HAV - hepatitis A virus of immunoglobulin classes M and G). It is advisable to limit contact with children (before testing or up to 45 days after identifying a case of the disease). After the situation is clarified, it is advisable for healthy non-immune employees (negative test results for IgG antibodies to HAV) to be vaccinated against viral hepatitis A, as well as hepatitis B, to prevent similar crises in the future.
Question:How is the hepatitis virus transmitted? And how to avoid getting sick.
Answer: Hepatitis A and E viruses are transmitted through food and drink (the so-called fecal-oral transmission). Hepatitis B, C, D, G, TTV are transmitted through medical procedures, injections (for example, among injecting drug addicts using one syringe, one needle and a common “Shirka”), blood transfusions, during surgical operations with reusable instruments, as well as during sexual contact (so-called parenteral, blood transfusion and sexual transmission). Knowing the routes of transmission of viral hepatitis, a person can to a certain extent control the situation and reduce the risk of disease. There have been vaccines against hepatitis A and B in Ukraine for a long time, vaccinations with which provide a 100% guarantee against the occurrence of the disease.
Question:I have hepatitis C, genotype 1B. I was treated with Reaferon + Ursosan - without results. What medications to take to prevent liver cirrhosis.
Answer: For hepatitis C, the most effective combination antiviral therapy is: recombinant alpha 2-interferon (3 million per day) + ribavirin (or in combination with other drugs - nucleoside analogues). The treatment process is long, sometimes more than 12 months, under the control of ELISA, PCR and cytolysis syndrome indicators (AlT in whole and 1:10 diluted blood serum), as well as at the final stage - liver puncture biopsy. Therefore, it is advisable to be observed and undergo laboratory examination by one attending physician - it is necessary to understand the definition of “without result” (dosage, duration of the first course, laboratory results in the dynamics of drug use, etc.).
Question:Hepatitis C! A 9-year-old child has had a fever for 9 years. How to treat? What's new in this area? Will they soon find the right treatment? Thank you in advance.
Answer: Temperature is not the main symptom chronic hepatitis C. Therefore: 1) it is necessary to exclude other causes elevated temperature; 2) determine the activity of viral hepatitis C according to three main criteria: a) ALT activity in whole and 1:10 diluted blood serum; b) serological profile - Ig G antibodies to HCV proteins of classes NS4, NS5 and Ig M to the HCV nuclear antigen; 3) test the presence or absence of HCV RNA in the blood using the polymerase chain reaction (PCR), and also determine the genotype of the detected virus. Only after this will it be possible to talk about the need to treat hepatitis C. Today there are quite progressive drugs in this area.
Question:Is it possible to breastfeed a child if the mother has hepatitis C?
Answer: It is necessary to test the mother's milk and blood for hepatitis C virus RNA. If the result is negative, you can breastfeed the baby.
Question:My brother is 20 years old. Hepatitis B was discovered in 1999. Now he has been diagnosed with hepatitis C. I have a question. Does one virus change to another? Can it be cured? Is it possible to have sex and have children? He also has 2 lymph nodes on the back of his head, maybe he should be tested for HIV? Didn't take drugs. Please, please answer me. Thank you. Tanya
Answer: You know, Tanya, with a large share It is likely that infection with two viruses (HBV and HCV) occurs through injection drug use. Therefore, first of all, it is necessary to clarify this situation with your brother and, if necessary, recover from drug addiction. Drugs are a cofactor that accelerates the unfavorable course of hepatitis. It is advisable to get tested for HIV. One virus does not pass into another. Chronic viral hepatitis B and C are treated today and sometimes quite successfully. Sex life- with a condom. After treatment you can have children.
Question:How is the hepatitis A virus transmitted?
Answer: The hepatitis A virus is transmitted from person to person through the fecal-oral route. This means that a person with hepatitis A sheds viruses in their stool, which, if poor hygiene is not observed, can get into food or water and lead to infection of another person. Hepatitis A is often called the “disease of dirty hands.”
Question:What are the symptoms of viral hepatitis A?
Answer: Often, viral hepatitis A is asymptomatic, or under the guise of another illness (for example, gastroenteritis, flu, colds), but, as a rule, some of the following symptoms may indicate the presence of hepatitis: weakness, increased fatigue, drowsiness, in children, tearfulness and irritability; decreased or lack of appetite, nausea, vomiting, bitter belching; discolored stool; fever up to 39°C, chills, sweating; pain, feeling of heaviness, discomfort in the right hypochondrium; darkening of urine - occurs a few days after the first signs of hepatitis appear; jaundice (the appearance of a yellow coloration of the sclera of the eyes, body skin, and oral mucosa), as a rule, appears a week after the onset of the disease, bringing some relief to the patient’s condition. Often there are no signs of jaundice with hepatitis A at all.
One of the common viral liver diseases is Hepatitis A. A distinctive feature of this form is that the disease does not become chronic, so treating hepatitis A is a little easier.
Transmission of Botkin's disease occurs through the fecal-oral route. The virus is released:
- with the feces of a sick person;
- through unwashed hands;
- through dirty food and water it enters the body of another person.
Therefore, children often suffer from the so-called disease of unwashed hands.
The patient exhibits general symptoms, suspect this disease it's difficult right away.
