Hepatitis symptoms, diagnosis, treatment. Hepatitis E - symptoms, causes, diagnosis and treatment of hepatitis E. What should not be consumed

Viral hepatitis E is an acute viral disease with a fecal-oral transmission mechanism, which is characterized by a cyclic course and the frequent development of acute hepatic encephalopathy in pregnant women.

The assumption of the existence of at least two viral hepatitis with a fecal-oral transmission mechanism arose in the 1950s. when analyzing outbreaks of viral hepatitis associated with waterborne infection. After the discovery of the hepatitis A virus and the possibility of verifying this disease, it became obvious that during epidemic periods, along with hepatitis A, other mass diseases of hepatitis with fecal-oral transmission occur. This was confirmed in a number of studies conducted in India, Nepal, as well as in Central Asian countries. Attention was drawn to the fact that hepatitis A affects mainly children, mainly preschool age, and the incidence of other viral hepatitis with fecal-oral transmission occurred mainly in adults and older children. Experimental studies on monkeys made it possible to establish the nosological independence of the new viral hepatitis. A great contribution to the discovery and study of the hepatitis E virus was made by domestic researchers led by prof. M.S. Balayan. This disease is called “non-A, non-B” viral hepatitis with a fecal-oral mechanism of infection; according to WHO recommendations, it is classified as hepatitis E

ICD code -10

ICD-10 code

B17.2 Acute hepatitis E

Epidemiology of hepatitis E

The source of infection is a sick person suffering from a typical or atypical (anicteric, erased) form of the disease. Chronic carriage of the virus has not been registered. The virus is detected in the patient’s blood 2 weeks after infection, and in feces - a week before the onset of the disease and during the first week of the disease. Viremia lasts about 2 weeks. HEV has also been isolated from animals and birds, which may be reservoirs of HEV for humans. There is evidence of HEV transmission through blood transfusion from an asymptomatic donor with viremia.

The main mechanism of transmission is fecal-oral; Waterborne outbreaks associated with drinking water contaminated with feces have been described. There is a seasonality that coincides with the period of increase in the incidence of hepatitis A. In our country, the seasonality of viral hepatitis E occurs in the autumn-winter period, in Nepal - during the monsoon rains.

The disease affects mainly the adult population, and the majority of those affected are people aged 15 to 35 years. So. During an outbreak of hepatitis E in Central Asia, 50.9% of patients were aged 15 to 29 years and only 28.6% were children. It cannot be excluded that the small frequency of cases of this hepatitis in childhood is associated primarily with the subclinical nature of the disease in children.

Hepatitis E occurs with high frequency against the background of a high level of immunity to the hepatitis A virus.

Hepatitis E is reported mainly in regions of Southeast Asia; India, Nepal, Pakistan and Central Asia. The disease is characterized by its epidemic nature with the involvement of large groups of the population in the epidemiological process. A characteristic feature of this hepatitis is the frequent occurrence of severe and malignant forms in pregnant women. In the CIS countries, this hepatitis virus is also found in the European part and Transcaucasia, as evidenced by the detection of specific antibodies in mass-produced γ-globulins from these regions. At the same time, no antibodies to the hepatitis E virus are detected in γ-globulins produced in Siberia and the Far East.

The infection is characterized by seasonality: an increase in incidence is associated with the beginning or end of the rainy season in Southeast Asia, and in the countries of Central Asia the peak incidence occurs in autumn. Periodic increases in incidence in endemic regions are recorded every 7-8 years. Repeated cases of viral hepatitis E have been described, which may be due to the antigenic heterogeneity of the virus. HEV can be transmitted to the fetus from the mother in the third trimester of pregnancy. In Europe and North America, the incidence of viral hepatitis E is sporadic and is recorded in persons returning from endemic regions. It should be noted that in patients with chronic hepatitis (viral, autoimmune), donors, patients with hemophilia and persons who have undergone kidney transplantation, the frequency of detection of anti-HEV IgG is high. which confirms the hypothesis about the risk of parenteral transmission of the virus from donors.

What causes hepatitis E?

Hepatitis E virus (HEV) has a spherical shape, a diameter of about 32 nm and its properties are similar to caliciviruses (family Caliciviridae). The genome of the virus is represented by single-stranded RNA. The virus is quickly destroyed by chlorine-containing disinfectants. It is less persistent in the environment than HAV.

