Viral hepatitis A, as well as C, unfortunately, occupyis far from the last in the list of common liver diseases - they account for up to 70% of all ailments. However, despite the fact that these hepatitis viruses are quite similar to each other, the differences in their clinical manifestations and negative impact on the body are radically different. In order to determine the type of hepatitis and get the necessary medical care, the sick person should seek medical care as soon as possible. The doctor will diagnose the disease, specify the type of hepatitis virus, and prescribe the necessary treatment.
Hepatitis A
Viral hepatitis A, which is also known asthe name Botkin's disease, and the common name of viral hepatitis "jaundice", is radically different from all other types of viral hepatitis. This disease, unlike all the others, does not have chronic forms of the course, and is transmitted by the fecal-oral route. In this viral hepatitis A is similar to hepatitis E - the least common form of hepatitis. Viral hepatitis A differs very favorably from hepatitis C in that it has a damaging effect on liver cells. In fact, viral hepatitis A is an inflammatory process that involves liver cells affected by the virus. In response to the penetration of the pathogen into the liver cells, protective cells begin to be actively produced in the blood. Viral hepatitis A is very widespread - according to doctors, every fourth person has had this virus. Moreover, many of them had this disease in childhood, and often asymptomatically - children tolerate hepatitis C much easier than adults, and acquire immunity for the rest of their lives. In adults, the disease often takes an extremely severe form - the sick person has to be hospitalized. As a rule, this is explained by the fact that adults have many more different concomitant diseases. Today, outbreaks of hepatitis A are most often localized in countries with a warm climate, especially if sanitary conditions are unsatisfactory. Doctors note the fact that people who have recently returned from trips to countries such as Turkey, India, Central Asia, Egypt often seek their help. As a result of the examination, doctors diagnose hepatitis A. The insidiousness of hepatitis C is that it is very resistant to various external influences, and in the environment it can remain viable for a very long time - sometimes up to several months. Even with targeted treatment, the hepatitis A virus does not die immediately. Judge for yourself:
- Boiling for ten to fifteen minutes, and in some cases more.
- Chlorination of the infected surface is approximately 30 to 40 minutes continuously.
- Treatment of the infected surface with formalin - at least three hours continuously.
- Treatment of the infected surface with 20% ethyl alcohol.
Methods of transmission of hepatitis A
The only source of hepatitis C infection isсегодняшний день является больной человек. С калом он выделяет в окружающую среду вирус гепатита А, который рано или поздно попадает в природный круговорот воды. А это значит, что вирус с высокой долей вероятности может попасть в питьевую воду, продукты питания – и с ними проникнуть в организм человека. Именно поэтому так важно тщательно термически обрабатывать все мясные и рыбные блюда, а также блюда из морепродуктов. Кроме того, львиная доля всех заражений приходится на летний период, когда очень много овощей и фруктов – на них зачастую также находится весьма большое количество вирусов гепатита А. Именно поэтому ни в коем случае недопустимо употребление грязных овощей и фруктов. Да и для их мытья подходит далеко не любая вода – не стоит использовать непригодную для питья, так как в ней также могут содержаться вирусы гепатита А. В отличие от гепатита С, инфицирование гепатитом А во время переливания зараженной крови или ее компонентов происходит крайне редко. И это неудивительно – дети, у которых данная форма гепатита может протекать бессимптомно, донорами крови являться не могут, а у взрослых людей она протекает в ярко выраженной форме, поэтому донором он также стать не сможет. Схема инфицирования стандартная – вирус гепатита через ротовую полость попадают в пищеварительную систему, а из кишечника всасываются и проникают в кровь. С током крови вирусы очень быстро проникают в клетки печени, в которых и развивается воспалительный процесс. После этого вирусы через желчные протоки в кишечник, а из кишечника – снова в окружающую среду. Наиболее опасен для окружающих больной человек в следующий промежуток времени – на протяжении последней недели инкубационного периода и первой недели заболевания. Инкубационный период гепатита А равняется примерно 14 – 20 дням, однако в большинстве случаев время инфицирования, конечно же, больному человеку не известно. В то время, когда вирус гепатита А находится в крови больного человека, внешне болезнь проявляется симптомами острого респираторного заболевания: кашель, насморк, повышение температуры тела, общие признаки интоксикации. Но как только наступает желтушный период, вирус гепатита А целиком и полностью покидает организм больного