Chronic hepatitis in children
Last reviewed: 23.04.2024
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Chronic hepatitis in children is a chronic polyethological inflammatory-dystrophic-proliferative lesion of the liver without disturbing its structure.
According to WHO, about 2 billion people are infected with the hepatitis B virus in the world, of which more than 400 million are chronic carriers of this infection. In 10-25% of cases, the chronic carrier of the hepatitis B virus turns into a serious liver disease. In cases of congenital hepatitis B, chronic disease occurs in 90% of cases.
About 500 million people in the world are carriers of the hepatitis C virus. In 65-75% of them in the future chronic hepatitis is formed, 10-20% of patients with chronic hepatitis C have liver cirrhosis, and 15% have hepatoma.
[Causes of chronic hepatitis
Most often, the formation of chronic hepatitis is etiologically associated with hepatitis viruses.
- Chronic hepatitis is caused by viruses, mainly transmitted parenterally:
- hepatitis C virus (HCV) in children with chronic hepatitis is detected in 30-50% of cases;
- hepatitis B virus (HBV) - in 15-20% of cases, as a rule, simultaneously with the delta virus (HDV);
- viruses of hepatitis F, G - less than 1% of cases;
- viruses of cytomegaly, herpes, rubella, enteroviruses, Epstein-Barr virus - very rare, mainly in young children.
What causes chronic hepatitis?
Symptoms of Chronic Hepatitis
Symptoms of chronic hepatitis in children and adults are similar in many respects.
Chronic viral hepatitis with moderate activity (I degree) is characterized by a benign course. Dull pain in the right hypochondrium, moderate hepatomegaly. Subicbacteria of mucous membranes and skin only during periods of exacerbation. Hemorrhagic syndrome, "hepatic signs" are not typical. In the blood, 65-70% of patients are diagnosed with hepatitis B surface antigen (HBsAg), in some cases - hepatitis B nuclear antigen (HBeAg). During the exacerbation there is a moderate increase in activity of cytolytic enzymes, gamma globulins, sediment samples.
Where does it hurt?
What's bothering you?
Diagnosis of chronic hepatitis
Diagnosis of chronic hepatitis is based on a comprehensive examination of the patient:
Diseases of the digestive system
- clinical and biochemical;
- virological;
- immunological;
- morphological;
- assessment of the condition of portal hemodynamics.
The liver status is judged by the severity of cytolytic syndrome, hepatocyte insufficiency syndrome, mesenchymal inflammatory syndrome, cholestatic syndrome, liver shunting syndrome, the presence of indicators of regeneration and tumor growth.
What do need to examine?
Treatment of chronic hepatitis in children
Treatment of chronic hepatitis in children is carried out on the same principles as in adults.
At the time of exacerbation of chronic hepatitis, the patient needs a bed rest. Expansion of the regime is carried out gradually, as the general condition and functional capacity of the liver improve.
The diet depends on the stage of the disease. The amount of fat in the diets is slightly reduced, and the carbohydrate content is increased in comparison with physiological needs. In cases of hepatic insufficiency, the amount of protein is halved.
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