Pathogenesis of hepatitis E

The pathogenesis of hepatitis E is not well understood. It is believed that HEV enters the human body through contaminated water or food. From the intestine through the portal vein, the hepatitis E virus enters the liver and is adsorbed on the membrane of hepagocytes, penetrates into the cytoplasm, where it replicates. HEV does not have a cytopathogenic effect. Many people believe that liver damage due to hepatitis E is immune-mediated. After leaving the infected liver cells, the hepatitis E virus enters the blood and bile, and then the virus is released from the intestines in the feces. Animal models of hepatitis E (monkeys, pigs) have provided evidence to suggest that HEV can replicate in intestinal lymph nodes.

Viral hepatitis E is characterized by a severe course of the disease in the third trimester of pregnancy, but the reasons for this phenomenon are unknown. The severe course of the disease is based on massive necrosis of hepatocytes, the development of thrombohemorrhagic syndrome due to a sharp deficiency of plasma hemostasis factors, as well as hemolysis leading to acute liver failure. In these cases, cerebral edema and disseminated intravascular coagulation syndrome can lead to death.

Pathomorphology

The pathomorphological picture of hepatitis E does not differ from that of other viral hepatitis. Focal necrosis is revealed by twilight infiltration of Kupffer cells and leukocytes, the phenomenon of cytoplasmic and lobular cholestasis, and in the fulminant form, confluent necrosis with complete disruption of the structure of the liver tissue is detected.

Symptoms of hepatitis E

Hepatitis E has an incubation period of 15-40 days, with an average of about 1 month.

There are icteric and anicteric forms of the disease (ratio 1:9).

Jaundice forms are characterized by an acute cyclic, predominantly mild course of the disease (60% of all cases). There are acute and gradual onset of the disease. The pre-icteric period is often short and lasts 2-5 days; manifestations of dyspeptic syndrome predominate. Symptoms of hepatitis E such as short-term fever (usually low-grade fever) occur in 10-20% of patients. In approximately 20% of patients, hepatitis E begins with a change in the color of urine and the development of jaundice. The duration of the jaundice period ranges from several days to one month (on average 2 weeks); the development of a cholestatic form with prolonged jaundice and skin itching is possible.

In 1% of patients with icteric forms of viral hepatitis E, fulminant hepatitis develops. Severe cases of viral hepatitis E are observed in pregnant women (especially in the third trimester), as well as in women giving birth during the first week after birth. Harbingers of such a course even in the pre-icteric period of the disease can be pronounced symptoms of hepatitis E: intoxication, fever, dyspeptic syndrome, pain in the right hypochondrium. After the appearance of jaundice, the symptoms of hepatic encephalopathy rapidly increase until the development of coma. In this case, pronounced hemolysis, hemoglobinuria, oligoanuria are noted, as well as a pronounced hemorrhagic syndrome caused by a decrease in the activity (up to 2-7% of normal values) of hemostasis factors included in the prothrombin complex (II, VII, X). With the development of hemorrhagic syndrome, massive gastrointestinal, uterine and other bleeding occurs, which often leads to death. Pregnancy in most cases ends with intrauterine fetal death, miscarriage, and premature birth. Of those born alive, every second person dies within a month. In endemic regions, viral hepatitis E in pregnant women is fulminant in 70% of cases. Mortality is more than 50%, especially in the third trimester of pregnancy.

Diagnosis of hepatitis E

When making a diagnosis, it is necessary to take into account a complex of epidemiological data and clinical symptoms in the pre-icteric and icteric periods.

The presence of viral hepatitis E may be indicated by:

assumption about the water transmission route of the disease:
visiting a country where viral hepatitis E is endemic;
clinical manifestations similar to those of viral hepatitis A;
identification of severe forms with symptoms of hepatic encephalopathy, especially in pregnant women in the second half of pregnancy, early postpartum period or in nursing mothers.

Diagnosis of hepatitis E involves detecting anti-HEV IgM in the blood serum, which appears in the blood 3-4 weeks after infection and disappears after a few months.

