Viral inflammation of the liver (viral hepatitis). Liver diseases: causes, types, symptoms and prevention What is a virus in the liver

With purulent liver abscesses, the infectious agent, as a rule, penetrates the liver through the portal route; in young people, such abscesses are often a complication of acute appendicitis. Thanks to early diagnosis and treatment, the prevalence of purulent liver abscesses has decreased. However, the frequency of detection of liver abscesses that have developed against the background of obstruction and infection of the bile ducts, as well as in older patients, continues to increase. The decrease in immunity observed during AIDS, intensive chemotherapy or after organ transplantation leads to an increase in the prevalence of abscesses caused by opportunistic microorganisms.

Nowadays, thanks to the more intensive use of scanning and cholangiography, liver abscesses are diagnosed earlier. Errors in making a diagnosis are usually due to the fact that some doctors do not take into account the possibility of such a disease.

Abscesses due to portal pyaemia

Infectious diseases of the gastrointestinal tract or pelvic organs can lead to the development of portal pylephlebitis or the formation of septic emboli. Such conditions can develop against the background of appendicitis, empyema of the gallbladder, diverticulitis, regional enteritis, ileitis caused by Yersinia, perforated gastric or colon ulcer, anastomotic leak, pancreatitis or infected hemorrhoids.

In newborns, septic lesions of the umbilical vein can lead to the spread of infection through the portal vein with the subsequent development of liver abscesses.

Biliary abscess

The biliary tract is the most common source of infection. Any form of bile duct obstruction, especially partial, can be complicated by purulent cholangitis. As a rule, multiple abscesses are observed. The cause of the development of the disease can be stones in the gall bladder, cancer, sclerosing cholangitis, congenital anomalies of the biliary tract, especially Caroli's disease. An abscess may develop after a biliary tract intervention, such as insertion of a stent, removal of a stricture, or due to reflux of intestinal contents through a biliodigestive anastomosis; in these cases it may be asymptomatic.

Contact abscess

A solitary liver abscess can develop as a result of penetrating injury to the liver or with direct spread of infection from a septic focus to adjacent tissues, for example from a perinephric abscess. It can occur after secondary infection of amoebic abscesses, metastases, cysts or intrahepatic hematoma. In addition, blunt trauma to the liver during road traffic accidents or due to other causes can lead to the formation of an abscess.

Other abscesses

Liver abscess can develop due to iatrogenic influences such as liver biopsy, percutaneous biliary drainage, or hepatic artery injury or perfusion. It can form in patients with hematological diseases, such as leukemia, receiving chemotherapy. The presence of a malignant disease in the patient plays an important role; however, the abscess may be caused by a fungal infection and amphotericin may be effective.

When the cause of a liver abscess is not clear, it is necessary to consider the possibility of its development against the background of diabetes mellitus, often in the presence of gas-forming bacteria of the genus Klebsiella.

The formation of a liver abscess can be associated with severe dental diseases.

In approximately half of patients, especially the elderly, no clear predisposing cause can be identified.

Bacteriological picture

In liver abscess, the most common infectious agent is gram-negative bacteria. Two thirds of patients have Escherichia coli. Also often detected Streptococcus faecalis, Klebsiella spp.. And Proteus vulgaris. Recurrent purulent cholangitis can be caused by Salmonella typhi.

Currently, the role of anaerobic microorganisms in the development of liver abscesses is increasing.

The most common pathogens include Streptococcus milleri, belonging to group F according to the Lancefield classification, which is neither a true anaerobic nor a microaerobic.

In approximately half of patients, especially those receiving chemotherapy, staphylococci are detected, which are usually resistant to therapy. In patients with liver abscess, Friedlander's diplobacillus can also be detected, Pseudomonas spp.. And Clostridium welchii.

Rare causes of liver abscess include the septic form of melioidosis, infection Yersinia enterocolitica And Pasteurella multocida.

Sources of infection are often multiple.

Upon examination, an abscess may appear sterile, but this is usually due to inadequate culture techniques, especially anaerobic microorganisms, or previous use of antibiotics.

Morphological study

In an enlarged liver, multiple yellow abscesses with a diameter of 1 cm or a single abscess surrounded by fibrous tissue can be identified.

In cases where concomitant pylephlebitis is observed, pus and blood clots may be found in the portal vein and its branches. Abscesses usually form in the right lobe of the liver. In this case, the development of perihepatitis or the formation of adhesions may be observed.

In cases where the disease is caused by bacteroids, the pus has an unpleasant odor, and the abscess wall is difficult to distinguish.

If the infection spreads through the bile ducts, multiple foci of infection may be found corresponding to the bile ducts.

A chronic single liver abscess can last at least 2 years until diagnosis or death of the patient.

Small purulent abscesses can have multiple locations, including the lungs, kidneys, brain and spleen. Direct spread of infection from the liver can lead to the formation of a diaphragmatic abscess or pleural empyema and lung abscess. Spread of infection to the peritoneum or an abscess under the skin is rare. Approximately a third of patients have a small amount of ascitic fluid.

Histological examination of liver tissue away from the abscess reveals infection in the portal tracts, surrounded by scattered liver cells infiltrated with polymorphonuclear leukocytes.

Clinical picture

Before the advent of antibiotics, the clinical picture of liver abscess was characterized by hectic fever and pain in the right upper quadrant of the abdomen, often with prostration and shock. At present, the disease manifests itself less acutely and is accompanied by malaise, low-grade fever and dull pain in the abdomen, aggravated by movement. The latent course of the disease is especially common in elderly patients.

A liver abscess often occurs unnoticed and can take at least a month before it is diagnosed. The development of multiple abscesses is accompanied by more pronounced systemic disorders, and the cause of their occurrence can be determined more often. Single abscesses occur with less severe symptoms and often turn out to be cryptogenic. In the case of subdiaphragmatic irritation or pleuropulmonary spread of infection, the patient may complain of pain in the right shoulder and cough. In this case, an enlarged and painful liver and pain on percussion of the lower ribs are determined.

In chronic abscesses, the spleen is palpable. Severe ascites is rare. Jaundice occurs in late stages, except in cases of purulent cholangitis.

After recovery, portal hypertension may develop due to portal vein thrombosis.

Research methods

As a rule, in patients with liver abscess, jaundice is mild, with the exception of cholangiogenic abscesses. It is more common in patients with amoebic liver abscess.

An increase in alkaline phosphatase activity is usually observed in the blood serum. ESR is significantly increased. As a rule, the number of polymorphonuclear leukocytes in the blood is increased.

In 50% of cases, pathogens can be identified in blood culture.

X-ray

With fluoroscopy, one can observe high standing and limited mobility of the right dome of the diaphragm, deformation of its contours and pleural effusion. Tomography can reveal fluid levels indicating the presence of gas-forming microorganisms.

Localization of the abscess

Ultrasound examination (ultrasound) of the liver helps to distinguish solid space-occupying formations from formations containing fluid.

CT scanning is especially effective, although false-positive results are possible if the abscess is highly localized or with microabscesses. The grouping of multiple small abscesses may indicate their fusion into a single large abscess.

