Вирусен хепатит: какво е това?
За какво е дадено заболяване? Като цяло се приема, че хепатитите се наричат чернодробни възпаления. Те могат да бъдат както инфекциозни, така и не инфекциозни. Не са инфекциозни хепатити, причинени от причините, които не са свързани с активността на микроорганизмите. Най-разпространените неинфекциозни хепатити са токсични и алкохолни.
Virus hepatitis: symptoms and treatment
Вирусен хепатит: какво е това?
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The liver is a body which seldom declares itself publicly, in difference, for example, from a stomach or the heart which diseases are usually accompanied by severe pains and an indisposition. Nevertheless, the liver is subject to illnesses at all most less than other bodies. And one of most dangerous of them are virus hepatitises.
Virus hepatitis: what is it?
Because of what there is a given illness? As a whole it is accepted hepatitises is called liver inflammations. They can be both infectious, and not infectious nature. Not infectious hepatitises are that are caused by the reasons not connected with activity of microorganisms. Most widespread of not infectious hepatitises are toxic and alcoholic.
However there are infectious versions of disease is much more often. They can be caused by viruses, the elementary and bacteria. Thus, the virus hepatitis is the illness caused by viruses, amazing liver cages.
Bacterial and parasitic versions of disease are rather rare, that will not tell about virus hepatitises. Estimations show that with virus hepatitises had been ill not less than 2 billion persons, and carriers of viruses of a hepatitis is 300-400 million persons. Virus hepatitises enter into ten leading reasons of death rate among people all over the world and are comparable in the given plan to such diseases, as AIDS, a tuberculosis and a malaria.
Forms of a virus hepatitis
The technique of treatment of disease in many respects depends on its form. Forms of a virus hepatitis concern three basic types:
At initial hit of a virus in an organism of not infected person who does not have immunity, a virus causes an acute hepatitis attack (seldom – lightning). The chronic form of a virus hepatitis is characteristic only for hematogenous activators. In it pass acute hepatitises in the event that immunity will not manage to destroy completely a virus.
Now it is allocated at least 6 viruses specialising on defeat of cages of a liver. Also there are no doubts – this list the next years will replenish with new points. As it is a lot of versions of virus hepatitises, scientists have decided to designate their letters of the Latin alphabet. Now by a medical science it is carefully studied five basic versions of forms of the virus hepatitis designated by letters A, B, C, D, E. Also there is a number exotic, little explored and less common the viruses breeding in a liver. Besides, in rare instances virus hepatitises can be caused by activators of other diseases. Their number concern:
Virus of Epstein-Barra,
All activators causing virus hepatitises, from the point of view of classification concern various families. The part from them contains a genetic code in DNA, and a part – in РНК.
Nevertheless, the pathogenetic processes leading to development of illness in case of various viruses are approximately identical:
The virus arrives in an organism from environment (hematogenous or an oral way);
The virus through a blood current gets into a liver;
The virus gets through a membrane of cages of a liver (hepatocytes);
The virus transfers the code genome cages;
hepatocyte starts to develop virus copies;
The cage perishes or as a result of virus influence, or destroyed by immune forces of an organism (limfotsitami-killers and phagocytes);
There is a mass destruction hepatocytes because of what in a liver areas некроза are formed;
Symptoms of infringements of functions of a liver are observed.
So the sharp type of disease develops. The further succession of events can proceed under several scenarios – or immunity destroys all virus particles both the cages infected with them and the person recovers from a hepatitis, or immunity manages to constrain avalanche reproduction of viruses, but the part of viruses nevertheless remains in an organism. Illness passes in a stage of a virus chronic hepatitis. However in certain cases hepatic insufficiency can lead to death of the patient.
Some versions of virus hepatitises can cause so-called lightning or фульминантные disease forms. They are characterised by faster, than at acute hepatitises, increase of signs of a heavy intoxication of an organism which within several days can pass in a hepatic coma and lead death from sharp hepatic insufficiency.
At activator hit in an organism for the first time it causes a virus hepatitis in the sharp form. Quite often, however, the acute hepatitis can not be accompanied by obvious symptoms.
Also the acute hepatitis usually anticipates the incubatory period. During the given period of symptoms of disease it is not observed, but the patient already is infectious for associates.