Crucial importance is given to the results of serological studies for markers of viral hepatitis A, B and C. In the absence of antibodies to the hepatitis A virus (anti-HAV IgM), markers of the hepatitis B virus (HBsAg anti-HBcore IgM), hepatitis C virus (anti-HBcore IgM) in the blood serum. -HCV) and in the absence of a parenteral history (in the next 6 months before the present disease), the assumption of hepatitis E would be legitimate.

The most accurate etiological diagnosis of this disease is based on the detection of viral particles using immune electron microscopy in fecal samples. Viral particles can be detected in stool starting from the last week of the incubation period until the 12th day from the onset of clinical manifestation of the disease. However, there is also a serological diagnosis of hepatitis E by detecting specific antibodies (anti-HEV and IgG) in the blood serum using the ELISA method. If necessary, determination of HEV RNA in blood serum using PCR is used.

The discovery of various markers of HEV infection has expanded modern diagnostic capabilities. Depending on the detection of certain markers in the blood serum, one can judge the presence or history of hepatitis E.

Specific markers of hepatitis E virus infection and interpretation of their detection (Mikhailov M.I. et al., 2007)

Hepatitis E is a viral liver disease caused by the hepatitis E virus (HEV).
Globally, an estimated 20 million cases of HEV infection occur each year, causing 3.3 million symptomatic cases of hepatitis E (1).
WHO estimates that approximately 44,000 people died from hepatitis E in 2015 (representing 3.3% of deaths from viral hepatitis).
Transmission of the virus occurs through the fecal-oral route, mainly through contaminated water.
Hepatitis E occurs throughout the world, but is most common in East and South Asia.
A vaccine has been developed to prevent hepatitis E virus infection, which is licensed in China but is not yet available in other countries.

Hepatitis E is a liver disease caused by the hepatitis E virus (HEV). The virus has at least four different types: genotypes 1, 2, 3 and 4. Genotypes 1 and 2 have only been found in humans. Genotypes 3 and 4 circulate in several animals (including pigs, wild boar and deer) without causing disease, and occasionally infect humans.

The virus is released into the environment through the feces of infected people and enters the human body enterally. The virus is transmitted primarily through contaminated drinking water. The infection is usually self-limiting and resolves within 2-6 weeks. In rare cases, a serious condition known as fulminant hepatitis (acute liver failure) develops, which can be fatal.

Epidemiological situation

Hepatitis E infection is common throughout the world. In places where hepatitis E is found, two different backgrounds are observed:

areas with limited resources and frequent water pollution; And
areas with safe drinking water.

The disease is mainly prevalent in low- and middle-income countries with limited access to water, sanitation, hygiene and health services. In these areas, the disease occurs in both outbreaks and sporadic cases. Outbreaks typically follow periods of fecal contamination of drinking water sources and can affect several hundred to several thousand people. Some of these outbreaks occur in areas of conflict and humanitarian emergencies, such as war zones, and in refugee or internally displaced persons camps, where sanitation and safe water supplies are particularly challenging.

Sporadic cases are also believed to be related to water contamination, although on a smaller scale. Cases in these areas are caused mainly by infection with genotype 1 virus and much less frequently with genotype 2 virus.

In areas with better sanitation and water supplies, hepatitis E is uncommon and occurs only in sporadic cases. Most of these cases are caused by genotype 3 virus of animal origin, which usually occurs through the consumption of undercooked animal meat (including animal liver, especially pork), and are not associated with contamination of water or other food products.

Serological evidence of previous exposure to the virus was found in most areas, with higher seroprevalence (the proportion of people testing positive for HEV antibodies) observed in Asia and Africa. However, the presence of these antibodies does not mean the presence or increased risk of the disease. The usefulness of such data for epidemiological purposes may also be limited due to the variable and possibly suboptimal performance of available serological assays and the possible loss (over time) of antibodies in individuals exposed to the virus.

Virus transmission

Hepatitis E virus transmission occurs through the fecal-oral route as a result of contamination of drinking water. This route of spread accounts for a very significant proportion of clinical cases of this disease. Risk factors for hepatitis E include poor sanitation, which allows the virus shed in the feces of infected individuals to enter the drinking water supply.

Other routes of transmission of the virus have been identified, but they appear to explain a much smaller number of clinical cases. These routes of transmission include:

eating insufficiently heat-treated meat or meat products obtained from infected animals (for example, pork liver);
transfusion of contaminated blood products; And
vertical transmission from a pregnant woman to her fetus.