человека, а желтуха является всего лишь иммунным ответом организма. Однако хотелось бы еще раз напомнить о том, что зачастую вирусный гепатит А может протекать вовсе без желтушного периода. Появление желтушного периода свидетельствует о том, что произошло довольно обширное поражение печени – примерно 65 – 70%, поэтому больному человеку показана немедленная госпитализация в инфекционное отделение. Отказываться от госпитализации все же не стоит, потому что при правильном и своевременном лечении, которое обеспечивается в условиях больницы, работа печени, равно как и ее структура, восстанавливается в полном объеме. В том случае, если вирусный гепатит А возникает у абсолютно здорового человека, оно всегда заканчивается полным выздоровлением. А вот в том случае, если у заболевшего человека имеется то или иное заболевание, особенно хронические формы иных видов гепатита, заболевание протекает гораздо тяжелее и длительнее, а прогноз врачей не столь оптимистичен. У некоторых больных людей через некоторое время – недели, а порой и месяцы, возможно развитие рецидива – у человека снова появляются все симптомы желтушного периода – пожелтение склер и слизистых оболочек, общая интоксикация организма. И лечение гепатита приходится начинать снова. Подобные рецидивы наблюдаются примерно у 25% всех взрослых людей, заболевших гепатитом А. В некоторых случаях гепатит А может спровоцировать развитие такого осложнения, как гемолиз. Гемолизом врачи называют разрушение таких клеток крови, как эритроциты. В результате этого может произойти поражение почек и, как следствие, развитие острой почечной недостаточности – в результате жизнь человека окажется под угрозой. Несмотря на то, что вирусный гепатит А практически никогда не приводит к патологическим изменениям печени, в некоторых случаях это все же происходит. В основном подобное явление имеет место у пожилых людей, у которых заболевание протекает практически бессимптомно. Как правило, в подобных случаях постельный режим больной человек не соблюдает, а значит, очень велик риск развития печеночного фиброза – патологического рубцового изменения печеночной ткани. Подобное осложнение может привести у дискинезии желчных протоков.
Diagnosis of hepatitis A
Diagnosis of hepatitis A is not particularly difficult.difficulties if, of course, we are not talking about an asymptomatic course of the disease. First of all, the doctor pays attention to the obvious clinical manifestations of the disease - symptoms of acute respiratory disease, icteric manifestations. Having noticed these manifestations, the doctor will prescribe a number of examinations. The first thing that needs to be done is to test the blood in the laboratory. As a rule, the doctor - laboratory assistant notes an increased content of certain liver enzymes and, of course, bilirubin. These indicators clearly indicate that there is damage to the cells and tissues of the liver. Immediately after this, it is necessary to conduct a differential diagnosis of other viral hepatitis.
Treatment of viral hepatitis A
The most important in the treatment of acute hepatitis Ais strict adherence to the regime and dietary diet. In the first two weeks of the disease, the patient is prescribed strict bed rest. Doctors explain this requirement by the fact that the blood supply to the liver in a lying position is much more effective, which means that the restoration of liver cells and tissues damaged by the hepatitis A virus will be much more intense. Strict adherence to the therapeutic diet is no less important. Firstly, it is immediately necessary to pay attention to the fact that the optimal option is fractional nutrition - the sick person should receive food in small portions, but the time interval between meals should not be more than two hours. Allowed foods for a sick person: A sick person should refuse fresh bread, replacing it with crackers, or, in extreme cases, bread baked at least a day ago. Of the first courses, preference should be given to vegetable and milk soups, as well as pasta soups based on vegetable broth. For main courses, a sick person can eat lean beef and chicken breast, either baked or boiled. In addition, you can eat lean varieties of boiled fish, such as hake, carp, pike, navaga. In addition, you can eat vegetables, greens, semi-viscous porridge, oatmeal and cottage cheese puddings and casseroles without limitation. Of the drinks, it is recommended to drink tea, cranberry fruit drinks, and kissels. If viral hepatitis A is mild, no additional treatment is required. However, despite this, the sick person must be in a hospital setting, under the constant supervision of health workers, so that if deterioration begins, immediately begin pharmacological therapy. In the same case, if the symptoms of the disease are very pronounced, doctors will begin detoxification therapy. The essence of this therapy is to reduce the level of toxins in the body of a sick person. These toxins accumulate as a result of liver dysfunction. For this purpose, intravenous administration of special solutions is usually used.
