Hepatitis

Hepatitis is considered one of the main causes of all inflammatory processes in the liver. The disease of viral etiology is blamed for the pathologies of this important organ, not accidentally, according to statistics worldwide, there are more than 500 million people with viral hepatitis. This does not mean that the figure is final, because often hepatitis proceeds in a latent form and a person can be a virus carrier, without knowing it.

Hepatitis derives its name from the Greek denotation of the liver - hepatos, it is the most vulnerable organ for viruses that cause hepatitis. However, the cause of the disease can be not only viruses, but intoxication, including alcohol, cholecystitis and cholangitis, as well as burn intoxication and toxicosis during pregnancy.

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Hepatitis viral etiology and the main viruses of hepatitis

Hepatitis A

The disease, which we call hepatitis A, was discovered by the great clinician Sergei Petrovich Botkin in the 19th century, later his name was not only a disease, but also a medical institution in St. Petersburg, a clinical infectious disease hospital.

Hepatitis A is caused by a virus that has a membrane, a stance to acids and enzymes. So the harmful agent penetrates into the body, easily overcoming the acidity of the gastrointestinal tract. In addition, the virus perfectly "feels" itself in any liquid medium, therefore its distribution through water is most typical. The only relative plus of hepatitis A is the fact that a person is more than them only once in a lifetime, then in his immune system protection from this virus is developed for a lifetime.

The prevalence of hepatitis A is not quantifiable and accurate statistical data. It is only known that 99% of children are infected with hepatitis A in Europe, Europeans are less likely to get sick, but according to the latest information, every second of a thousand Europeans was also sick with this disease.

The source of infection are food, fruit, water, fish, uncooked or not thermally processed. Also, the virus A is transmitted through elementary dirt, it's not for nothing that this hepatitis is called the problem of unwashed hands. An infected person excretes hundreds of millions of viruses into the environment with feces, and viruses stay on dirty hands for a long time. Even without a rich imagination, it is easy to imagine the danger of infection with this ubiquitous virus that surrounds a person literally everywhere. Infection occurs by fecal-oral routes, the virus unhindered enters the intestine, then into the bloodstream and the liver, more precisely into the cells most attractive to it-hepatocytes. Hepatitis virions are fixed inside the cell (in the cytoplasm) and there they begin to multiply. With bile, the virus is transferred again into the intestinal tract and is excreted with feces. Liver cells are destroyed not by the virus itself, but by its own immune system, which sends T-lymphocytes to fight the virus. Lymphocytes see hepatocytes as carriers of a harmful agent and destroy them. The result is an inflammatory process of the liver, death of hepatocytes and complete freedom for the viruses multiplied in a comfortable environment.

The incubation period of the disease can last from 14 to 42 days, all this time the person continues to infect the environment, sometimes without knowing it. It should also be taken into account that hepatitis A can be completely unnoticed, that is, it can be asymptomatic or manifest as insignificant signs. The main symptoms of viral hepatitis A depend on how much the patient is sick (in children the symptoms are often not manifested at all). Classical symptoms are as follows: 

• Feverish condition, headache; 
• Weakness; 
• Skin rashes of unclear etiology; 
• Possible diarrhea, decreased appetite; 
• Darkening of urine and depigmentation of feces; 
• Yellow shade sclera (whites of the eyes); 
• Jaundice (skin).

Hepatitis B

Hepatitis caused by the B virus is a more serious and health-threatening form of the disease. Acute hepatitis can lead to chronic inflammation of the liver, at least, to cirrhosis and even death - as a maximum. The path of infection with this virus, as a rule, parenteral (through the blood), less often sexual, even less often - vertical (from mother to child during pregnancy). Hepatitis caused by the B virus is much better preventable, since there is a procedure for vaccinating against this disease. Also, precautions and protection during sexual intercourse help contain the spread of the B virus. Pregnant women, when staged for obstetrics and gynecology, take mandatory tests that determine the virus at an early stage.

Signs of hepatitis B are similar to signs of infection with virus A, but there are differences. The latent period lasts longer, sometimes up to six months, in young children, the disease often passes without obvious manifestations. The acute course of the disease also proceeds secretly. The main signs on which hepatitis B can be recognized are the following: 

• Nausea, sometimes to vomiting; 
• Pain in the right side of the epigastrium, often in the hypochondrium; 
• Fever; fever; 
• Sore joints; 
• Yellow, sometimes gray-yellow shade of the skin, sclera of the eyes; 
• Depigmentation of feces and staining of urine in a dark color; 
• Splenomegaly (enlargement of the size of the spleen); 
• Hepatomegaly (increase in liver size).

Diagnosis of hepatitis caused by the virus B is carried out on the basis of anamnesis, abdominal palpation, biochemical studies. This type of hepatitis is fraught not only with chronic inflammation of the liver and destruction of its cells, but also liver failure, cirrhosis, up to oncoprocess.