Nevertheless, in most cases acute hepatitis signs include:
All-overishness, weariness, weakness;
Diarrheas, a nausea, vomiting;
Yellowness of integuments;
Pulling or paroxysmal pains in right подреберье;
The liver increase, is more rare – spleens;
Light colour of excrement;
Dark colour of urine.
At some forms of an acute hepatitis one symptoms can be present, and others to be absent. For example, the sharp type of disease can have гриппоподобную the form. In a similar case on the foreground there is a rise in temperature, headaches, pains in muscles. The sharp type of illness with a gastroenteric syndrome is shown by various frustration Gastrointestinal tract (vomiting, a diarrhoeia, метеоризм, a nausea, belly-aches, locks). The basic symptoms of a hepatitis in asthenovegetative to the form – weakness, weakness, a breakdown.
The icteric syndrome at an acute hepatitis (yellow colouring of mucous membranes, eyeballs, integuments) is caused getting of the destroyed cages of a liver in blood by bilirubin. Usually the jaundice is shown in the second phase of disease when the patient goes on the amendment. However, the acute hepatitis quite often can proceed and on anicious to type.
Symptoms of the chronic form of illness are usually expressed in ready smaller degree, than the pathological phenomena of acute hepatitises. Frequently sick of decades do not suspect about the illness, and illness displays write off on overfatigue, stresses or other diseases. The patient is treated for any other things, accepting a considerable quantity of medicines because of what than a liver only becomes worse. Only when disease enters the final stage, symptoms of hepatic insufficiency become obvious.
What signs of a hepatitis can deserve steadfast attention:
Tolerance decrease to physical activities,
Infringements of a dream,
Periodic frustration Gastrointestinal tract,
Weight in right подреберье.
Diagnostics and therapy
To begin effective treatment, it is necessary to make the exact diagnosis. The diagnosis of a virus hepatitis is put taking into account all-round inspection of the patient including:
The blood analysis on antibodies and antigenes of a virus,
The general analysis of blood (revealing of shifts in лейкоцитарной to the formula),
The biochemical analysis of blood (definition of level of bilirubin, aspartate aminotransferase, Alanine aminotransferase),
The analysis on definition of presence of a virus in blood.
The technique of treatment of disease as different types of virus hepatitises are usually treated in the different ways depends on correctness of the diagnosis.
In most cases disease treatment is spent in out-patient conditions. Only at a heavy current of the sharp form of a hepatitis of the patient can be hospitalised.
If the chronic virus hepatitis progresses, and adequate treatment of disease is not spent, healthy fabrics of a liver becomes ever less. They are gradually replaced with a connecting fabric. Similar process is called fibrosis. The fourth and last stage fibrosis – a cirrhosis. At this disease the liver cannot carry out the function any more. The organism intoxication accrues. First of all, at accumulation of toxins in blood the nervous system suffers. The similar circumstance frequently leads to brain defeat – a hepatic encephalopathy.
One more possible terrible complication of a chronic hepatitis – carcinoma liver (cancer). Both at a cirrhosis, and at carcinoma the probability of a lethal outcome is very high.
The sharp type of disease also can lead to serious consequences, up to a lethal outcome, especially when the patient has the weakened immunity or heavy accompanying diseases, is in advanced age.
The infection reasons a virus hepatitis
The mechanism of infection with a virus can be divided on two categories – fekalno-oral (alimentary) and hematogenous. To the viruses, an extending first way, it is necessary to carry viruses of hepatitises And and Е. All other viruses are hematogenous.
At fekalno-oral type of disease viruses from a liver arrive in bile, and therefrom in intestines and are deduced outside together with excrements. Similar viruses can remain long time in environment and in various reservoirs. If the person uses dirty not boiled water, the foodstuff containing a virus, or transfers his hands from surrounding subjects to itself to a mouth the disease activator gets in ЖКТ. Safely to pass through a stomach with sour gastric juice to viruses the cover helps special кислотоустойчивая. In intestines the virus is soaked up in blood and then reaches a liver. So the cycle of reproduction of a virus becomes isolated.
To viruses with hematogenous infection type to reach a liver, it is necessary to get directly to a human body blood-groove. Actually, similar situations meet not too seldom:
Use of the same cutting and pricking subjects by infected and healthy people,
Passage of the newborn child on patrimonial ways.