To diagnose cholangiogenic abscesses use endoscopic or percutaneous cholangiography.

At magnetic resonance imaging(MRI) reveals a space-occupying lesion with clear boundaries of low intensity on T1-weighted images and high intensity on T2-weighted images. MRI findings are nonspecific and do not allow one to determine the biliary or hematogenous origin of the abscess.

From aspirated It is possible to isolate pathogens from the abscess contents in 90% of cases. The resulting material should be cultivated under aerobic, anaerobic conditions and in an environment enriched with carbon dioxide to identify Streptococcus milleri. Aspiration using a 16- to 22-gauge percutaneous puncture needle under ultrasound or CT guidance is usually effective. If necessary, the procedure can be repeated every 3-7 days.

Treatment

Prevention of the development of liver abscesses consists of treating acute infectious diseases of the biliary tract and abdominal organs at an early stage, as well as adequate, usually percutaneous, drainage of intra-abdominal accumulations of pus using antibiotics.

Intravenous antibiotics alone are rarely effective, so mandatory drainage should not be delayed. In each case, the choice of antibiotic depends on the pathogen.

Once a single abscess is localized, it must be drained. If amebiasis is suspected in a patient, metronidazole should be prescribed before aspiration.

In some cases, to drain an abscess, it is necessary to use a catheter with a spirally curved end, inserted percutaneously.

In case of multiple abscesses, the largest abscess is drained; Smaller abscesses usually resolve spontaneously with antibiotic therapy. In some cases, percutaneous drainage of each abscess is necessary.

Isolated high-dose antibiotics for at least 6 months may be effective, especially for streptococcal infections.

“Open” drainage of an abscess is rarely performed. However, a single left-sided abscess requires surgical drainage, especially in children.

It is necessary to restore the patency of the bile ducts. Typically this is achieved using endoscopic retrograde cholangiopancreatography (ERCP), papillosphincterotomy and stone removal. If necessary, an endoprosthesis is installed in the bile duct.

Even with adequate treatment, fever may persist for 1-2 weeks.

Forecast

The use of abscess puncture with aspiration of the contents and antibiotic therapy reduced the mortality rate from liver abscess to 16%. The prognosis is better for a single abscess of the right lobe of the liver, in which 90% of patients survive. With multiple abscesses affecting the entire liver, especially of biliary origin, the prognosis is extremely unfavorable - only 20% of patients survive.

The prognosis worsens with delayed diagnosis, prolonged fever, multiple pathogens detected in blood culture, hyperbilirubinemia, concomitant diseases, hypoalbuminemia, pleural effusion, and in elderly patients.

Hepatitis is an inflammatory liver disease of various nature, characterized by necrosis of liver cells. The most common cause of hepatitis is specific viruses (for example, hepatitis A, B, C virus etc.), less often - other viruses ( cytomegalovirus, infectious mononucleosis virus).

Hepatitis A virus

Hepatitis A virus (HAV) is spread primarily through the fecal-oral route, i.e. infection can occur through food, water, etc.), sometimes through blood. Epidemics caused by contamination of water or food are very common, especially in underdeveloped countries. The infection is very often asymptomatic or remains unrecognized. Population screening for anti-HA antibodies reveals a high prevalence of the virus.

The incubation period of the disease (the time from the onset of infection to the appearance of signs of damage to internal organs) for viral hepatitis A lasts from 2 to 6 weeks. The disease begins with symptoms of malaise, loss of appetite, nausea, vomiting, and sometimes fever. After a few days, jaundice appears - yellowness of the skin, mucous membranes, sclera, urine becomes dark. At this time, the general symptoms preceding jaundice are significantly weakened. Jaundice lasts about 2-4 weeks. A significant increase in the content of liver enzymes (AST, ALT) is detected in the patient’s blood. Hepatitis A is diagnosed by the presence of Ig M antibodies. It usually heals spontaneously after 4-8 weeks. Hepatitis associated with the hepatitis A virus rarely becomes chronic, has a benign course, cirrhosis and an aggressive chronic form do not develop.

Personal hygiene helps prevent the spread of hepatitis A. Currently, little importance is attached to the isolation of hepatitis patients. Standard immunoglobulin (Ig or IgG) provides protection against hepatitis A infection and is prescribed to those who have household contacts with known carriers of the virus and to persons who are expected to spend a long period of time in endemic areas.

Hepatitis B virus

Hepatitis B virus (HBV) is usually transmitted parenterally through contaminated blood or donor blood products. Currently, testing donated blood for the presence of HbsAg antigen has sharply reduced the number of cases of infection after blood transfusion. The risk of infection is increased for cancer patients, for patients on hemodialysis, as well as for hospital staff in contact with blood. The possibility of transmission of infection through insect bites has not been proven. In many cases of acute hepatitis B, the source of infection remains unknown. The spread of infection is sometimes recorded between sexual partners. Chronic carriers of HBV (hepatitis B virus) serve as a reservoir of infection. Transmission of the virus in utero from mother to child is possible. When infected with HBV, any form of liver damage is possible: carriage, acute and chronic hepatitis, cirrhosis, hepatocellular carcinoma. The role of HBV in initiating the development of such serious diseases as periarteritis nodosa, glomerulonephritis, etc. cannot be ruled out.

The incubation period for infection with the hepatitis B virus is 6-25 weeks. A specific method for diagnosing hepatitis B is the presence of HbsAg in the plasma or the presence of anti-HBc antibodies of the Ig M class. With hepatitis B, the prognosis is usually less favorable than with HAV infection, especially in the elderly and after blood transfusion, mortality reaches 10-15%. Hepatitis B also has a tendency to be chronic (5-10% of cases), with the following forms possible: mild persistent hepatitis, advanced chronic hepatitis with outcome in cirrhosis, subclinical (i.e. asymptomatic) state of chronic carriage. The latter especially often leads to the development of hepatocellular carcinoma (malignant liver tumor).

The likelihood of post-transfusion (i.e. after blood transfusion) HBV infection can be minimized if transfusion is performed only when absolutely necessary, according to strict indications, and using blood from donors tested for Australian antigen. Hepatitis B immunoglobulin (HBIg) contains high titer antibodies against HBV. This drug is expensive and is prescribed for accidental puncture with a needle that has come into contact with HBsAg-positive blood, for prevention during regular sexual contact with an identified carrier. It is effective in 70% of cases in preventing chronic HBV infection in infants born to HBsAg-positive mothers.

Vaccination against HBV leads to the production of antibodies in healthy recipients and allows for a sharp reduction (almost 90%) in the prevalence of hepatitis B. Currently, there is a need to vaccinate all newborns, and vaccine prophylaxis is also recommended for people at high risk of infection with the hepatitis B virus (sick and employees in hemodialysis departments, staff of medical institutions, dentists, etc.).

Currently, four different antigen-antibody systems are known that are closely related to the hepatitis B virus (hepatitis B antigen, for example, are viral envelope proteins, the presence of which can be determined in blood plasma by immunological methods).

Hepatitis B surface antigen (HBsAg), Australian antigen. Its detection in plasma makes it possible to diagnose acute hepatitis B. The patient’s blood becomes a potential source of infection. Appears during the incubation period and disappears during recovery. Antibodies (anti-HBs) can be detected later, usually persist throughout life, and their presence in the blood indicates past infection and future protection against HBV. If HBsAg continues to be detected for a long time, but antibodies do not appear, this means that the patient has developed chronic hepatitis and has become an asymptomatic carrier of the virus.

The HbcAg antigen is associated with the core of the viral particle. Detected in infected liver cells. The presence of antibodies (anti-HBc) indicates previous HBV infection; they are regularly found in HBsAg carriers.

HbeAg antigen is part of the viral core and is detected if HBsAg is positive. The presence of this antigen indicates active replication (multiplication) of the virus, combined with a higher infectivity of the blood and an increased likelihood of developing chronic liver damage. The presence of antibodies (anti-HBe) indicates low infectivity and portends a favorable outcome.

Hepatitis C

Hepatitis C is widespread and is transmitted parenterally (i.e., through the blood). It is known that it causes about 80% of post-transfusion hepatitis (i.e., hepatitis that occurs after blood transfusion or blood substitutes). The process is usually chronic (sometimes latent). For example, it is assumed that some healthy people in the population are chronic carriers of hepatitis C. You can become infected with hepatitis C through blood transfusions, the use of non-sterile syringes (among drug addicts), during hemodialysis, and organ transplantation. The incubation period (the period of active reproduction of the virus and impact on tissue) averages 7-8 weeks, although it can last up to 6 months.

Acute hepatitis C is rarely detected, because it occurs easily, often even without jaundice. However, chronicity (i.e., a long wave-like course of the disease) of the process is characteristic of hepatitis C.

Chronic hepatitis C is often benign, but in 20% of patients it ends in cirrhosis. The diagnosis is made during examination - markers of hepatitis C are detected, increased levels of liver enzymes, jaundice (increased bilirubin content), according to ultrasound - signs of liver tissue damage, incl. cirrhosis. In most cases of acute hepatitis, specific treatment is not required; in chronic cases, antiviral drugs (usually interferons) are used.

Preventive measures include donor monitoring, maximum limitation of indications for blood transfusion, use of disposable needles, syringes, infusion systems, etc.

Hepatitis D virus

Hepatitis D virus (HDV, delta factor) is a virus that multiplies only in the presence of HBV or is combined with acute hepatitis B, or manifests as a superinfection in definite chronic hepatitis B. Clinical HDV infection usually manifests as very severe hepatitis B.

Signs of hepatitis in men can appear only in the presence of an acute form of the disease. This pathology is characterized by the development of an inflammatory process in the liver and a change in the cytological qualities of the organ. Often the disease is discovered during a routine medical examination. In many cases, patients believe that they have an acute respiratory illness. This leads to incorrect treatment. Signs of the disease disappear. The organ retains the damage received. This form leads to the development of various complications that may appear after several years.

Varieties of the disease

There are several types of hepatitis that affect the liver. The difference lies in the distribution methods. Hepatitis A is detected during an acute inflammatory process in the liver. This disease is transmitted to others through household means. Form A responds well to therapeutic effects and is completely eliminated under the strict supervision of a specialist.

Hepatitis type B is more dangerous for others. It spreads through the circulatory system and is similar to a viral disease. With this pathology, liver cells are attacked by microorganisms. Microbes cause changes in the cell membrane. After treatment, scar tissue atypical for an organ is discovered on the liver.

The viral form of hepatitis C is widespread. This disease cannot be completely eliminated and leads to irreversible processes in the liver. The danger lies in the form of its transfer. Often the carrier does not have characteristic signs of the disease. This form of the disease is called carriage. A man with hepatitis type C is contagious to others. If the diagnosis reveals this disease, urgent hospitalization is required, followed by isolation until stable remission is achieved.

All forms of hepatitis have a number of signs that can suggest the presence of such a diagnosis. To clarify the type of pathology, doctors conduct a full examination of the blood fluid and ultrasound diagnostics of the liver.

Type C liver damage

This form of the disease is widespread among the population of the entire planet. More than 3% of people are carriers of this hepatitis. The form refers to viral diseases.

When the virus enters the liver, it causes irreversible changes in the cell membrane. She begins to decompose. The spread of the disease is accompanied by gradual destruction of the liver and a decrease in its function. The organ stops purifying blood in the required volume. The quality of the liquid decreases.

Blood is the main supplier of oxygen to various tissues. Oxygen is necessary to maintain metabolic processes. Deterioration in the quality of blood purification leads to a decrease in metabolic processes. Fabrics begin to age quickly and lose elasticity.

The danger lies in its rapid spread and long incubation period. Pathology is transmitted in several ways:

• through blood fluid;
• common household items;
• sexually.

This disease is considered a problem for men who are addicted to drugs. Using a shared syringe when administering a substance is accompanied by rapid infection.

Many men become infected with this disease through sexual contact. Unprotected sexual intercourse and promiscuity lead to rapid infection of a large number of people. Hepatitis C has this feature.

This disease also has common similarities with other types. It spreads easily through household means. The use of common household items leads to the development of the disease in several members of the same family. The same danger exists when visiting public saunas and baths. Poor surface treatment does not completely eliminate the infection. There is a risk of infection.

Time of development of the disease

Each form has a certain time of incubation development. Hepatitis A spreads most quickly. This disease is popularly called jaundice. After contact with a sick man, the first signs of the disease appear after 7–10 days. In rare cases, carriage may last two weeks.

Hepatitis type B may not appear until 5–6 months later. Rarely are signs detected early. This is due to a decrease in the protective properties of the body. The decline of immunity causes the rapid spread of the virus through the liver.

Type C may have a variable incubation period. For many men, the pathology has no external manifestations. The average incubation period is 4–5 months. Pathology can be identified by the presence of additional signs.

Symptoms of the disease

All types of hepatitis in men have a number of common symptoms with oral viral diseases. The following symptoms of the disease initially appear:

• increase in temperature indicators;
• feverish condition;
• presence of headaches;
• development of dyspeptic symptoms;
• pain in right side.

In the first days after the virus is activated, the patient notices a slight increase in temperature. For several days the temperature remains at 37.3–37.5 degrees. Gradually the figures are increasing. Feverish syndrome is added to this symptom. The man feels chills. Tremor of the limbs appears.

After fever, pain appears in the right side. This sign indicates the development of pathology. Symptoms of an oral viral infection are added to the pain. After every meal, the man feels the urge to vomit. Acute diarrhea appears. Gradually, eating food leads to loss of digestion ability.

For hepatitis types A and B, these symptoms may disappear during antibiotic therapy. In this case, you should pay attention to the specific signs of the disease.

Characteristic symptoms of the disease

There are clearer signs of hepatitis of the liver. These symptoms appear when the disease is actively spreading. Often these symptoms reveal an advanced form of hepatitis.

When establishing a disease, it is necessary to pay attention to the following phenomena:

• change in the quality of stool;
• skin coloring;
• characteristics of the sclera.