Hepatitis C
Today, one of the most relevantfor doctors, the problem is viral hepatitis C. This disease is very insidious - doctors have dubbed it a "gentle killer". Often, it is possible to suspect the disease only when a person develops cirrhosis or even liver cancer. As medical statistics show, these pathologies develop in about half of all people with hepatitis C. There are several types of hepatitis, but viral hepatitis C is the most widespread. Doctors believe that this trend is due to the fact that this disease is asymptomatic for a very long time, which means that a sick person, unaware of his disease, infects people around him. According to official medical statistics, today only in Russia there are more than 5 million infected people. The hepatitis C virus is of great interest to scientists - microbiologists - today a considerable number of different varieties of this virus are known. And what is most interesting is that several varieties of the hepatitis C virus can coexist in the same sick person. These varieties in medicine are usually called pseudospecies. These so-called pseudo-types of the virus are formed due to the amazing ability of the hepatitis C virus to change, and already in the body of an infected person. Due to this property, the hepatitis C virus avoids the destructive effect of immune system cells. This is why the disease progresses so quickly, sometimes even despite complex treatment. In addition, the hepatitis C virus is quite resistant to environmental negative influences and is viable. Even at room temperature in the environment, the virus remains unchanged for 16-24 hours. In some cases, some subtypes of the hepatitis C virus remain viable for several days.
Infection with the hepatitis C virus
Today, doctors know two main ways of transmitting the hepatitis C virus:
- Sexual intercourse
The hepatitis virus is found in large quantitieson the mucous membranes of the genitals and in all biological fluids - sperm, vaginal discharge. Therefore, in case of unprotected sexual contact, the risk of infection is very high and can reach 90%. Therefore, in no case should sexual contact be allowed without taking all necessary precautions. The risk group for sexual transmission of the hepatitis C virus includes homosexuals and all those people who lead a promiscuous sex life without using personal protective equipment.
- Hematogenous method
The hepatitis C virus can also penetrate intothe human body during a transfusion of blood or its components, the donor of which is an infected person. Not so long ago, this route of infection was very widespread, but in recent years, with the introduction of laboratory diagnostic methods and mandatory laboratory testing of donors for the presence of the hepatitis C virus, such a route of infection is extremely rare.
- Non-sterile instruments
Currently, the most commonAnother way to become infected with hepatitis C, in addition to, of course, sexual intercourse, is by using non-sterile medical and cosmetic instruments. For example, recently there has been a real surge in hepatitis C among people who have had tattoos or piercings. Unfortunately, even the most expensive beauty salons sometimes do not sterilize their instruments in good faith. Therefore, try to choose salons that use disposable instruments. The same applies to manicure salons. And do not forget about the rules of personal hygiene - do not give anyone yours or take other people's toothbrushes or razors. Medical needles also often become a source of infection with the hepatitis C virus. For example, the largest number of people with hepatitis are drug addicts. As a rule, they almost never care about any kind of sterility - often the same needle is used to inject two, three, four people, and sometimes more. In addition, sometimes medical workers become victims of such methods of infection, accidentally sticking themselves with needles that they had previously used to inject a sick person.
Acute hepatitis C
The incubation period of hepatitis C isduration can vary greatly - from two weeks to 160 days. However, the average duration is approximately 50 days. And despite the fact that most people have hepatitis without any symptoms for several months, and sometimes years, sometimes some patients develop an acute form of hepatitis C. Acute hepatitis C develops in two stages. The first stage of the disease is called the anicteric period, since at this stage the patient experiences a number of signs of general malaise, such as:
- Decrease or total loss of appetite, a significant decrease in the body weight of the patient.
- Rapidly arising fatigue, increased drowsiness, general lethargy.
- Disturbance of digestion - nausea, vomiting, increased gas formation, belching.
- In some cases, a significant increase in body temperature is possible.
- Signs of ARI - cough, runny nose, headache, pain in the throat.
This condition lasts for about two weeks,after which the icteric period of acute hepatitis C begins directly. The very first symptom that causes alarm is a change in the color of urine - its darkening. Urine acquires the color of dark beer, dark brown. About a day after the change in the color of urine, the sclera, mucous membranes of the eyes and mouth, skin - especially the palms - acquire a yellow tint. When the icteric period begins, the symptoms of general malaise, so pronounced in the first period, almost completely disappear. And they are replaced by a feeling of heaviness in the right hypochondrium and the need to pass stool, which occurs due to blockage of the bile ducts. Treatment of hepatitis C is quite complex and lengthy, so it can only be carried out under the careful supervision of medical personnel. However, sick people should not despair - viral hepatitis C today allows sick people to lead a full life! We recommend reading:
