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Through water, manicure and from rabbits: how you can get hepatitis

The term hepatitis includes all inflammatory diseases of the liver.

The term hepatitis includes all inflammatory diseases of the liver.

A photo: Shutterstock

Baruch Samuel Blamber was born on July 28, 1925. In 1976, together with virologist Daniel Carlton Gaidusek, he received the Nobel Prize for the discovery of the hepatitis B virus and its multifaceted research over many years.

Several more types of hepatitis virus have been discovered since the middle of the last century. But, unfortunately, it is still not always possible to recognize them in time and start treatment. Most often, the patients themselves are to blame for this: many do not know about their disease and, accordingly, are not treated.

The term hepatitis includes all inflammatory diseases of the liver. To date, hepatitis viruses A, B, C, D, E, G, TTV are known. The new one stands out childhood hepatitis unknown etiology. So far, scientists still cannot come to a consensus about the cause of this pathology.

WHAT CAN BE PREVENTED

On the eve of World Hepatitis Day, we spoke with leading expert of the CMD Center for Molecular Diagnostics of the Central Research Institute of Epidemiology of Rospotrebnadzor, infectious disease specialist Margarita Provotorova.

– Why is hepatitis dangerous?

– Hepatitis is an inflammatory process of liver cells that can be caused by many reasons. Most severe cirrhosis, as well as liver cancer, is the result of infection with hepatitis B, C, D viruses. According to WHO, more than a million people die from hepatitis B and C every year. But these deaths could have been prevented. Today it is already possible not only to diagnose the disease in the early stages, but also to effectively treat viral hepatitis C. Or protect yourself from viral hepatitis B with a vaccine. The problem is that not all patients with viral hepatitis are aware of their disease and are not included in the official data.

– And, alas, few people know about the manifestation of hepatitis, except for its external manifestation – “jaundice” …

– Yes, indeed, the most common signs of all hepatitis in the acute period are yellowing of the skin, sclera of the eyes. At the same time, as a rule, urine acquires a rich dark color, reminiscent of strongly brewed tea, and the stool, on the contrary, becomes discolored. But there are other manifestations as well.

We will analyze the main types, signs and methods of treatment of many-sided hepatitis.

MOST COMMON HEPATITIS

1. Hepatitis A is a disease of dirty hands.

Transmission way:

Fecal-oral. That is, a person infected with viruses went to the toilet, did not wash his hands and generously began to leave viral particles everywhere he touched. This is how food becomes contaminated. Also, the virus can be contained in open sources and reservoirs – if the water was contaminated with feces and was not disinfected (this is typical not only for Africa, India, but also for Russia).

Symptoms:

Symptoms can be different – from SARS, intestinal manifestations to asthenovegetative, that is, weakness, drowsiness, irritability.

Treatment, vaccination:

There is no specific treatment for viral hepatitis A.

But there is a vaccine that is not included in the national calendar, so it is not mandatory for everyone. You can find out if you have been sick before by a blood test for the presence of IgG antibodies to the hepatitis A virus.

Complications, chronic course:

Complications are rare. On average, recovery occurs after three weeks.

But there are cases when hepatic encephalopathy and coma developed within a very short time.

2. Hepatitis B is the most contagious.

Transmission way:

Every person is at risk of contracting viral hepatitis B during their lifetime. Contact of the damaged skin or mucous membrane with the virus is sufficient for infection. It is transmitted sexually and through objects that have come into contact with the blood of an infected person. And also through medical instruments that were poorly processed.

There are known cases of transmission of hepatitis B through … a bite! When an infected child has bitten another and infected him through the wound.

Symptoms:

The incubation period is from 6 weeks to 6 months. In the acute period, many patients complain of severe pain in the joints, fever. There is weakness, headache, loss of appetite, nausea, pain in the right hypochondrium. The duration of the course of acute viral hepatitis B is no more than 6 months.

Treatment, vaccination:

There is a vaccine. And this is the main good news. All infants are vaccinated against hepatitis B in the first 24 hours of life. But it was included in the National Immunization Calendar not so long ago.

If you do not know if you have been vaccinated, a blood test will tell you to quantify antibodies to the HbsAg surface antigen. It will show if you have been ill or have already been vaccinated.

It is impossible to completely cope with chronic hepatitis: modern drugs can suppress the reproduction of the virus, but not destroy it.

Complications, chronic course:

In 95% of adults, the disease resolves on its own, without complications, and strong immunity is formed.

But if a chronic form occurs, then the inflammatory process of cells starts, cirrhosis develops. There is liver failure. In about 10% of cases, liver cancer also develops. In such cases, only a transplant can help, but, unfortunately, not everyone has time to find a suitable donor.

3. Hepatitis C is the main cause of liver disease.

Transmission way:

The main route of infection with the hepatitis C virus is damage to the skin or mucous membranes with sharp objects (instruments) that have been contaminated with the blood of an infected person and poorly processed. These can be syringes used by several people, reusable tools for tattooing, piercing, manicure, etc.

Symptoms:

The incubation period is from two weeks to six months. In the acute period, along with jaundice, pruritus can be observed. There is weakness, nausea, loss of appetite. Only in 20-25% of people the disease goes away on its own with recovery. The rest flows into a chronic form.

Treatment, vaccination:

There is no vaccine. But a highly effective treatment method has been developed: modern interferon-free drugs are well tolerated, and recovery occurs after 12 weeks. However, if you do not start specific antiviral therapy, the disease remains for life.

