Hepatitis

Hepatitis is considered one of the main causes of all inflammatory processes in the liver. It is no coincidence that a disease of viral etiology is blamed for the pathologies of this very important organ; according to statistics, there are over 500 million people worldwide who suffer from viral hepatitis. This does not mean that the figure is final, because quite often hepatitis occurs in a latent form and a person can be a virus carrier without even suspecting it.

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

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Hepatitis of viral etiology and the main hepatitis viruses

Hepatitis A

The disease that we call hepatitis A was discovered in the 19th century by the great clinician Sergei Petrovich Botkin; later, not only the disease was named after him, but also a medical institution in St. Petersburg - the Clinical Infectious Diseases Hospital.

Hepatitis A is caused by a virus that has a shell that is resistant to acids and enzymes. Thus, the harmful agent penetrates the body, easily overcoming the acidity of the gastrointestinal tract. In addition, the virus "feels" great in any liquid environment, so its spread through water is most typical. The only relative advantage of hepatitis A is the fact that a person gets it only once in a lifetime, then his immune system develops protection against this virus for life.

The prevalence of hepatitis A cannot be calculated or given precise statistical data. It is only known that in Asian countries 99% of children suffer from hepatitis A, Europeans suffer from it less often, but according to the latest data, every second out of a thousand European residents also suffered from this disease.

The source of infection is food, fruit, water, fish, unpeeled or uncooked. Also, the A virus is transmitted through basic dirt, it is not for nothing that this hepatitis is called the problem of unwashed hands. An infected person releases hundreds of millions of viruses into the environment with feces, and viruses also remain on dirty hands for a long time. Even without a rich imagination, it is easy to imagine the danger of infection with this omnipresent virus, which surrounds a person literally everywhere. Infection occurs through the feco-oral route, the virus freely enters the intestines, then the bloodstream and liver, or rather the most attractive cells for it - hepatocytes. Hepatitis virions are fixed inside the cell (in the cytoplasm) and begin to multiply there. With bile, the virus is transferred back to the intestinal tract and 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 viruses that have 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 others, sometimes without suspecting it. It should also be taken into account that hepatitis A can go completely unnoticed, that is, be asymptomatic or manifest itself with minor signs. The main symptoms of viral hepatitis A depend on how old the patient is (in children, symptoms often do not appear at all). The classic signs are as follows:

• Fever, headache;
• Weakness;
• Skin rashes of unknown etiology;
• Diarrhea and loss of appetite are possible;
• Darkening of urine and depigmentation of feces;
• Yellow tint of the 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 a minimum, to cirrhosis and even death at a maximum. The route of infection with this virus is usually parenteral (through blood), less often sexual, and even less often vertical (from mother to child during pregnancy). Hepatitis caused by the B virus is much more amenable to prevention, since there is a vaccination procedure against this disease. Also, precautions and protection during sexual intercourse help to contain the spread of the B virus. Pregnant women, when registering for obstetric and gynecological care, undergo mandatory tests that determine the virus at an early stage.

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

• Nausea, sometimes to the point of vomiting;
• Pain in the right epigastric region, often in the hypochondrium;
• Increased temperature, feverish state;
• Aches in the joints;
• Yellow, sometimes gray-yellow tint of the skin, sclera of the eyes;
• Depigmentation of feces and dark-colored urine;
• Splenomegaly (enlargement of the spleen);
• Hepatomegaly (enlarged liver).

Diagnosis of hepatitis caused by the B virus is based on anamnesis, abdominal palpation, and biochemical studies. This type of hepatitis is fraught with not only chronic inflammation of the liver and destruction of its cells, but also liver failure, cirrhosis, and even cancer.

Hepatitis C

It is no coincidence that hepatitis caused by the C virus is paradoxically called the "gentle killer". It is also transmitted parenterally, that is, through the bloodstream. This can be an injection made with a non-sterile needle, which is often found in drug addicts, hepatitis of this type is transmitted during unprotected sexual intercourse, possibly by blood transfusion from an infected donor, which is almost never seen these days. Most often, hepatitis C proceeds completely unnoticed, which is where the name "gentle" comes from. There may not be a jaundice period, typical for hepatitis.