Symptoms

The incubation period after exposure to HEV ranges from 2 to 10 weeks, with an average of 5 to 6 weeks. Infected individuals shed the virus from a few days before the onset of the disease to 3-4 weeks after it.

In areas of high endemicity, symptomatic infection is most common among young people aged 15–40 years. In these areas, although infection occurs in children, they often either have no symptoms or develop only mild illness without jaundice and go undiagnosed.

Typical signs and symptoms of hepatitis include:

initial phase of mild fever, decreased appetite (anorexia), nausea and vomiting for several days; some patients may also experience abdominal pain, itching (without breaking the skin), skin rash or joint pain;
jaundice (yellowing of the skin and whites of the eyes), dark urine and colorless stool; And
slightly enlarged, tender liver (hepatomegaly).

These symptoms are often no different from those experienced during any acute stage of liver disease and usually last from one to six weeks.

In rare cases, acute hepatitis E can lead to fulminant hepatitis (acute liver failure) and death. Fulminant hepatitis most often develops during pregnancy. Pregnant women with hepatitis E, especially in the second and third trimester, are at increased risk of acute liver failure, fetal loss, and death. The mortality rate of hepatitis E among pregnant women can reach 20-25% in the third trimester.

Cases of chronic hepatitis E infection have been reported in immunosuppressed individuals, especially organ transplant recipients using immunosuppressive drugs, infected with HEV genotype 3 or 4. They remain rare.

Diagnostics

Clinically, cases of hepatitis E do not differ from other cases of acute viral hepatitis. However, in appropriate epidemiological settings, reasonable guesses about the diagnosis often arise, for example, if several cases of the disease occur in populated areas in known endemic areas or in areas at risk of water contamination, if the disease is more severe in pregnant women, or if hepatitis A was excluded.

The definitive diagnosis of hepatitis E infection is usually based on the detection of specific IgM antibodies to the virus in a person's blood; This is usually sufficient in areas where the disease is common. Rapid tests are available for field use.

Additional tests include reverse transcription-polymerase chain reaction (RT-PCR) to detect hepatitis E virus RNA in blood and/or stool; this analysis is carried out in specialized laboratories. Such testing is especially needed in areas where hepatitis E is rare, as well as in cases of chronic HEV infection.

Treatment

Treatment that can change the course of acute hepatitis E has not been developed. The disease is usually self-limiting and hospitalization is usually not required. The main thing is to avoid unjustified prescription of medications. Acetaminophen/paracetamol and anti-vomiting medications should not be given.

However, hospitalization is necessary in cases of fulminant disease and may also be required for pregnant women with severe symptoms.

In immunosuppressed patients, treatment with ribavirin (an antiviral drug) is indicated to improve their condition. Interferon has also been used successfully in certain cases.

Prevention

The most effective method of combating this disease is prevention. At the population level, the risk of HEV transmission and development of hepatitis B disease can be reduced by the following measures:

maintaining high standards of public water supply; And
establishing proper systems for disposal of human faeces.

At an individual level, the risk of infection can be reduced by:

compliance with hygiene rules;
abstaining from drinking water and ice of unknown purity.

A recombinant subunit vaccine for the prevention of hepatitis E was registered in China in 2011. It has not yet received approval in other countries.

In 2015, the WHO Strategic Advisory Group of Experts (SAGE) on Immunization reviewed the available evidence on the burden of hepatitis E and the safety, immunogenicity, effectiveness and cost-effectiveness of the licensed hepatitis E vaccine:

Global prevalence of and susceptibility to hepatitis E virus infection: a systematic review
Systematic review of hepatitis E in the world

Based on the SAGE review, a WHO position paper was issued:

WHO position paper on hepatitis E

Guidance on sanitary and epidemiological measures

Waterborne hepatitis E outbreaks: detection, investigation and control

In summary, if a hepatitis E outbreak is suspected, the following actions are recommended:

verifying the diagnosis and confirming the existence of an outbreak;
determining the mode of transmission and identifying populations at increased risk of infection;
increasing the effectiveness of sanitary and hygienic measures to eliminate fecal contamination of food and water; And
eliminating the source of infection.

