Virus Hepatitis

Virus Hepatitis – a quite widely spread and dangerous type of inflectional disease. Hepatitis A is the most widely spread type, hepatitis B and C are spread among injection-drug users.

Hepatitis A needs 5-50 days after the contamination for the symptoms of hepatitis to appear.  The first symptoms are usually fever-like and are accompanied with temperature. Most of the cases are released with self-healing process and do not need the active treatment. Only few sever cases needs dropping basin to detox the body from the poisonous effect of the virus upon the liver.
Hepatitis B is transmitted through intercourse, non-sterile injections and also from the pregnant mother to the fetus. Typically the symptoms of the B-type start from fever, weakness, joints, nausea and vomiting. Sometimes eruptions occur. Liver and spleen get swollen, the urine may get darker and the stool – very light.
Hepatitis C – the most severe type of virus hepatitis. It is also been called posttransfusion hepatitis. It is very often gets transmitted among the injection drug users. Also sexual and maternal way of transmission is possible. The most dangereous form of this type of hepatitis is a chronic form which is embracing 70–80% of the type-C patients. The conjunction of  C-type of hepatitis with the ones types is making the illness much harder and is often leading to death.
Hepatitis D is s follower of type B, making it much more harder to heal.
Hepatitis E is very much alike type A, but it starts slower and is more dangerous for the pregnant women.
Hepatitis G is very close to type C, but it is less dangerous.

Ways of tramsmittion
Hepatit viruses are being transmitted mainly by 2 ways. First type is called fecal-oral type: the in infected stool is getting dissolved in water and somehow comes to the intestine of other people. Types A and E are being transmitted this was – by the misuse of a private hygiene or the imperfect system of water purification – which often happen in the underdeveloped countries. Second type of transmission is through the blood. This type of infection is valid for type BCDG. B and C types of hepatitis are most dangerous for their impact on the health of a person. The most often infections happens during the donor-blood transmission. Worldwide about 0.01 to 2 % of donors are infected by one of the hepatitis types.  That’s is why all the donor blood is being tested on B and C hepatitis. The risk of getting infected is increased among the persons who have to make blood transmission more than once. Using the same needle for different people can increase the risk of hepatitis B, C, D and G transmission by many times. This is the most common way of disease transmission among the drug-users. Viruses B, С, D, G can be transmitted by sexual contact. Most often it is type B that is getting transmitted sexually. It is also known that the possibility of transmitting the virus between a husband and a wife is very small. A way of infecting the baby through the mother (it is called the “vertical” way of transmission) is quite rare.  The risk is increasing of the virus if during pregnancy the virus is in active phase or if the woman got infected during the last trimester of the pregnancy. Also, the possibility of infecting a child gets very high is along with the hepatitis, the woman also has HIV. Hepatitis is not transmitted through the mother’s milk. Viruses B, С, D, G can also be transmitted by unsafe tattoo procedure, acupuncture, piercing. In 40% of cases the hepatitis its way of transmission is unknown by the patient.

The period from the moment of infection until the first signs of illness is usually 2-4 weeks (virus A) or 2-4-6 months (virus B). During this period the virus is getting adapted and duplicated, and then the symptoms start expressing themselves. At the beginning, before the yellow plague, virus A looks like a fever with a headache and common weakness. B and C viruses have a longer and softer beginning, with a subtle fatigue and fever, skin disorders and joint pain. The primal symptoms of virus C can be expressed only as a little weakness and the loss of appetite. A few days later the picture changes: the appetite is even less, there is pain in the upper right side of the body, vomiting and nausea, dark urine and almost white stool. The liver usually gets bigger, and a bit less frequent – spleen also.  Blood test also shows the specific markers for hepatitis: belirubin is high, liver indications are 8-10 times bigger. Usually when the yellow plague appears, patients start feeling better (accept for virus C patients, chronic alcoholics and drug users independently of the type of virus). The rest of the patients, after the yellow plague crisis start feeling better and recover. Here is how the acute forms of hepatitis viruses are progressing. The clinical symptoms of the virus can be of different severity: mild form, medium form and acute form. The forth form is a fulminant hepatitis, i.e. an instant form of the virus. This is the most dangerous form of the virus which is expressed in the huge necrosis of the liver and usually is fatal to the patient. The most danger show the chronic forms of the viruses. Only viruses B, C and D can be chronic. The most common expression the chronic forms is fatigue which gets strong by the end of each day, when even simple routine things are being hard to obtained.  Only after a long while the patients start having the rest of the symptom: losing weight, yellow plague, the dark urine and the swollen liver and spleen, bleeding of skin etc.

