Hepatitis is an inflammation of the liver from any cause.
Hepatitis is usually caused by a virus, especially one of the five hepatitis viruses - A, B, C, D or E. Less commonly, hepatitis caused by other viral infections such as infectious mononucleosis, yellow fever and cytomegalovirus infection. Nevirusni main causes of hepatitis are alcohol and drugs. Hepatitis can be acute (lasting less than 6 months) and chronic. It occurs generally throughout the world.
• The hepatitis A virus spreads primarily through the stool of a person other mouth (fecal-oral route of spread).Such a transfer is typically due to poor hygiene. There are frequent outbreaks of water or food, especially in developing countries. Sometimes it is responsible eating contaminated raw shellfish. There are frequent and isolated cases due to contact from person to person. Most caused by hepatitis A virus causes no symptoms and go unrecognized.
• Hepatitis B virus is transmitted more difficult than hepatitis A. One of the ways that can be transmitted through contaminated blood or blood products. However, because of the precautions taken to ensure a safe blood supply, blood transfusions are rare in the United States responsible for the transmission of hepatitis B. Transmission usually occurs among drug users who share common pins and between gay men and heterosexual partners.Pregnant women infected with hepatitis B virus during childbirth may transmit the virus to their babies.
Risk of exposure to hepatitis B virus increases in patients who go on dialysis because of kidney disease or cancer in the departments and the hospital staff who come into contact with blood. At risk are people in indoor environments (such as prisons and institutes for mental illness), where there is a narrow mutual contact.
Hepatitis B can transmit healthy people who are chronic carriers of the virus. It is not clear whether the virus is transmitted insect bites. Many cases of hepatitis B have no known source. In some areas of the world such as the Far East and parts of Africa, hepatitis B virus is responsible for many cases of chronic hepatitis, cirrhosis and liver cancer.
• Hepatitis C virus causes at least 80% of cases of hepatitis that are due to blood transfusions, with many individual cases of acute hepatitis. The most commonly spread among drug users who each use the same needle. Transmission through sex is rare. Hepatitis C virus is responsible for many cases of chronic hepatitis and some cases of cirrhosis and liver cancer. For unknown reasons, and people with alcoholic liver disease often have hepatitis C, a combination of disease sometimes leads to significant loss of liver function than they would have caused any illness separately. It seems that a small portion of healthy chronic carriers of hepatitis C.
• Virus Hepatitis D occurs only as a common infection with hepatitis B virus infection and makes hepatitis B more severe. The relatively high risk beneficiaries to the drug.
• Hepatitis E virus causes occasional outbreaks similar to those caused by hepatitis A. So far, the outbreak occurred only in developing countries.
Acute viral hepatitis
Acute viral hepatitis is liver inflammation caused by infection with one of the five hepatitis viruses, with most people the inflammation begins suddenly and lasts only a few weeks.
Symptoms and diagnosis
Symptoms of acute viral hepatitis usually begin suddenly. Include poor appetite, malaise, nausea, vomiting and often fever. In smokers, the typical symptom of distaste for cigarettes. Sometimes, especially when infection with hepatitis B, people get joint pain and hives (a red skin rash that itches).
After several days, the urine becomes dark and jaundice may occur. Most of the symptoms at that time typically disappears and the person feels better, although the jaundice is getting worse. May develop symptoms of cholestasis (stagnation or reduction of bile flow), such as pale stools and general itching.
Jaundice is usually the strongest 1-2 weeks, then goes over 2-4 weeks.
Acute viral hepatitis is diagnosed based on symptoms and results of blood tests used to assess liver function. In about half of people with this disease, the doctor will find a delicate and slightly enlarged liver.
Acute viral hepatitis should be differentiated from several other diseases that cause the same symptoms, for example. influenza-like symptoms early in the disease may resemble other viral diseases such as influenza and infectious mononucleosis. Fever and jaundice and symptoms of alcoholic hepatitis that occurs in people who regularly drink substantial quantities of alcohol. The specific diagnosis of acute viral hepatitis may ask if blood tests indicate the viral proteins or antibodies against the hepatitis virus.
Forecast
Acute viral hepatitis can be expressed in a range from mild influenza-like illness to fatal liver failure. It is generally more severe than hepatitis B and hepatitis A sometimes fatal disease, especially in the elderly. The course of hepatitis C in some ways unpredictable: acute illness is usually mild, but the function of the liver can be fixed, and then repeated in a few months to worsen.
A person with acute viral hepatitis usually after 4-8 weeks of recovery, even without treatment. Hepatitis A is rarely, if ever, becomes chronic. In 5% - 10% of infected people become chronic hepatitis B, and can be mild or fully developed. Hepatitis C is most likely to become chronic in about 75% of cases. Although usually mild and often without symptoms, hepatitis C is a serious problem, because about 20% of affected people eventually develop cirrhosis.
A person with acute viral hepatitis may become chronic carriers (carriers) of the virus. In the state of carriers of the virus a person has no symptoms, but still addictive. This condition occurs only in the case of hepatitis B and C viruses and not A. Chronic carrier of the virus may eventually get cancer of the liver.
Treatment
People with unusually severe acute hepatitis may be necessary to accommodate the hospital, but in most cases, treatment is needed. After the first few days usually appetite returns and the person does not have to be in bed.They did not need any major restrictions of diet or activity or vitamin supplements. Most people can safely return to work after the jaundice disappears, although their liver function test results are not entirely normal.