WHO activities

WHO has released a technical report, “Waterborne Hepatitis E Outbreaks: Recognition, Investigation and Control.” It provides information on the epidemiology, clinical manifestations and diagnosis of hepatitis E. The report also provides recommendations for public health authorities to respond to outbreaks of hepatitis E virus infection.

In 2015, the WHO Strategic Advisory Group of Experts on Immunization released a position paper on hepatitis E, which provides an overview of the available evidence on the burden of the disease and on the safety, immunogenicity, efficacy and cost-effectiveness of licensed hepatitis vaccine E. With regard to the use of hepatitis E vaccine, SAGE made the following recommendations:

WHO recognizes the importance of hepatitis E as a public health problem especially for special populations such as pregnant women and people living in displaced persons camps and outbreak settings.
WHO does not recommend introduction of the vaccine into national routine immunization programs in countries with epidemic or sporadic cases of hepatitis E. However, national authorities in these countries may decide to use the vaccine based on local epidemiological conditions.
Due to the lack of sufficient information on the safety, immunogenicity and effectiveness of the vaccine in the following population subgroups, WHO does not recommend routine use of the vaccine in children under 16 years of age, pregnant women, patients with chronic liver disease and patients awaiting organ transplantation, and travelers persons
There may be special situations, such as outbreaks, where the risk of getting hepatitis E or developing complications from the disease or dying is particularly high. WHO's current position on routine immunization programs should not preclude the use of the vaccine in these specific situations. In particular, consideration should be given to the use of the vaccine to reduce the risk of or prevent outbreaks of hepatitis E, as well as the use of the vaccine to reduce the impact among high-risk groups such as pregnant women.
As more data becomes available, WHO's position on hepatitis E vaccine will be reviewed and updated as necessary.

WHO is currently working with experts and global partners to develop a standard protocol for the use of hepatitis E vaccine in response to outbreaks. Similar groups are also working to develop a simplified algorithm for diagnosing, triaging and managing patients during outbreaks.

In May 2016, the World Health Assembly adopted the first Global Health Sector Strategy on Viral Hepatitis 2016–2021. It highlights the critical role of universal health coverage and sets targets that are aligned with the Sustainable Development Goals.

The strategy contains the concept of eliminating viral hepatitis as a public health problem. This is reflected in global targets to reduce the number of new cases of viral hepatitis infection by 90% and mortality from viral hepatitis by 65% by 2030. The strategy sets out the actions that countries and the WHO Secretariat must take to achieve these targets.

To support countries to achieve the global goals of eliminating hepatitis as part of the 2030 Agenda for Sustainable Development, WHO is working in the following areas:

raising awareness, facilitating partnerships and mobilizing resources;
formulating evidence-based policy and generating evidence for action;
prevention of transmission of infection; And
expanding coverage of screening, care and treatment services.

WHO recently published the Progress Report on HIV, Viral Hepatitis and Sexually Transmitted Infections 2019, which outlines the progress made towards eliminating them. The report provides global statistics on viral hepatitis B and C, rates of new infections, chronic infections and deaths caused by these two common viruses, as well as information on key actions taken at the end of 2016 and 2017.

Since 2011, WHO has worked with national governments, civil society and partners to organize annual events around World Hepatitis Day (one of the nine major annual health campaigns) to raise awareness and understanding of viral hepatitis . The date of July 28 was chosen to honor the birthday of Nobel Prize-winning scientist Dr. Baruch Blumberg, who discovered the hepatitis B virus and developed a diagnostic test and vaccine against the virus.

For World Hepatitis Day 2019, WHO is focusing on the theme “Investing to end hepatitis” to highlight the need for increased funding at national and international levels to scale up hepatitis prevention, screening and treatment services to meet hepatitis targets. elimination by 2030

Good day, dear readers!

In today's article we will continue to consider hepatitis in all its aspects and next in line is hepatitis E, or as it is also called, viral hepatitis E, as well as its causes, symptoms, diagnosis, treatment and prevention. So…

What is hepatitis E?

Hepatitis E– an inflammatory infectious disease of the liver, caused by infection of the body with the hepatitis E virus (HEV). In severe cases, the infection can also affect the kidneys. The main mechanism of infection is the fecal-oral route.