The Treatment
Hepatitis A is usually getting cured after 1 month. No special treatment is usually needed. The routine includes the basic therapy, bed rest and a diet. If there are indications, the detoxication procedures can be made (intravenous or orally) as well as symptomatic treatment. It is recommended to avoid alcohol intake that can weaken the liver more. Severe virus Hepatitis B has a good prognosis in 80% of cases. If the yellow plague stage was not reached and the virus stayed in subclinical stage – this type of hepatitis can become chronic, which is very dangerous, because the chronic hepatitis can lead then to liver cirrhosis and cancer. It is almost impossible to get completely healed from the chronicle B-virus, but it is possible to have a state of the persistent remission, following certain lifestyle rules, diet, the low level of psycho-emotional tensions, as well as the intake of the prescribed medications that enhance the metabolic processes within liver cells. Basic therapy and the antivirus treatment with interferon (under the strict control of the physician) is necessary for the chronic B-form of hepatitis. The treatment is long in time. Usually it is needed to repeat the courses of treatment. Hepatitis C – is the most serious type of the disease. Each seventh patient has a chronic form of the illness. These patients are under the risk group for the cirrhosis and the liver cancer.  Alpha-interferon is a base of the treatment, which prevents the new cells of the liver (hepatocytes) to get infected. The mentioned treatment cannot guarantee the full recovery, but it is a high prevention factor from the liver damage by cirrhosis and the liver cancer. Hepatitis D only shows within the Hepatitis B. It needs the stationary treatment. Basic and the antivirus protocols of treatments are necessary. Hepatitis E is not being treated, since the human being is strong enough to fight with it by itself. After 1 – 1.5 months the recovery usually occurs.  Sometimes the symptomatic treatment is being used for the headaches, nausea etc.

Complications of the virus hepatitis include functional and inflammatory disorders of the biliaries and liver coma. If the first can be treated with a good prognosis, the liver coma can be a sign of the fulminant hepatitis, which is incurable and leads to a very sudden death in 90% of cases. The liver coma happens as a result of the massive necrosis of the liver cells. The products of the necrosis very rapidly appear in the blood stream and lead to the fast inflammation of the central nervous system and the decay of all the systems of the body. Chronic hepatitis, on its side, is mostly dangerous because it may often lead to the cirrhosis and cancer of the liver. The most difficult process of the illness happens when several types of the virus combine (B and D or B and C). Sometimes the patient has B, D and C viruses together. In this case the prognosis can hardly be positive.

It is necessary to follow just a few simple rules in order not to get infected with the hepatitis. Hepatitis A. It is important to drink only boiled water, always wash fruits and vegetables, cook products good. It is in general important to avoid a contact with the liquids of the other person’s body. For B and C hepatitis – not to have contact with a blood of the other person.  In extremely small amounts blood can stay on the razors, toothbrushes, manicure scissors etc. Do not share personal belongings with other people. Do not do piercing and tattoo with the used or unsterile tools. Have safe sex.

Vaccines from Hepatitis B
In order to prevent people from hepatitis B vaccination is being used. (Engerix-B, Generix, Combiotex, Euvax and others). We are using the vaccine Generix (USA).

How the hepatitis B vaccine works?
Vaccine consists of the immunologically relevant protein of the virus B, HВs Ag. Antibodies to this protein are being produced by the body 2 weeks after the vaccination. The vaccine has to be given 3 times after some period of time. Then in 99% of the cases the body will attain the protection from the virus.

How the vaccination of the hepatitis B is being done?
One month after the first vaccination the second one is done and then – 6 month later – the third one.  Each vaccine is 1 ml liquid injected into the deltoid muscle of the shoulder.

Are there complications after the vaccine?
Modern hepatitis vaccines do not produce serious side-effects. The place of injection can be painful,  sometimes the slight fever may occur, very rare – allergic reactions. All the effects go by themselves. The rate of side effects in population is 2-5%.  In general, the medical society considers the registered hepatitis B vaccines effective and safe for both – adults and children.

Is there a need to confirm the effectiveness of the vaccine by additional analysis?
No, there is no need to confirm the result of vaccination.

How reliable is the protection of the vaccine from hepatitis B?
Vaccination gives a reliable protection of the person from getting infected by the disease. Following the mentioned protocol of the triple vaccination allows to create specific antibodies that prevent from getting ill in 98% of the vaccine patients. Immunity for Hepatitis B stay for at least 8 to 10 years, and most often – for the rest of one’s life.

Who should get vaccination?
The vaccination should be done by everyone. Also, the patients with other liver viruses (like HCV) should also be infected as well as families with a Hepatitis B person, HIV-patients, medical workers and students, everyone working with blood; patients on “the artificial kidney” protocol, drug users and people from other risk-groups.

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