Hepatitis C

Hepatitis caused by the virus C, is not accidentally called paradoxically - "affectionate killer." They are also infected parenterally, that is, through the bloodstream. This may be an injection made with an unsterile needle, which is often found in addicted people, hepatitis of this type is transmitted through unprotected sex, possibly by transfusion of blood from an infected donor, which in our time is practically not found. More often than not, hepatitis C is completely imperceptible, and this is the name - "affectionate". An icteric, typical for the hepatitis period, may not be.

Symptomatics is manifested, as a rule, at the last stage, when pathological processes are already developing - cirrhosis, oncology. There may be ascites (bloating), general weakness and asthenia. Most often, this hepatitis is determined in laboratory studies of very different diseases. Vaccines for this health-threatening disease do not exist today. The virus is very tenacious: within 4-5 days it does not lose its harmful properties even in the external environment.

There are also viruses D, F, E and G. Hepatitis D is not an independent disease, it is possible only as a pathological "ally" of hepatitis B.

The rest of the viruses have not been studied, as they mostly infect people from Asia and the African continent who live in hard-to-reach populated areas and have their own cultural traditions that do not allow them to seek medical help.

Hepatitis of non-viral etiology: causes, signs, disease detection and prognosis

Hepatitis can have a non-viral nature, when the factors that cause inflammation are not viruses, but toxins. The liver is rightly considered the main organ that processes and neutralizes various harmful substances. Also, the liver is able to self-repair, regenerate, but its regenerative properties are not unlimited. Liver mitochondria are granular organelles, which are responsible for the respiration of cells, their saturation with energy. Also mitochondria and are able to self-reproduce, this process is also broken as a result of liver intoxication. Moreover, under the influence of toxins, mitochondria begin to increase in size - swell, autoreplicirovatsya - rapidly grow and divide, so the inflammatory process begins. Non-viral hepatitis can be a toxic etiology, caused by a radiotherapy or autoimmune cause.

The main factors provoking non-viral hepatitis:

• Chronic alcohol dependence; 
• Acute alcohol poisoning; 
• Drug intoxication; 
• Poisoning by poisonous mushrooms; 
• Poisoning by substances, industrial production - trichlorethylene, phosphorus, vinyl chloride and others; 
• Radiation irradiation.

To toxic factors include alcoholic poisoning, both with chronic alcoholism, and with a single use of the excess dose of alcohol. Also toxic causes include eating inedible mushrooms, drug poisoning. The radiation factor is the effect of irradiation, radiation on the human body, both single ionizing irradiation, and dosed, but constant. The autoimmune factor in clinical practice is less common. As a rule, the autoimmune type of hepatitis is revealed during examination of the main autoimmune disease - NJC - ulcerative colitis, autoimmune endocrine diseases (thyroiditis), intraarticular inflammatory processes - synovitis.

The symptomatology of hepatitis of non-viral etiology is obvious, as a rule, signs of intoxication appear in the first day, less often within two days. Such a rapid development of the disease often leads to death. The main signs that signal the danger are: 

The yellow shade of the skin (yellowness develops within a day), but this sign may not manifest itself; 

• General strong weakness, chills; 
• Sleepy, apathetic condition; 
• Depigmentation of feces and staining of urine; 
• When tetrachloride is intoxicated, the first sign is headache; 
• With drug intoxication, rashes in the epigastric region, elevated body temperature are typical.

The symptomatology of this type of hepatitis is very similar to the signs of other hepatitis, but it develops much faster and its manifestations are more acute.

Diagnosis of non-viral hepatitis is difficult, because the disease starts suddenly and develops rapidly. Symptoms often are similar in the clinic with signs of other acute inflammatory diseases, the toxic hepatitis of alcoholic etiology is best diagnosed for explanatory and obvious reasons. In biochemical studies, the main indicator of inflammation is the protein index and the level of bilirubin. The final confirmation of the diagnosis of hepatitis, as a rule, gives a biopsy of liver cells.

With a timely diagnosis of hepatitis and the absence of significant concomitant pathologies, the prognosis for treatment of non-viral hepatitis is quite favorable. Sorption drugs, long-term use of hepatoprotectors, detoxification measures and vitamin therapy give positive results. Only in cases of acute, rapid inflammation and lack of necessary medical care in the first day of the destructive process can not be stopped (usually, this applies to acute alcohol intoxication).

How to prevent hepatitis?

Hepatitis can be prevented. For this it is necessary to adhere to elementary, civilized rules, including hygienic ones: 

• Every time after visiting the toilet, contact with dirty laundry, it is necessary to wash or clean hands; 
• It is mandatory to wash hands before each preparation of food; 
• It is mandatory to wash hands after public transport or visiting public places; 
• Use only purified, decontaminated or boiled water; 
• Any products that have had contact with the soil need to either be thoroughly washed, or peeled, or subjected to heat treatment; 
• Periodically do cleaning in a residential or office space with the use of disinfectants; 
• All sexual contacts are permissible only under the condition of protection, contraception and so on; 
• Using other people's hygiene items can lead to infection, a toothbrush, razor, scissors must be individual; 
• Consult with your doctor and, if there are no contraindications, get vaccinated.