Hepatitis B

Forms

The reasons

Hepatitis B development mechanisms

Manifestations

Hepatitis B treatment

Complications

Prevention

Hepatitis vaccinations

Hepatitis B is a viral infection predominantly affecting the liver and leading to the chronic progressive form of the disease, carriage of the virus, the development of cirrhosis and liver cancer. 

The relevance of hepatitis B is high due to the possibility of its long latent course and transmission to other people.

Forms

The acute and chronic course of the disease is distinguished; in addition, the carriage of hepatitis B is distinguished by a separate variant.

The acute form may occur immediately after infection, occurs with severe clinical symptoms, and sometimes with fulminant development. Up to 95% of people are completely cured, the remaining part of acute hepatitis becomes chronic, and in newborns chronic disease occurs in 90% of cases.

Chronic form may occur after acute hepatitis, and may be initially without the acute phase of the disease. Its manifestations can vary from asymptomatic (carriage of the virus) to active hepatitis with the transition to cirrhosis.

The reasons

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Hepatitis B is caused by a particular virus that is fairly stable in the external environment. It is transmitted by parenteral route, that is, during sexual intercourse of all options, injections, blood transfusions or surgeries. Infection is possible during dentistry, manicure, shaving, tattooing, if the instruments are not properly treated and there is skin trauma.

The virus can be transmitted from an infected mother to a baby during childbirth, but the virus does not get into the milk when breastfeeding.

Domestic cases of hepatitis B infection are unlikely: it is impossible to get infected through common dishes and kisses, towels, handshakes and hugs, the amount of the virus is negligible. But the use of common razors or toothbrushes increases the likelihood of infection.

The virus is found in most human biological fluids – saliva, sweat, tears, urine, but its highest concentrations are found in the blood.

Hepatitis B development mechanisms

Hepatitis B virus when it enters the body spreads through the body and is fixed in the liver cells. The virus itself does not damage the cells, but the activation of protective immune systems recognizes the cells damaged by the virus and attacks them.

The more active the immune process is, the stronger the manifestations will be. With the destruction of damaged liver cells develops inflammation of the liver – hepatitis. It is the work of the immune system that determines the carriage and the transition to the chronic form.

Manifestations

Hepatitis B occurs in strictly defined stages, starting from an incubation period that lasts from 30–40 days to six months, but on average it is 60–90 days. During this time, the virus multiplies in the body and penetrates the liver tissue. This is followed by a prodromal ( anicteric ) period of the disease, with the appearance of common infectious manifestations, similar to most colds.

These include:

  • violation of health with loss of appetite, weakness, lethargy;
  • nausea and vomiting;
  • temperature increase to insignificant numbers;
  • muscle and joint pain;
  • headaches, feeling of weakness;
  • there may be respiratory manifestations (runny nose, cough, sore throat).

Gradually, the symptoms pass into the icteric period. They also appear in a certain sequence:

  • darkening of urine occurs , the color resembles dark beer; 
  • yellow sclera and mucous membranes of the mouth, especially if you raise the tongue to the sky;
  • stained hands and skin.

As jaundice appears, the general symptoms of intoxication decrease, and the condition improves. There may be pain or heaviness in the right subcostal area at the site of the projection of the liver. Sometimes there may be a cleansing of feces due to blockage of the bile ducts.  

On average, hepatitis lasts about three months, but changes in blood tests can still be quite long.

Severe and fulminant forms of hepatitis B are especially dangerous, since they flow hard and quickly enough. There are attacks:

  • sharp weakness, inability to get out of bed;
  • dizziness;
  • vomiting;
  • nightmares at night as signs of brain tissue damage;
  • fainting, collapse of consciousness;
  • bleeding gums, nasal bleeding; 
  • bruises appear on the skin, edemas on the legs.

When fulminant forms develop symptoms of coma and death is not uncommon.

In chronic hepatitis B, the onset of the disease is usually gradual, and the patient himself may not immediately notice the onset of the disease.

The first signs of chronic hepatitis:

  • fatigue, gradually increasing, weakness and drowsiness;
  • difficulty in waking up;
  • disturbed sleep and waking cycles, daytime sleepiness and sleeplessness at night;
  • anorexia, nausea, bloating, vomiting;
  • manifestations of jaundice occur: urine darkens, sclera and mucous membranes turn yellow (jaundice is usually persistent or manifested by waves).

Hepatitis B treatment

The use of therapies is aimed at combating viruses, at alleviating the patient’s condition, eliminating toxicosis and liver damage.

For the purpose of therapy they conduct:

  • special regime activities with the creation of peace – physical and psychological;
  • the appointment of a special “liver” diet with the exception of fatty, spicy and liver-loading products, alcohol, salt restriction; fractional meals and small portions;
  • treatment with antiviral agents from the interferon group;
  • immunostimulating treatment in order to activate its own immunity;
  • with the aim of eliminating intoxication, drip injection of solutions is prescribed – hemodez , polyglucin , glucose, saline;
  • preparations are added to the treatment to maintain the liver, enzymes to improve digestion, cholagogue;
  • Vitamin therapy is indicated for a tonic effect and speedy recovery of impaired metabolism.

In the future, in order to restore the immune system, it is necessary to conduct long-term courses of interferon to prevent the infection from becoming chronic.

Complications

Mostly they occur in weakened people with chronic pathology. The transition of hepatitis B to the chronic form is directly dependent on age. The younger the children, the higher their chances of a chronic process. Up to five years, the risk of liver damage by a chronic process is greatest.

Prevention

The basis of hepatitis prevention is a healthy lifestyle and loyalty to your sexual partner.

In addition, it is important to use disposable tools for any manipulations with skin puncture, dental treatment, careful processing of tools for haircuts and shaving.

Hepatitis vaccinations

Vaccination for hepatitis is carried out according to the national calendar.

Children are vaccinated three times, immediately after birth, after one month and six months from the first vaccination. Adults are vaccinated in the same way at any age. At the same time, immunity lasts up to 10–15 years.

First of all, people at risk are vaccinated:

  • doctors, people working with biological materials
  • nursing home patients prisoners
  • children of all ages
  • family members of hepatitis
  • patients receiving blood or hemodialysis
  • sexually active people
  • travelers
  • people with diseased liver and other hepatitis.

To date, hepatitis B vaccination is relevant to all.

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