First of all, damage occurs in the liver cells. It is responsible for cleansing the blood and removing various breakdown products from the liquid. The deterioration of this function leads to the retention of negative substances in the organ. As decay products pass through the intestines, stool becomes discolored. The masses become white or gray. Stool sticking is also observed. Its structure resembles plasticine.

More severe damage to the body leads to changes in the color of the skin. Normally, a man's skin is pink-beige in color. With hepatitis, a change in the structure of epidermal cells is observed. The skin begins to turn yellow. A severe form of the disease leads to severe yellowness. The spread of the process is accompanied by a change in the color of the eye sclera. She begins to turn yellow.

After the spread of hepatitis, negative processes in the kidneys are observed. All accumulated breakdown products from the liver begin to enter the renal pelvis. The urine fluid begins to gradually darken. The accumulation of negative substances leads to severe turbidity and darkening of the urine. The liquid turns brown. The appearance of these signs is observed when the body is severely damaged.

Research and prevention methods

The appearance of all signs of hepatitis should be accompanied by urgent hospitalization of the man.

For the study, a small amount of blood is taken from the cubital vein. It examines the content of red blood cells and the presence of antibodies. Antibodies are produced by a man's autoimmune system. The substances serve as a means of protection against viral microorganisms. If a small number of young red blood cells are detected, the doctor will order an ultrasound examination of the liver.

To avoid contracting this disease, you must follow certain rules. Sexual contact with an unfamiliar partner should only be made using a condom. It is prohibited to use shared personal hygiene items. You should get rid of drug addiction.

Hepatitis is a dangerous disease in modern men. This disease is not always treatable. If the patient is not careful, the consequences can be fatal.

One of the 10 most common causes of human death is liver disease. The liver is affected to varying degrees in 200 million people. There is a clear medical classification of diseases; not all of them lead to irreversible consequences. Yet the liver is a vital organ, and failure of its functioning affects the entire body.

general information

The liver is a gland consisting of two lobes, which, in turn, are divided into 8 segments. The main biochemical processes of the body take place here. The organ has high regenerative abilities, however, they are not enough under systemic influence of external factors. Main functions of the liver:

• bile production;
• neutralization of toxins and poisons;
• removal of excess medications and hormones;
• control of carbohydrate metabolism;
• breakdown of fats;
• storage of vitamins A, B12, D;
• synthesis of bilirubin and cholesterol.

Causes of liver diseases

Alcohol disrupts liver function and negatively affects the body as a whole.

Liver dysfunction occurs as a result of various factors. It could be:

They are classified according to the type of damage to the organ structure. Diseases of the biliary tract and gallbladder are another type of disease. The list includes the most common diagnoses. Each diagnosis requires serious treatment. Types of damage:

Name	A (Botkin's disease)	IN	WITH
Method of infection	Fecal-oral route. Through food, water, and poor hygiene. Often diagnosed in children.	Through damage to the skin, sexual contact, or contact of mucous membranes.	Through common hygiene items, through blood (transfusion, tattooing, etc.), drug use, unprotected sex.
Common symptoms of liver disease	Nausea and vomiting, brown urine, abdominal pain, fever, fatigue, muscle pain	Itching of the skin, darkening of the urine, aversion to food, nausea, heaviness in the liver area, enlargement of the organ, dry mouth.	There are practically no symptoms in the early stages. In case of acute infection: yellowing of the skin, headache, lack of appetite, joint pain, enlarged liver, yellowing of the skin, and sometimes the whites of the eyes.
Incubation period	1 week – 1.5 months	1.5 – 6 months	From 14 to 60 days
How to treat?	Bed rest, table No. 5, drug treatment.	Bed rest, detoxification, drug therapy, diet.	Hepatitis C is treated only under the supervision of a doctor.
Specifics of the disease	After an illness, the body develops immunity.	Complication: hepatitis B in the chronic stage leads to cirrhosis.	In 20% of cases in children and 90% in adults, the acute stage develops into chronic hepatitis. Diagnosis in the early stages is difficult.

Toxic lesions

An overdose of vitamin A provokes organ intoxication.

The affected liver reacts to intoxication in different ways: it accumulates fat or bile, and cell necrosis is possible. Chronic, severe liver damage is usually asymptomatic for the first few months. Over time, blood clotting deteriorates, jaundice appears, and cirrhosis appears. The chronic course is caused by an overdose of vitamin A, long-term use of ethanol, methotrexate or amiodarone. Acute toxic damage is manifested by jaundice, impaired hemostasis, and fever. A characteristic disease is parenchymal inflammation of the liver. Parenchymal hepatitis is also a complication after viral hepatitis.

Toxic substances enter the body through the skin, respiratory system, food and drink. The incidence is high among people over 40 years old, when working in industrial zones, workers in hazardous industries often get sick, the pathology manifests itself in obesity. Depending on the stage of the disease, both conservative treatment and surgical intervention are possible.

Neoplasms

The most common signs of liver problems in the presence of tumors: weight loss, jaundice, nausea, ascites. For detection, liver tests, ultrasound, and biopsy are prescribed. Benign tumors occur without noticeable symptoms, grow slowly, and complaints about health are quite rare. The most common liver adenomas are hemangiomas and cysts. Some of them are fraught with rupture of the tumor and twisting of the leg. Malignant neoplasms are often the result of cancer in another organ. Existing cancer diseases have the following names:

1. The tumor in children is called hepatoblastoma.
2. Angiosarcoma (source - vascular endothelium).
3. Cholangiocarcinoma (from epithelial cells of the bile ducts).
4. Hepatocellular carcinoma is a primary cancer that originates in the cells of the liver parenchyma.

Most often, neoplasms are a consequence of hepatitis types B and C. Symptoms: subfernal temperature, weight loss, heaviness in the liver area. Time is not on the patient’s side: late diagnosis leads to death within 1 year. Life expectancy after cancer removal is on average about 3 years, up to 5 years - about 20%. These are statistics, so you need to remember that each person is individual and has his own body reserves. Psychosomatics has an impact on fatal diseases.

Exchange disorders

Junk food can trigger hepatosis.

Liver cells are sensitive to any metabolic disturbances, because it is in them that the main fat metabolism is ensured. If this happens, organ obesity, or hepatosis, develops. The causes are poor nutrition, alcoholism, and diabetes. Initially, fatty substances accumulate in cells, and the body experiences an excess of free radicals and inflammation. The result of this process is necrosis of healthy tissue and its replacement with connective tissue. Often the disease is asymptomatic, sometimes there are signs of indigestion, nausea, bloating, fever, and bitterness in the mouth.

Symptoms of liver diseases

Signs of the disease: discomfort in the liver area, in the right hypochondrium. The pain does not disappear, it intensifies when doing exercises, during classes, when shaking, after eating fatty, spicy foods. The first signs of liver and biliary tract disease are nausea, vomiting, characteristic bitterness in the mouth, heartburn, belching, and gastrointestinal upset.