Prevention
Good hygiene measures will help prevent the spread of hepatitis A. Since the stool of people with hepatitis A virus infection, contagious, health workers must handle stool samples with particular care. The same goes for the blood of people with any type of viral hepatitis. On the other hand, infected people do not have to be insulated, to a little help in preventing the transmission of hepatitis A, and will not prevent transmission of hepatitis B or C.
Medical personnel reduces the risk of infection by avoiding unnecessary blood transfusion blood transfusion, using blood donated by volunteers rather than paid blood donors and blood donors by searching all the virus B and C.Because of such a search of cases of hepatitis B and C transmitted by blood transfusion has decreased significantly, although not completely removed.
Vaccinated against hepatitis B stimulates the body's immune defenses and protects most of the good people.However, patients on dialysis, those with cirrhosis, and people with impaired immune systems gain less protection from the vaccine.
Vaccination is especially important for people who are at risk of infection with hepatitis B, although it is not effective when the disease has already occurred. Because of that general vaccination of all persons against hepatitis B is recommended in all large scale.
Hepatitis A vaccine given to all men of high risk of acquiring infection, such as passengers in parts of the world where the disease is widely prevalent. Against hepatitis C, D and E has no vaccine.
People who were not vaccinated and exposed to hepatitis may get protection for the preparation of antibodies (immune serum globulin). Antibodies have the right to protection against viral hepatitis, but the scope of protection varies widely in different situations. People who have been exposed, perhaps accidental needle prick blood of persons infected with hepatitis B immune antijela against hepatitis B provides better protection than normal serum immunoglobulin.
Newborns of mothers with hepatitis B immune globulin is given to the hepatitis B vaccine and the. This combination prevents chronic hepatitis B in about 70% of newborns.
CHRONIC HEPATITIS
Chronic hepatitis is inflammation of the liver that lasts at least 6 months.
Chronic hepatitis, although much less common than acute hepatitis, it can take years, even decades. It is usually quite mild and no symptoms or significant liver damage. In some cases, however, ongoing inflammation slowly damages the liver, eventually leading to cirrhosis and liver failure.
Causes
Hepatitis C virus is a common cause of chronic hepatitis, 75% of acute hepatitis C becomes chronic. The hepatitis B virus, sometimes with hepatitis D, causing a small percentage of chronic infection. Hepatitis A and E do not cause chronic hepatitis. Medications such as methyldopa, isoniazid, nitrofurantoin, and paracetamol can be also cause chronic hepatitis, especially when taking a long time. In children and young adults, chronic hepatitis can cause Wilson's disease, a rare hereditary disease with abnormal accumulation of copper.
No one knows exactly why the same viruses and drugs in some people cause chronic hepatitis, while others do not, that is why the degree of severity varies. The only possible interpretation is that the people who develop chronic hepatitis immune system over-reacts to the viral infection or the drug.
Many people with chronic hepatitis can not find the real cause. In some of them leads to the excessive reaction of the immune system that is responsible for chronic inflammation. This condition, called autoimmune hepatitis is more common in women than in men.
Symptoms and diagnosis
About a third of cases of chronic hepatitis develops after an attack of acute viral hepatitis. The rest are being developed gradually, without any apparent underlying diseases.
Many people with chronic hepatitis have no symptoms at all. In those who have them, the symptoms are often feeling sick, poor appetite and fatigue. Sometimes a person has a mild fever and a feeling of discomfort in the upper abdomen. Jaundice may develop, but not necessarily. Finally you can develop forms of chronic liver disease. This may include an enlarged spleen, blood vessels in the skin such as spiders and fluid retention. There may be other forms, especially in young women with autoimmune hepatitis. This can involve virtually any body system, including acne, cessation of menstrual cycles, joint pains, lung scarring, inflammation of the thyroid and kidney function and anemia.
Although symptoms and liver function test results provide useful diagnostic information for a definitive diagnosis is essential liver biopsy (taking a sample of tissue for examination under a microscope). Examination of liver tissue under the microscope allows a doctor to determine the severity of inflammation and whether it has developed scar tissue and cirrhosis. A biopsy can determine the real cause of hepatitis.
Prognosis and treatment
Many people have chronic hepatitis for years without developing liver damage that progresses.
In others the disease gradually worsens. When this happens the disease is the result of infection with viral hepatitis B or C, inflammation can be stopped protivirusni (antivirus) factor interferon-alpha. However, this drug is expensive, often have side effects and when to stop treatment, it is likely recurrence of hepatitis. Therefore, this treatment keeps the selected men with this infection.
Autoimmune hepatitis is usually treated with corticosteroids, sometimes together with azathioprine.
These drugs suppress inflammation, improve symptoms and improve long-term survival. However, scar changes (fibrosis) of the liver may gradually get worse. Discontinuation of treatment usually leads to relapse, and because most people are constantly taking medication. After a period of many years, 50% of people with autoimmune hepatitis will develop cirrhosis, liver failure, or both.
If the occurrence of hepatitis suspected a drug, people should stop taking it.
It seems that chronic hepatitis may disappear.
Regardless of the cause or type of chronic hepatitis, any complications such as ascites (fluid in the abdominal cavity) or encephalopathy (abnormal brain function) requires medical treatment.
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