The main danger of infection with the hepatitis E virus is the acute course of the disease in pregnant women with frequent adverse pregnancy outcomes in the last trimester, leading to death for both the mother and the fetus. In other cases, this disease usually proceeds benignly, often the person even heals on its own, usually 2-6 weeks after the disease.

Diagnosis of hepatitis E includes the following tests and examination methods:

Taking anamnesis and visual examination of the patient;
PCR (polymerase chain reaction) method with reverse transcriptase (RT-PCR);
Blood test for markers of viral hepatitis A, B and E - IgM (anti-HEV IgM) and IgG;
Biochemical analysis of stool;
abdominal organs.

Additionally, a liver biopsy may be prescribed.

Treatment of hepatitis E begins with a visit to an infectious disease doctor and a thorough examination of the body. This is an essential step in the effective treatment of hepatitis E, thanks to which it will be possible to exclude possible secondary infections and diseases, especially other, more serious types of hepatitis (A, B and C).

If complications of hepatitis E are not detected, the patient is not a pregnant woman, and the rapid development of the disease is not detected, hospitalization and antiviral treatment are not used, because The human immune system is strong enough to fight off the infection on its own. In these cases, symptomatic treatment is prescribed - to eliminate nausea and vomiting, and drugs to restore liver cells.

In other cases, hepatitis E therapy usually consists of the following:

1. Hospitalization and bed rest (if necessary);
2. Drug therapy:
2.1. Antiviral therapy;
2.2. Therapy aimed at maintaining liver health;
2.3. Detoxification therapy;
2.4. Supporting the patient's immune system;
2.5. Relief of symptoms of viral hepatitis E.
3. Diet.
4. Good rest.

Treatment for viral hepatitis E includes:

2. Drug therapy (medicines for hepatitis E)

Important! Before using medications, be sure to consult your doctor!

2.1. Antiviral therapy

To stop an infection in the body - the HEV virus - the use of the following antiviral drugs is indicated, sometimes in combination with each other:

Group of alpha interferons - “Alfaferon”, “Interferon”;
Nucleoside analogues - Adefovir, Lamivudine;
"Ribavirin" (categorically contraindicated during pregnancy!)

The course of treatment is prescribed by the attending physician.

2.2. Therapy aimed at maintaining liver health

Due to the fact that hepatitis viruses settle and primarily affect the liver, it needs to be supported. To strengthen liver cells, as well as their restoration, hepatoprotectors are prescribed.

Among the hepatoprotectors we can highlight: “Hepatosan”, “”, “Legalon”, “Ursonan”, “”.

To speed up the recovery of hepatocytes, ursodeoxycholic acid (UDCA) is sometimes additionally prescribed: Ursodex, Ursorom.

2.3. Detoxification therapy

When it enters the body, the infection poisons it with its waste products (toxins), which can cause unpleasant symptoms such as nausea, vomiting, and elevated body temperature. To prevent this from happening, detoxification therapy is used, aimed at adsorbing toxins and removing them from the body.

Among the detoxification drugs, the following products can be distinguished: “Atoxil”, “Albumin”, glucose solution (5%), “Enterosgel”.

2.4. Supporting the patient's immune system

The immune system, the main role of which is to protect the body from infection and other unfavorable factors for the normal functioning of the body, when sick, needs reinforcement. In a healthy state, the immune system will additionally or primarily destroy the infection.

As immunostimulants, we can note: Vilozen, Zadaxin, Thymogen, especially (ascorbic acid), (tocopherol) and.

Among the natural sources of vitamin C, scientists note - cranberries and other natural products.

2.5. Relief of symptoms of viral hepatitis E:

To alleviate the course of hepatitis E, symptomatic medications are usually prescribed.

Against nausea and vomiting:" ", "Pipolfen", " ".

Against insomnia, anxiety– sedatives: “Valerian”, “Tenoten”.

3. Diet for hepatitis E

For hepatitis E, a therapeutic nutrition system developed by M.I. is usually prescribed. Pevzner - which is also prescribed for the treatment of liver cirrhosis and.

The basis of the diet is:

drink plenty of fluids (2-3 liters of liquid/day), fresh juices have a particularly beneficial effect on the body (be careful during pregnancy!);
gentle soups;
steamed porridge;
fresh vegetable salads.