Thus, to catch a virus it is possible even having gone in a hairdressing salon and having shaved there, in salon where do tattoos, or in a stomatologic office if the doctor does not disinfect properly tools. Nevertheless, the basic contingent infected with hepatitis viruses – the addicts using IV drugs. Infection during household contacts or through surrounding subjects is not excluded, though and it is improbable. Many viruses of a hepatitis long time, within weeks and months, can exist in environment, and for infection of the person with them their insignificant quantity is necessary.
Hepatitises A, B, С and D
The given versions of disease are most of all extended and represent the greatest danger to the person. On the other hand, these diseases are most well investigated, and the medicine for their treatment or preventive maintenance develops perfect enough methods.
Virus hepatitis And also names Botkin's illness, on a surname of the known Russian doctor 19 century which for the first time have assumed infectious character of disease. However the virus of a hepatitis And (HAV) has been allocated only in 1970th About the given hepatitis it is known that it is transferred by a fekalno-oral way. It also quite often name «illness of dirty hands». The hepatitis has only sharp form lasting of some weeks. In the chronic form the acute hepatitis And never passes. Death rate from a hepatitis And makes approximately 0,5 %. Treatment of a hepatitis And mainly symptomatic. The sharp heavy hepatitis And is treated in a hospital. After successful treatment the person gets lifelong immunity to a virus.
The hepatitis In (HBV) extends hematogenous a way. The hepatitis virus In belongs to the class of DNA-viruses and possesses extreme firmness. With illness had been ill all over the world more than 2 billion people, and virus carriers are not less than 300 million
The incubatory period lasts from 50 till 180 days. However sharp type of illness – its first stage at which clinical signs are observed. Acute hepatitis B usually proceeds hard enough. If at the person the sharp heavy hepatitis is observed In hospitalisation is necessary. Летальность at an acute hepatitis In it is high enough and can reach 4 %. Treatment of the sharp form of disease mainly symptomatic, can be used anti-virus therapy.
Then illness can pass in chronic (in 1 of 10 cases), or treatment is observed. Most often illness synchronisation is observed at chest children (in 95 % of cases). Treatment chronic illness forms includes interferon injections, reception of anti-virus preparations and hepatoprotectors. Vaccination from a virus can be spent from first days of life to age in 55 years and protects from a virus within 10-20 years.
Disease on a method reminds distribution V.Odnako's hepatitis it is caused by absolutely other virus which is belonging to the class of RNK-VIRUSES. 70-150 million sick of the given illness all over the world is. This virus causes a considerable quantity of diseases in the chronic form. The sharp form of a hepatitis usually proceeds not so hard as at a hepatitis In, and the hepatitis With at all has no lightning form. Also the virus has not less than 11 genotypes. Each genotype, in turn, has subtypes, therefore total of versions of a virus makes nearby 100. Because of such genetic variety of the activator the vaccine against it is not developed till now.
For treatment of the chronic form of illness anti-virus means and hepatoprotectors are used. Some medical products existing for today help to get rid of disease in 95 % of cases. Besides, the patient recommends inoculations from viruses HВV and HАV as simultaneous infection with these viruses can lead to heavy complications.
Virus of the given disease also quite often name delta-virus. From the scientific point of view the virus is very unusual, after all it not only is a parasite of a human body, but also to some extent parasitizes on virus HBV, using as a cover fibers developed by it. It is accepted to name similar type of viruses viruses-satellites. Thus, the given disease is not independent, and concerns the complications caused by virus HBV more likely. A way of transfer delta-virus also hematogenous. In various regions from 1 % to 10 % of carriers of virus HBV also are infected also delta-virus. It considerably complicates a current and without that heavy hepatitises In, increasing percent of lethal outcomes. Specific treatment of the given form of disease usually is not spent, therefore at infection delta-virus the basic emphasis should be made on struggle against virus HBV.
Hepatitises Е, F, G
This group concerning rare illnesses, whose activators have been opened only recently.
At hepatitis Е the fekalno-oral way of distribution is observed. The virus of hepatitis Е a little less racks, than HAV and disease by it caused, usually proceeds in easier form, than Botkin's illness. However in certain cases, for example, in pregnancy, very heavy form, quite often coming to an end a lethal outcome is characteristic.
Virus hepatitises G and F are a little investigated now. They are transferred hematogenous by a way and extended basically only among the addicts using IV drugs.