Symptoms usually appear 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 tests for completely different diseases. There is currently no vaccine for this health-threatening disease. 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 remaining viruses have been practically unstudied, since they mainly infect residents of Asia and the African continent, who live in hard-to-reach settlements and have their own cultural traditions that do not allow them to seek medical help.

Non-viral hepatitis: causes, symptoms, detection of the disease and prognosis

Hepatitis can be non-viral in nature, when the factors causing inflammation are not viruses, but toxins. The liver is rightfully considered the main organ that processes and neutralizes various harmful substances. The liver is also capable of self-healing, regenerating, but its regenerative properties are not unlimited. Liver mitochondria are granular organelles that are responsible for cellular respiration and energy saturation. Mitochondria can also self-reproduce, and this process is disrupted as a result of liver intoxication. Moreover, under the influence of toxins, mitochondria begin to increase in size - swell, self-replicate - grow rapidly and divide, and this is how the inflammatory process begins. Non-viral hepatitis can be of toxic etiology, caused by radiation or autoimmune causes.

The main factors that provoke non-viral hepatitis:

• Chronic alcohol dependence;
• Acute alcohol poisoning;
• Drug intoxication;
• Poisoning by poisonous mushrooms;
• Poisoning by substances produced industrially – trichloroethylene, phosphorus, vinyl chloride and others;
• Radiation exposure.

Toxic factors include alcohol poisoning, both in chronic alcoholism and in the case of a single excessive dose of alcohol. Other toxic causes include eating inedible mushrooms and 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 is less common in clinical practice. As a rule, the autoimmune type of hepatitis is detected during examination for the main autoimmune disease - UC - nonspecific ulcerative colitis, autoimmune endocrine diseases (thyroiditis), intra-articular inflammatory processes - synovitis.

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

A yellow tint to the skin (yellowing develops within 24 hours), but this symptom may not appear;

• General severe weakness, chills;
• Sleepy, apathetic state;
• Depigmentation of feces and staining of urine;
• In case of tetrachloride intoxication, the most common first symptom is headache;
• In cases of drug intoxication, rashes in the epigastric region and elevated body temperature are typical.

The symptoms of this type of hepatitis are 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, as the disease starts suddenly and develops rapidly. Symptoms are often clinically similar to signs of other acute inflammatory diseases; toxic hepatitis of alcoholic etiology is best diagnosed due to explainable and obvious reasons. In biochemical studies, the main indicator of inflammation is the protein index and bilirubin level. The final confirmation of the diagnosis of hepatitis, as a rule, is given by a liver cell biopsy.

With a timely diagnosis of hepatitis and the absence of significant concomitant pathologies, the prognosis for the treatment of non-viral hepatitis is quite favorable. Absorbent drugs, long-term use of hepatoprotectors, detoxification measures and vitamin therapy give positive results. Only in cases of acute, rapid inflammation and the absence of the necessary medical care in the first day is it impossible to stop the destructive process (as a rule, this applies to acute alcohol intoxication).

How to prevent hepatitis?

Hepatitis can be prevented. To do this, it is necessary to adhere to basic, civilized rules, including hygienic ones:

• Every time after visiting the toilet or coming into contact with dirty laundry, you must wash or clean your hands;
• It is mandatory to wash your hands before every food preparation;
• It is mandatory to wash your hands after using public transport or visiting public places;
• Use only purified, disinfected or boiled water;
• Any products that have had contact with soil must be either thoroughly washed, peeled, or heat treated;
• Periodically clean residential or office premises using disinfectants;
• All sexual contacts are permitted only under the condition of protection, contraception, etc.;
• Using other people's hygiene items can lead to infection; toothbrushes, razors, and scissors should be individual;
• Consult your doctor and, if there are no contraindications, get vaccinated.