For any hepatitis, it is strictly prohibited to consume alcohol, as well as spicy, salty, fried, fatty, canned and smoked foods, instant food, chips, crackers and other unhealthy foods. It is also necessary to stop smoking and using drugs.

3. Good rest

In case of any illness, proper rest is as necessary as a breath of air, because... it helps to accumulate strength to fight infection, as well as relieve neurological disorders, for example.

Treatment prognosis

The prognosis for treatment of hepatitis E is very favorable, and in many cases, even without the intervention of doctors, and with strengthening of the immune system, recovery comes on its own.

Even during pregnancy, if you consult your doctor in a timely manner, the positive outcome for the recovery of both the mother and the unborn child is quite high.

But even if the doctors do not promise anything good, remember, you can always turn to God in prayer, because the Lord is much stronger and wiser than any person, and His love for His creation is very great, as is His mercy!

Important! Before using traditional methods of treatment, be sure to consult your doctor!

Folk remedies against hepatitis E are aimed only at maintaining the liver during drug therapy for hepatitis, as well as at restoring liver cells during the recovery period.

Infectious liver damage includes a disease such as hepatitis E. Infection occurs through the fecal-oral route and is characterized by an acute form of the course. Hepatitis of this group poses a particular danger to pregnant women. The duration of the incubation period is from several weeks to 2 months. The symptoms of the disease are similar to hepatitis A. Hepatitis can be detected using differential diagnosis, instrumental and laboratory tests. When treating group E diseases, the body is detoxified and special nutrition is prescribed.

general information

The hepatitis E virus affects the liver and kidneys.

Viral hepatitis E is most similar in symptoms and course of the disease to hepatitis A. The first disease has a more acute course and quickly causes complications. Hepatitis E tends to affect not only the liver, but also the kidneys. If not detected and treated in a timely manner, the disease can be fatal for pregnant women. This is due to the fact that the disease causes acute encephalopathy, which in half of the cases ends in the death of the fetus and woman. Diagnostic procedures for hepatitis E often provoke spontaneous miscarriage or fetal death.

How is it transmitted?

The causative agent of this type of hepatitis is a virus of the Calicivirus genus, which is less resistant to environmental influences. Pathogens of this group are able to live for a long time in the body if comfortable thermal conditions are created (about 20 degrees). Often, virus microorganisms live in patients and people who have an infectious disease. The incubation period of hepatitis E lasts from 14 days to several months.

The most common route of transmission is contaminated water.

The routes of transmission of infection occur through nutrition, in most cases through water. Sometimes the infection is transmitted to a person through unwashed dishes or household items. Often, a viral infection enters through the oral cavity through the consumption of raw shellfish. An epidemic of hepatitis E has been noticed in regions where there are problems with water purification and people often drink contaminated liquid.

Doctors have noticed cases of infection through blood when a transfusion was given from a sick donor with asymptomatic hepatitis E. In most cases, the disease occurs in men and people aged 15 to 45 years. You need to be careful when pregnant at 30 weeks, as during this period the likelihood of infection increases significantly.

Features of the flow

In its progression, the pathology resembles hepatitis A. After a person consumes contaminated water and food, after a certain period, damage to the cells of the liver parenchyma occurs. This leads to impaired liver function and intoxication of the body. The disease is noted from all hepatitis by the complexity and severity of the course. There are many symptoms that are often fatal.

Main symptoms

In the first stages of the disease, a person feels constant weakness of the whole body.

The hepatitis E virus may not appear for a long time and develop in a latent form. The incubation period lasts on average one month. Gradually, a person begins to be bothered by various minor symptoms, to which the patient does not attach much importance. The first sign of deviation is pain in the right hypochondrium. The following symptoms are observed:

general weakness and fatigue;
loss of appetite;
aching joints;
high body temperature;
darkening of urine;
discoloration of stool.

Within a week, the patient experiences yellowing of the sclera of the eyes, skin and mucous membranes of the oral cavity.

Unlike hepatitis A, group E disease is manifested by an increase in symptoms after jaundice. As it progresses, the main symptoms include itching of the skin due to the increased concentration of bile acids in the blood. Over time, the liver enlarges and its function is impaired. Often, a few weeks after the onset of symptoms, regression of the disease occurs, which lasts up to 2 months. And sometimes the pathology actively progresses and causes a number of complications. Patients often develop hemolytic syndrome and acute liver failure. With hemorrhage, bleeding occurs in the stomach, intestines or uterus. This type of hepatitis often causes liver cirrhosis.