Yellowness of the skin and sclera appears. Urine darkens, feces become discolored. Jaundice causes itchy skin due to an increase in the concentration of bile in the blood. In some cases, the temperature rises, weakness, fatigue, and lethargy appear. Performance decreases sharply. Symptoms on the skin - “stars”, local hemorrhages. Women have cycle disorders, men have sexual dysfunction.

This liver damage is caused by improper functioning of the immune system, which produces antibodies to the structural elements of the liver tissue. Immune cells produce antibodies to liver tissue. Antibodies and the immune cells themselves attack the cells and intercellular substance of the liver. The gradual destruction of liver tissue leads to disruption of liver function and signs of hepatitis.

Symptoms of hepatitis

Pain in the right hypochondrium. As a rule, the pain is constant and is described by patients as pressing or burning. When palpating the right hypochondrium, the pain intensifies.
In some cases, acholic stool is observed (the stool becomes light-colored).
Urine becomes dark brown.
Yellowness of the skin and mucous membranes.

The symptoms listed above are common to all hepatitis. However, each type of hepatitis has its own distinctive features. Pain in hepatitis mainly occurs due to an increase in liver volume and stretching of the capsule. It is in the liver capsule that there are pain receptors that respond to its mechanical stretching. Changes in the color of feces and urine are associated with a violation of the metabolic processes of bilirubin, which leads to a decrease in the excretion of bilirubin in the bile, while bilirubin is excreted mainly in the urine, giving it a special color.

Viral hepatitis - what are the mechanisms of infection?

Viral hepatitis B, C, D are transmitted through blood or biological fluids (blood and blood components, semen, vaginal lubricant):
When transfusion of blood or its components
During unprotected sexual intercourse (oral, anal or genital).
Injecting drug use
When carrying out certain medical procedures (injections, IVs), during operations or dental procedures.
When using non-sterile instruments when applying tattoos, piercings, manicures.
Sharing certain household items: razors, toothbrushes, depilatories.
Viral hepatitis A and E are primarily transmitted through food. That’s why in a number of countries this disease is called “dirty hands disease.”

Diagnosis of liver inflammation

First, let's look at the laboratory and ultrasound signs of hepatitis common to all types of hepatitis.

Increased transaminases. Identification of enzymes of a nonspecific inflammatory reaction - increased levels of transmaminases AlAt and AsAt. These enzymes are released into the bloodstream during an inflammatory reaction in any tissue of the body. However, with the massive death of liver cells, it is the ALT level that increases significantly, which is why this indicator is so important for the doctor when conducting diagnostics. The level of transaminases provides information about the extent of damage to body tissues.

Increased bilirubin levels is a sign specific for hepatitis. The fact is that bilirubin is a product of heme processed by the liver (a structural component of hemoglobin). Bilirubin is excreted in the form of bile acids in the bile into the intestinal lumen. During the period of liver inflammation, liver tissue does not work fully, therefore the volume of processed bilirubin falls, which leads to an increase in the level of total and unbound bilirubin in the blood. It is worth noting that it is precisely the dysfunction of bilirubin processing that is associated with the appearance of three clinical symptoms of hepatitis:

Clarification of stool (normal formation of bile does not occur, which leads to impaired breakdown of fats)
darkening of urine, which contains high concentrations of bilirubin, which is excreted mainly in urine
yellowness of the skin is also a common symptom of bilirubin intoxication - in this case, bilirubin is deposited in the skin.

Read more about deciphering a blood test for liver inflammation in the article: Blood test for liver diseases .

Ultrasound of the liver detects an increase in liver volume at the initial stage of the disease, allows you to exclude or confirm the presence of cancer as the cause of liver failure. In the later stages, an ultrasound examination allows you to dynamically monitor the development of hepatitis and identify signs of its transition to cirrhosis. Also, with the help of an ultrasound examination, it is possible to diagnose the condition of the bile ducts (often the cause of jaundice and inflammation of the liver is an exacerbation of cholelithiasis).

Diagnosis of autoimmune hepatitis

Basically, this diagnosis is made on the basis of laboratory tests:

Microscopic examination of a liver biopsy reveals a specific pattern of liver damage. In this case, using a special needle, a puncture is made in the liver area and a piece of the liver is taken. Subsequently, this fragment is treated with special reagents and examined under a microscope.
Detection of gamma globulin G levels increased by at least 1.5 times the upper limit of normal.
Detection of anti-smooth muscle, anti-nuclear and anti-mitochondrial antibodies in high titer - more than 1:80.

However, in addition to these examinations, the patient may show all laboratory signs of inflammation of the liver tissue and signs of liver failure.

Diagnosis of viral hepatitis B

Diagnosis of infection activity is carried out using laboratory research methods.
In the diagnosis of this type of hepatitis, serological blood tests, as well as the results of PCR studies, are of greatest value. Serological studies are usually carried out using an enzyme-linked immunosorbent assay (ELISA).

Laboratory diagnostics are carried out to detect either fragments of the virus itself or antibodies to these fragments.

HbsAg- detection of this “Australian antigen” indicates infection with the hepatitis B virus. In this case, the structural component of the virus itself is revealed. If this antigen is detected in the patient’s blood for more than 6 months, we can conclude that no cure has occurred and the disease has become chronic.

Anti HbsAg– this analysis determines the presence of antibodies to the same viral antigen HbsAg. Therefore, the determination of these antibodies is an important indicator of infection with the hepatitis B virus, and also provides information about the activity of specific humoral immunity against this virus. The study allows us to assess the fullness of immunity and the need for vaccination. Anti HbsAg can be detected for a long time after the disease has been cured.

Anti HbcAg are detected from the onset of clinical manifestations of the disease and continue to be consistently detected throughout the entire period of the disease - at any stage. Laboratory studies detect these antibodies in two classes:
IgM- early antibodies that are synthesized in the early stages of the immune response. These antibodies indicate recent infection or highly active infection. They can also be detected during an exacerbation of the process of viral infection.
IgG- these antibodies are formed several months after initial contact with the virus, but they can be present in the blood for a long time even after treatment, providing lasting immunity to infection. Even after treatment, these antibodies remain in the human blood for a long time, which indicates the formation of stable immunity. If IgM is not detected against the background of a stable IgG titer, this indicates the formation of stable immunity.
Total Anti HbcAg is a quantitative summary indicator of the number of antibodies of different classes of IgM + IgG.

HbeAg- its detection indicates a high activity of viral infection. Detection of high activity of viral infection requires immediate antiviral treatment. Patients who have been diagnosed with HbeAg are considered dangerous for the transmission of viral infection and must take special precautions.

Anti-HbeAg– this indicator indicates the formation of full immunity against viral hepatitis B. If antibodies to HbeAg are detected, the risk of infection of surrounding people by such patients is low.

For a more visual representation of the dynamics of the titer of various markers of viral hepatitis B, we present you with a graph of the most frequently occurring laboratory parameters.

Diagnosis of viral hepatitis C

Serological studies are carried out by enzyme-linked immunosorbent assay (ELISA). In the diagnosis of hepatitis C, the presence and quantity of specific Anti-HCV antibodies are determined.

Anti-HCV- these antibodies come in two types: IgM and IgG. The analysis can also determine the total amount of antibodies Anti-HCV total = IgM + IgG.