Hepatitis A is an environmentally resistant virus. The peculiarity of all type A viruses is that they are suppressed by the same antigens and immunogens.
They are sensitive to a standard set of reagents and preventative agents.
These organisms live in humid environments, and the higher the temperature, the less chance they have of survival. This is how they live:
- up to 4 weeks at a temperature of about 21 °C,
- about 4 months at temperatures up to 6 °C,
- at 100 °C they can live up to 5 minutes.
Active chlorine kills the virus within 15 minutes, but only at a concentration of 2 mg/ml. If there is less substance in the solution, it only suppresses pathogenic organisms, and they infect people. It is important that it is not sensitive to acids and alkalis.
The virus only affects people of any age. Children can get sick from birth.
The important thing is that children are susceptible to the virus in different ways, it all depends on the mother’s immunity, which is passed on to the baby. So, if the baby’s mother has been vaccinated against this disease, the child is immune to hepatitis A until 1 year of age. If the mother is not vaccinated, the baby may become infected. Parents often do not understand how their child could become infected and how hepatitis is transmitted. The route is the same - oral-fecal. 
Photo: facts about the virus
Causes
The disease is transmitted not only by direct contact. They become infected due to simple failure to comply with hygiene rules. There is a chance of getting sick among people who do not wash their hands after visiting the toilet and going outside.
If you use someone else's cutlery while eating, or use someone else's personal hygiene products, the virus infects the body through dirty water and food.
Children aged 3 to 5 years are most often affected. In kindergartens they actively communicate with each other, viral hepatitis A gets from the dirty hands of one child to another. Children who are not taught personal hygiene skills also get sick.
Therefore, everyone should know how they become infected with hepatitis A and be as careful as possible.
Classification of the disease
The symptoms of the disease depend on various circumstances. Therefore, there are two forms of the disease:
- Typical - classic symptoms, of three types (mild, moderate and severe).
- Atypical - hidden symptoms. This form can be confused with a slight malaise. The main differences are that there is no change in the color of the skin or whites of the eyes, and there are also no other visible manifestations. Therefore, the diagnosis is made on the basis of laboratory tests.
In children, symptoms and signs of hepatitis A manifest themselves differently.
How dangerous is hepatitis A?
The disease is dangerous because it affects the liver, leading to necrosis of its cells, this is the main danger. Symptoms of the disease also negatively affect the functioning of the body. This makes life and work difficult for the patient, and it is difficult to cure him.
The disease lasts quite a long time; the infected patient must spend all this time in the hospital. A period full recovery the body and, most importantly, the work of the liver lasts about 6 months. All this time you need to eat right. The process of recovery and return to the previous rhythm is also slow; a person feels a loss of strength and asthenia for a long time.
Botkin's disease very rarely leads to death. This is why hepatitis A is dangerous.
Symptoms and signs of hepatitis A
The incubation period, when the virus is already in the body, but symptoms do not appear, lasts up to 50 days, during which time it multiplies and adapts.
The pre-icteric period lasts the first 7 days, then the patient exhibits the following symptoms:
- causeless weakness, fatigue;
- frequent headache;
- muscles and joints hurt;
- nausea and vomiting appears;
- itchy skin;
- temperature rises to 38 °C;
- babies develop diarrhea;
- other patients experience pain in the liver area.
Jaundice period: hepatitis A enters the active stage. Acute symptoms worsen, appearing:
- characteristic skin tone;
- urine becomes darker;
- the stool, on the contrary, becomes lighter.
Jaundice in adults disappears after a maximum of 2 weeks. The disease can sometimes last for 2 months, after which the patient gradually recovers. The recovery period can last up to six months. Almost all cases of illness end with a sharp recovery of the patient, this is noted in the medical history.
Symptoms and signs of hepatitis in women are the same as in men. But, in addition to the main ones, they experience uterine bleeding, and the menstrual period increases significantly. It's all about disruption female hormones.
Methods for diagnosing the disease
If hepatitis A occurs with the manifestation typical signs, it is easy to diagnose. But if the symptoms are hidden, this becomes more difficult.
But in any case, doctors use standard methods diagnostics Including a visual examination of the skin, the following tests are studied:
- blood;
- feces;
- urine.
Instrumental methods are not particularly important; conclusions are drawn based on the results of the analyzes.
Treatment of hepatitis A
When a person learns about the disease, he first of all thinks about how to treat hepatitis A. The peculiarity of the viral disease is that it is treated exclusively in a hospital. The patient is treated in the hospital for 3 weeks or more, depending on the course of the disease.
The doctor discharges the patient only when:
- clinical symptoms disappeared;
- the test results are satisfactory.
After discharge, the patient must visit the doctor once every 2 weeks. He starts work only when all indicators have returned to normal and he has fully recovered:
- To support the liver, patients are prescribed Karsil, which protects the liver from toxins.
- Patients are often prescribed Ursosan; it acts on cholesterol molecules, which negatively affect the liver. He serves as an assistant during treatment.
- Essentiale Forte is prescribed during the recovery period of the body. It relieves symptoms, the patient’s well-being improves, and appetite returns. The drug helps restore liver cells and has a beneficial effect on its functioning.
Women have specific signs hepatitis A, they also treat it. Sometimes they need to consult a gynecologist during the treatment period.
Treatment with traditional methods is unacceptable, it will harm the person. 
Photo: Development process