Diagnosis of hepatitis E

One of the most common instrumental diagnostic methods is ultrasound.

During diagnostic procedures, it is important to identify viral disease antigens using a PCR reaction. During the diagnostic process, IgM and IgG to pathology antigens are detected. To find out? whether liver function is impaired, you should undergo instrumental and laboratory tests:

ultrasound examination of the liver;
coagulogram, which determines blood clotting;
liver tests;
magnetic resonance imaging;
donating blood for viral markers of hepatitis.

Differential diagnostic methods are often used, which take into account the history of the patient’s region of residence. For pregnant women, a study with markers of a viral disease is used. This is due to the fact that during pregnancy, hepatitis E often appears and is extremely dangerous. Late diagnosis and lack of treatment can lead to death.

Treatment complex

To eliminate the hepatitis E virus, you should undergo special treatment, which consists of a special diet and medication. All treatment takes place in a hospital setting under the supervision of a doctor. To eliminate symptoms, drugs of various spectrums of action are prescribed. They are aimed at preventing the development of liver or kidney failure.

Drug treatment

Most medications are administered intravenously.

In most cases, detoxification drugs are indicated for the disease, which are injected into the veins. Doctors prescribe Hemodez intravenously and glucose solution. Drug therapy includes isotonic sodium chloride solution and products containing potassium and magnesium. As preventive measures and elimination of hemorrhagic syndrome, the use of "Trental" and "Dicynon" is indicated.

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 a common feature - this 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 of different types of this disease are 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 serious complications due to the gradual destruction of liver cells.

Another characteristic feature of viral hepatitis is that 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 available 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, metabolic disorders) and often leads to cirrhosis of the liver 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 release of bilirubin enzyme, which is not processed in the liver, into the blood. But cases of absence of this symptom in hepatitis are not uncommon.

Typically, hepatitis in the initial period of the disease manifests itself flu symptoms. The following are noted:

temperature increase;
body aches;
headache;
general malaise.

As a result of the 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 radiate to the 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 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.

Treatment of hepatitis A

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 is a 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 of hepatitis B requires a comprehensive 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 transmitting the virus (as with viral hepatitis B): hematogenous (i.e. through blood) and sexual. The most common route is 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 3-5% of cases of unprotected sex can cause infection.

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 (relatively short period, severe course) and chronic (protracted 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 in the early or even late stages of the disease. Therefore, it is not uncommon for a person to be surprised to learn that he is sick after a random blood test, 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, fatigue.
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 consequences ranging from skin rashes to severe kidney 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.

Currently, 2 antiviral drugs are used, 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 it 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 of 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 pathological changes incompatible with life occur in the patient’s body.

The rate of progression of hepatitis C is influenced by various factors:

According to statistics from the World Health 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 minor or absent even if the infection lasts several decades, so you can live with hepatitis C for quite a long time. Thus, with 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, in severe forms of hepatitis E, severe damage is observed 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 the further development of the disease.

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; drug therapy is also necessary, 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 hygiene rules:

wash your hands before eating and after using the toilet;
do not eat unwashed vegetables and fruits;
Do not 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 preschool workers and healthcare workers be vaccinated against hepatitis A.

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 the blood of an 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.

The most effective protection against hepatitis B infection today is 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 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 in biochemical analysis are normal ; 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, for several years now I have been using a hormonal drug 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.

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 is not dangerous for your younger sons. A woman infected with hepatitis G can give birth to a healthy child in 70-75% of cases. 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 who are planning a pregnancy and have not had rubella or chickenpox must, in addition to hepatitis B, also be 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 - elevated ALT levels in whole and 1:10 diluted blood serum; 2) a positive test result for immunoglobulin M class antibodies 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 polymerase chain 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 injection drug addicts using one syringe, one needle and a common “shirka”), blood transfusions, during surgical operations with reusable instruments, as well as during sexual contacts (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 of chronic hepatitis C. Therefore: 1) it is necessary to exclude other causes of 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 high degree of probability, infection with two viruses (HBV and HCV) occurs precisely through injecting 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. Sexual 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.