Detection of antibodies to the hepatitis C virus is possible within 4-6 weeks after infection. At this time, class M antibodies (IgM) are formed and actively circulate in the blood. After some time, IgG synthesis starts. As a rule, this occurs 11-12 weeks after the initial infection. At the same time, long-term detection of Anti-HCV class M indicates a high activity of the viral infection and the transition of the disease to a chronic form. In chronic hepatitis, periodic detection of Anti-HCV class M indicates exacerbations of viral liver damage.
To illustrate the dynamics of antibody titer against the hepatitis C virus, a figure is presented.

Restoring liver function primarily involves restoring the cellular composition of the liver while maintaining the microscopic structure of the liver tissue. Of particular importance for the performance of the functions assigned to the liver is its microscopic structure. Read more about the anatomy and physiology of the liver in the article “Liver”. This is achieved thanks to drugs from the group of hepatoprotectors and diet.

Hepatoprotectors that are prescribed for hepatitis:

Essential phospholipids – these substances are structural components of the cell wall of hepatocytes (liver cells). Therefore, their intake from the outside significantly accelerates the processes of restoration of the damaged hepatocyte cell wall and the processes of regeneration of liver tissue.

Silymarin – this drug prevents the damaging effects of free radicals that are formed during the massive destruction of hepatocytes, which prevents the avalanche-like increase in liver tissue necrosis. This drug also interferes with the metabolic processes of hepatocytes, which accelerates the processes of regeneration and restoration of damaged hepatocytes.

Ademetionine – this drug simultaneously has several beneficial effects: it activates plastic processes in the cells of the liver and brain, optimizes oxidative processes in cells, and accelerates the processes of excretion of synthesized bile. The drug is often prescribed for toxic (including alcoholic) hepatitis and cholelithiasis. However, even in case of viral infection, the drug has a stable hapatoprotective effect.

Ursodeoxycholic acid – the drug interferes with the metabolic processes of cholesterol, which leads to a decrease in its concentration in bile. Changing the composition of bile leads to an improvement in the process of bile outflow and prevents cholestasis. As a rule, it is prescribed for cholelithiasis.

For detailed information on treating the liver with hepatoprotectors of plant origin, read the section: Hepatoprotectors.

Antiviral treatment of infectious hepatitis

Depending on the type of virus affecting the liver, its genotype, the dynamics of the disease and the stage of hepatitis at which the patient seeks help, treatment is prescribed. The treatment regimen is prescribed individually by a hepatologist or infectious disease specialist. As a rule, antiviral treatment consists of combining several types of drugs (interferon and an additional antiviral drug).

Naturally, antiviral treatment is carried out against the background of a course of treatment with hepatoprotectors.
Interferons are used in the treatment of viral hepatitis C and B. Currently, conventional alpha interferons and pegylated alpha interferons are used in the treatment of hepatitis. There is no difference in their mechanism of action. However, there is a significant difference between them in the duration of the created effect. Pegylated interferons have a much longer therapeutic effect when administered - this is due to the peculiarities of the chemical structure of interferon. Regular interferon will have to be administered every other day, but pegylated interferon should be administered no more than once a week.

In the treatment of hepatitis C The most widely used treatment regimen is using pegylated or conventional alpha interferon and ribavirin.

Ribavirin has a suppressive effect on the reproduction of viruses. Penetrating inside a virus-infected cell, the drug interferes with the formation of messenger RNA, through which the structural elements of viral particles are assembled. This leads to a significant reduction in the virus population (viral load), and in combination with interferon can even lead to the destruction of hepatitis C viruses.

In the treatment of hepatitis B A scheme using alpha interferon and an antiviral drug (nucleoside and nucleotide analogues) has become widespread.

Nucleotide analogues block the enzyme reverse transcriptase of the virus, which leads to stopping the process of copying maternal DNA information. This effect significantly reduces viral replication, resulting in a significant reduction in viral load.

Diet for hepatitis

With hepatitis, the liver experiences a double load - damaging factors prevent it from working normally. Inflammation of the liver tissue impairs their blood supply and the excretion of synthesized bile. At the same time, viruses mercilessly invade hepatocytes, destroying them from the inside. As you know, the liver is the main terminal of nutrients coming from the digestive tract, therefore the dynamics of the disease and the general condition of the patient largely depend on a balanced diet.
Some dietary recommendations:

2. Reducing the consumption of fatty foods. The fact is that in conditions of liver failure, bile production is reduced, so the breakdown of fats is difficult. It is recommended to consume lean meats (chicken breast, beef, veal, rabbit), and low-fat fish (cod, pike perch, pike). After digestion in the intestines, further processing of fats occurs in the liver, and this process is quite energy-consuming. Animal fats and margarine should not be consumed; butter should be limited.

3. It is necessary to enrich the diet with products containing substances with antioxidant properties (vitamins A, C, E, glutathione, lipoic acid). It is better that your body is enriched with these microelements through fresh fruits (citrus fruits, strawberries, kiwi, lemon) and vegetables (carrots, bell peppers, cucumbers, tomatoes), herbs and nuts.

5. It is advisable to exclude pickles, sauerkraut, legumes, sorrel, garlic, onions, and parsley. The diet should be enriched with fresh vegetables and fruits; consumption of borscht and soups with low-fat broth is recommended.

6. Honey, jam, marmalade can be consumed. However, you should avoid chocolate, cakes and ice cream.

7. Spicy seasonings, smoked meats, and mayonnaise should be excluded.

Complex treatment with the use of hepatoprotective drugs and diet prepares the liver for a stubborn battle against a viral infection. For toxic hepatitis, these measures are in most cases sufficient to achieve clinical cure.

In conclusion, I would like to draw your attention to the fact that the diagnosis of any type of hepatitis is not a death sentence. Without exception, all types of hepatitis can be cured. However, the outcome of the disease largely depends on you. The most difficult to cure at the moment are viral hepatitis B and C. These infectious lesions often lead to the development of cirrhosis or an oncological process in the liver. But timely seeking help and adequate treatment in most cases lead to the cure of the disease or the transition of the infectious process to an inactive form.

What to do if you are diagnosed with hepatitis C?

If you have been diagnosed with hepatitis C, the first thing you need to do is pull yourself together. Remember, in most cases this disease is curable. Then proceed according to plan.

1. It is necessary to retake the tests. It may happen that you were diagnosed with hepatitis C in error. Therefore, it is better to retake the tests in another laboratory. The main ones at this stage are:

• PCR-qualitative - polymerase chain reaction to determine sections of the RNA of the hepatitis C virus.

If the test results repeatedly indicate the presence of the virus in the blood, then a more detailed examination is necessary.

2. Ultrasound of the abdominal organs and advanced tests.

• Ultrasound gives an idea of ​​the condition of the liver and other organs functionally related to it.
• Serological blood test for the presence of antibodies against the hepatitis C virus (anti-HCV).

3. Determination of the type of virus and its amount in the body. Based on the results of these tests, the doctor will plan antiviral treatment.