Complications, chronic course:

The chronic form of the disease progresses to liver cirrhosis, fibrosis, or hepatocellular carcinoma (liver cancer), and patients may need a liver transplant.

The average age of a patient diagnosed with chronic viral hepatitis C in Russia is 30-49 years.

Alas, hepatitis C has many genotypes and re-infection with another type is possible after recovery. Therefore, regular examination is important.

4. Hepatitis D is a companion of hepatitis B.

Ways of infection:

The routes of infection are the same as those of hepatitis B and C. But: the hepatitis D virus cannot independently enter the liver cells. Infection is possible only if the hepatitis B virus is already present in the body.

Symptoms:

All manifestations of hepatitis B are significantly increased and more difficult to tolerate.

Treatment:

The hepatitis B vaccine also works against this parasite. An effective antiviral drug for hepatitis D has also recently appeared.

Complications, chronic course:

In patients, the combination of hepatitis B and D viruses leads to more rapid development of cirrhosis and liver fibrosis.

5. Hepatitis E is a disease of dirty water bodies.

Ways of infection:

Fecal-oral: through contaminated water and food. Outbreaks are associated with violation of sanitary standards. At the same time, the virus can infect not only humans, but also animals, such as rabbits, pigs, camels.

Symptoms:

The incubation period lasts from two weeks to two months. The illness is easy. The symptoms of the disease are quite diverse: weakness, malaise, discomfort in the epigastrium (colloquially – “sucks in the pit of the stomach”), loose stools are possible. In the analyzes, an increased level of enzymes ALT, AST, as well as bilirubin is observed.

Treatment:

There is no vaccine against hepatitis E in Russia. Therefore, always follow preventive measures. Do not drink water from bodies of water: springs, streams, ponds and other sources that can be used to water livestock and be a habitat for wild animals. When bathing, try not to swallow water.

Complications, chronic course:

It is easily treated and passes without complications.

The exception is pregnant women: up to 25% of cases are complicated by liver failure and end in death. And if the infection occurred in the third trimester, the fatal risk reaches 40%.

IMPORTANT POINTS

1. A and E do not cause cirrhosis.

In the hepatitis A and E virus, the route of transmission is fundamentally different from blood-borne (that is, through the blood and bodily fluids) viral hepatitis B and C. Enteral (transmitted mainly with contaminated food) hepatitis A and E do not cause chronic forms of liver damage, they are not the cause of her cirrhosis or cancer. After the disease, stable immunity remains.

2. C is not transmitted through kissing.

Hepatitis C is not transmitted by kissing, hugging, sharing utensils. An infected woman is not prohibited from breastfeeding – the number of viral particles in milk is relatively small. By the way, as in other biological fluids: saliva, semen, vaginal secretions. That is, the risk of contracting hepatitis C sexually is very small. Infection of permanent sexual partners occurs in no more than 5% of cases. Coughing, sneezing and talking with hepatitis C is also impossible to get infected.

3. Infection with hepatitis through donated blood is almost impossible.

Although almost all types of hepatitis are transmitted through the blood, there is no need to worry about blood transfusions: all donated blood undergoes multiple sensitive laboratory testing. Only after that the patient is transfused. In addition, donors are necessarily examined for markers of viral hepatitis.

Unfortunately, in the 20th century, many cases of infection with viral hepatitis B and C were associated precisely with blood transfusion or surgery. Therefore, if you or your loved ones underwent surgery or received blood transfusions before the year 2000, it will be useful to make sure that there is no disease and donate blood for markers of viral hepatitis.

4. Hepatitis B virus survives freezing and boiling.

Hepatitis B is much more resistant to various environmental factors than the human immunodeficiency virus and hepatitis C. In blood at room temperature, it retains viral activity for up to 3 months, in dried plasma – up to 25 years. The virus is able to withstand boiling up to 30 minutes, dry heat up to +160°C for an hour. And remains active even when treated with 80% ethyl alcohol. On various objects, hepatitis B can persist at room temperature for up to several weeks. These are, for example, blood stains on any surfaces, a razor blade, needles. If contaminated instruments are reused without proper treatment, the risk of infection increases significantly.

Actually, the hepatitis A virus is no less resistant: at a temperature of 14-20 ° C, it retains infectious properties on various surfaces for several months. There is evidence that the pathogen is active for several years at temperatures below -20°C and for about a month at temperatures around 0-5°C. To destroy it, you need to process the infected item at a boiling point for at least 20 minutes.

5. When two hepatitis merge.

Infection with two hepatitis at once is called hepatitis B+D co-infection. In this case, the development of rapid and massive destruction of liver cells is possible – fulminant hepatitis.

It is possible that infection with the hepatitis D virus occurs against the background of existing hepatitis B. This is called superinfection. This process significantly worsens the patient’s condition, since cirrhosis develops about 10 years faster.

BY THE WAY

Get tested for hepatitis B for free

If you have carefully studied this material, you can answer the questions of the test, which is specially designed for the social action of the Center for Molecular Diagnostics of the Central Research Institute of Epidemiology of Rospotrebnadzor. It runs from 20 to 31 July. Take the test “What do you know about hepatitis B» and get an individual promotional code. You can use it to take a test for free and find out if you have viral hepatitis B. You can take the test from July 28 to 31 at all CMD offices and clinics. Or call a nurse to take biomaterial at home.

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