• PRC-quantitative - the higher the concentration of viral RNA in the blood, the more severe the disease.
• Genotyping - the type of RNA determines what type and subtype the virus belongs to. Its genotype influences the course of the disease and the likelihood of it becoming chronic.

Once you have the research results in hand, you can begin searching for a qualified infectious disease hepatologist. An experienced doctor will individually select a treatment regimen for you that will help overcome the disease and minimize side effects from taking medications.

How to treat viral hepatitis using traditional methods?

Treatment of viral hepatitis with traditional methods is aimed at reducing the toxic effects on the liver and increasing the body's resistance.

Plant	Properties	Mode of application
Milk thistle	Milk thistle fruits contain silymarin. This biologically active substance binds to groups of free radicals that damage the liver. By taking a decoction, you protect liver cells and promote their regeneration.	You can use ready-made milk thistle flour or grind the dried seeds in a coffee grinder. Take 1 tsp. 3 times a day half an hour before meals. Take 150 ml of water. The course of treatment is 5-7 weeks.
Dandelion root	Has antiviral properties. Biologically active substances remove poisons and toxins from the body, facilitating the functioning of the liver. They also stimulate the entire gastrointestinal tract.	Dandelion root is dried in a dark place and calcined in the oven until it turns golden brown. 1. Uncomplicated hepatitis. The roots are ground in a mortar or coffee grinder and used to prepare an infusion. 2 tsp Pour the powder into a glass of boiling water. Leave for 8 hours. Take 1/3 cup 3 times a day. 2. Hepatitis accompanied by cirrhosis. 1 tsp powder, pour 300 ml of water and boil for 5 minutes. Cool and drink 100 ml 20 minutes before meals. Course 2 months. After a two-week break, resume treatment.
Liquorice root	Glycyrrhizic acid stimulates the synthesis of interferons, which ensure the fight against the hepatitis virus. Prevents the development of cirrhosis and liver cancer.	You can use ready-made pharmacy syrup. 2 tsp dissolve in a glass of water or tea. Consume 2 times a day after meals. Infusion of licorice root: 2 tablespoons of crushed dry root pour 0.5 liters of boiling water. Leave for 2 hours. Strain and drink 0.5 cups 2 times a day, 20 minutes before meals. Duration of treatment is 4-6 weeks.

It is necessary to treat viral hepatitis with traditional methods under the supervision of a doctor. Herbal medicine should be carried out in parallel with the main treatment. In this case, the chances of recovery are significantly increased.

Should you get vaccinated against hepatitis B?

Since 2002, vaccination against hepatitis B has been included in the list of mandatory vaccinations for children. It is especially necessary for certain categories of children and adults:

• people on hemodialysis;
• household members of a patient with chronic hepatitis B;
• people who often change sexual partners;
• medical workers and medical students;
• people working with blood and its preparations;
• people who use injection drugs.

Vaccination is recommended for newborns. Therefore, whether it is worth getting vaccinated against hepatitis B, young parents decide already in the maternity hospital. The starting dose of the vaccine is administered in the first 12 hours of the child’s life. Subsequently, at 1 month and at 6 months, the vaccine is administered again. Thus, the scheme looks like this: 0-1-6 months.

After three injections, a person develops a strong immunity - if infection does occur, then in 95% of cases the disease will not develop. The hepatitis B virus will be met and neutralized by specific antibodies that were developed after vaccination. Strong immunity lasts 20 years, but often remains for life.

The vaccine contains the protein of the hepatitis B virus. There are no live pathogens that can cause the disease in the preparation. But in some cases (8-23%) adverse reactions may occur - pain and hardness at the injection site and a slight increase in temperature.

The fears of some parents that vaccination can cause jaundice in newborns are unfounded. Yellowness of the skin in children on days 2-8 of life is a physiological condition associated with the process of adaptation of the child to new conditions. During this period, fetal hemoglobin is replaced with regular hemoglobin.

The decisive argument in the question: “why is it worth getting vaccinated against hepatitis B?” – this is the level of domestic medicine. Unfortunately, a mistake by medical personnel when performing medical procedures, during which damage to the skin and mucous membranes is possible, sometimes leads to hepatitis infection.

What to do if you have hepatitis at home, what are the preventive measures? How dangerous is he to others?

If the rules of hygiene are observed, a patient with chronic hepatitis is not dangerous to others, therefore, with the permission of a doctor, he can be treated at home. People with acute viral hepatitis tend to shed viruses more actively, but in some cases they may also be treated as outpatients. Patients and their households need to learn and strictly follow preventive measures to prevent the spread of infection.

Prevention of viral hepatitis A and E

The patient excretes the virus with feces, and through dirty hands the pathogen gets onto household items and products. The virus is not transmitted through talking, hugging, kissing, or sexual contact.

Prevention of viral hepatitis B, C, D, G

The disease is transmitted when the patient’s blood enters the bloodstream and damaged skin of a healthy person, as well as through sexual contact. In addition, the hepatitis virus is found in saliva, tears, urine and feces, but if these substances come into contact with the skin, the risk of infection is much less.

Hepatitis is not transmitted by airborne droplets, so you cannot become infected by talking, coughing or sneezing. There is no danger when shaking hands, hugging, eating or drinking, or using a shared bathroom or toilet.

• There is no need to isolate a patient with chronic hepatitis B, C, D, G in a separate room.
• Personal hygiene products: razors, toothbrush, washcloth, comb, epilator, manicure and hairdressing supplies, etc. These items must be stored separately and disinfected by soaking in 4% hydrogen peroxide for 20 minutes. To wipe objects or surfaces use “Steranios – 20%”.
• Disinfection in the apartment. It is carried out after diagnosis and daily while the patient is at home. Disinfect all objects that may come into contact with the patient’s blood or other biological fluids. For disinfection, use Steranios - 20%, 1% chloramine solution or other disinfectants that affect viruses.
• It is advisable to use personal utensils. There is a small chance of infection if there are abrasions on the oral mucosa. For disinfection, washing in hot water with detergents is sufficient.
• Triple vaccination in addition to unvaccinated family members with the hepatitis B vaccine. The vaccine is administered three times with an interval of 1 month.
• Medical observation of contacts. Once every 2 months for six months, the doctor examines all family members. A blood test is also performed to detect the hepatitis virus.
• Injury and blood must be avoided(and other biological fluids) of a patient onto the skin and mucous membranes of a healthy person. If you need to treat his wound, you need to wear rubber gloves.
  Objects that have come into contact with blood are treated with chlorine-containing detergents. Clothes are boiled or washed at 60 degrees for 30 minutes.
  If healthy family members have skin damage on their hands (injuries, dermatitis, burns), then it is necessary to take precautions: cover with adhesive tape, use a fingertip or rubber gloves.
• Use of barrier methods of contraception. Without condoms, the risk of infection is 30%.

What is the cost of treatment for viral hepatitis?

The cost of treatment for viral hepatitis depends on the type of virus and the form of the disease. Therapy is often very expensive. Patients should know that The law provides for free and preferential programs for the diagnosis and treatment of hepatitis. But, unfortunately, in practice, you often have to pay for tests and treatment yourself.

Ways to get free hepatitis treatment

• Free tests and treatment as part of compulsory health insurance. In each region there are regional hepatology centers that are equipped with equipment and drugs for the treatment of hepatitis. In order to get there, you need a written referral on a special form from the infectious disease specialist at the district clinic.
• Free treatment using funds allocated from budgets at various levels to combat hepatitis.
• Participation in clinical trials of new antiviral agents conducted by various pharmaceutical companies.
• Free receipt of antiviral drugs as part of “state social assistance provided in the form of providing citizens with a set of social services” (Chapter 2 of RF Law No. 122 of August 22, 2004 on the monetization of benefits). This right can be exercised by:
  • disabled children
  • disabled war veterans
  • combat veterans
  • participants of the Great Patriotic War
  • persons awarded the badge "Resident of besieged Leningrad"
  • family members of deceased war invalids, World War II participants and combat veterans and some other categories of citizens.
• Additional medical insurance (VHI) within the framework of programs providing compensation for the costs of hepatitis treatment.
• Treatment on preferential terms for certain groups of people (medics, indigenous peoples of the Russian Federation), however, such programs do not operate in all regions.
• Free treatment of viral hepatitis in HIV-infected people.

If you fail to obtain the right to free treatment, which, unfortunately, often happens, you will have to undergo treatment at your own expense. An infectious disease specialist will draw up a treatment regimen for you, and you will buy the drugs yourself.

Cost of treatment for viral hepatitis A

For 2-3 months they take drugs to remove toxins, hepatoprotectors and multivitamins. In general, the cost of such treatment can range from 3 to 10 thousand rubles, depending on the drugs chosen.

Cost of treatment for viral hepatitis B

In acute hepatitis B, detoxification medications and supportive care for the liver are required for 6-8 weeks. The cost of such treatment averages 6-15 thousand rubles.

Chronic hepatitis B requires complex treatment using interferons and drugs that reduce the replication of the virus. The cost of the course can reach up to $2400-19200, depending on the form of the disease and the chosen treatment regimen.

Cost of treatment for viral hepatitis C

The average duration of treatment for chronic hepatitis C is about 1 year. Depending on the selection of drugs, the patient spends $500-2500 per month or $6600-30000 per year.

What are the consequences of hepatitis A?

In the vast majority of cases, the immune system completely copes with the hepatitis A virus in 30-40 days and recovery occurs. However, people with severely weakened immune systems may experience unpleasant consequences from hepatitis A.

• Chronic form of hepatitis A. Develops in 15% of patients. In this case, the virus remains in the liver for 6-9 months. However, unlike other viral hepatitis, the liver does not develop scar and fatty tissue. Therefore, after treatment, the liver restores its function.
• Fulminant form of hepatitis A, accompanied by hepatic coma. In 0.1% of patients, the virus causes rapid death of a large number of liver cells. Liver failure develops, which is accompanied by toxic brain damage. An anxious cry appears, the patient falls into a coma. Breathing is rapid, heart rate is accelerated, and individual muscle spasms appear. With this development of events, the probability of death is high. This form develops in patients over 45 years of age.
• Relapses of hepatitis A develop in 10-15% of patients . Symptoms may reappear 1-3 months after the illness. In some cases, there are no symptoms, but laboratory tests deteriorate significantly: ALT and AST activity levels are increased. This happens in people 20-40 years old.
• Autoimmune hepatitis develops in patients with impaired immune system function (3-5%). They produce antibodies to smooth muscles, to a specific liver lipoprotein, which attack the cells of the organ. In this case, hepatitis A lasts for several months, in addition to jaundice and changes in the liver, a rash appears on the skin, damage to the heart and colon, and there is no menstrual bleeding. Women are predominantly affected at a young age.
• Inflammatory diseases of the biliary tract(15-20% of those who have recovered): biliary dyskinesia, cholecystitis. The inflammatory process from the liver spreads to the bile ducts. This can cause them to narrow and interfere with the flow of bile from the gallbladder, which leads to its inflammation. As a result of stagnation of bile, gallstones can form.

Cirrhosis and liver cancer do not develop after hepatitis A.

How to restore the liver after hepatitis A?

Following a daily routine, diet and herbal medicine will help restore the liver after hepatitis A. Rehabilitation may take 3-6 months. If you follow all the doctor’s recommendations, healthy hepatocytes are formed in the liver parenchyma.

• Need more rest. In a supine position, blood flow to the liver increases, metabolic processes and cell restoration improve.
• Avoid physical activity. Minor housework is allowed. Lifting heavy objects is prohibited. Maximum weight 1-2 kg.
  Significant exercise and sports will have to be postponed for 2-3 months. You can start using them only after your doctor’s permission.
  In the physical therapy room you will be shown a set of exercises that improves hepatic circulation and promotes liver recovery after hepatitis.
• Avoid overheating. Direct sunlight is contraindicated on a hot day. You should also refrain from visiting baths and saunas.
• Taking medications as prescribed by a doctor. Most chemicals are inactivated and eliminated by the liver. This creates additional stress on the organ and can cause drug-induced hepatitis.
• Avoid alcohol completely. For the first months after recovery, any alcoholic beverages, including beer, are prohibited. Alcohol has a toxic effect on the liver and slows down its recovery.

Traditional methods that will help restore the liver after hepatitis A

• St. John's wort flowers, calendula and crushed chicory roots mixed in equal proportions. In the evening 2 tbsp. pour the mixture with 2 glasses of cold water. In the morning, boil the infusion for 5 minutes and strain. Drink in small portions throughout the day. The course of treatment is 2 months. This herbal mixture stimulates bile formation, eliminates inflammation and accelerates liver regeneration.
• Oat decoction. 1 cup of oats is poured with a liter of boiling water. The water is evaporated over low heat until 1/4 of the volume remains. Drink the remaining liquid, one-third of a glass, 4 times a day. The course of treatment is 2-3 months. Oat decoction binds and removes toxins and stimulates the formation of new hepatocytes.
• Decoction of sandy immortal. 25 g of herb (2 tbsp.) Pour a glass of boiling water. Half the liquid volume is evaporated. The remaining broth is filtered and taken 1/4 cup 4 times a day half an hour before meals. Consume 2-2.5 months. Immortelle contains flamin, which has a choleretic and anti-inflammatory effect.

Herbal factories produce herbal preparations to restore the liver. They are affordable and contain a verified and repeatedly tested composition of plant materials.

What diet is needed for viral hepatitis?

For hepatitis, table No. 5 (Pevzner diet) is recommended - this is a complete healthy diet with a limit on fatty foods. It is also necessary to avoid cold dishes, foods that enhance fermentation, containing purines and oxalic acid.

• Eat food 5 times a day in equal small portions.
• The menu should contain about 100 g of protein, 80 g of fat and 400 g of carbohydrates. Liquid volume up to 3 liters.
• Boil, steam, bake, and occasionally stew. Fried foods are excluded.
• When serving, dishes should be warm.

Recommended products for hepatitis

• Soups. Dairy, vegetarian, sometimes with secondary broth: the first water is drained after 10 minutes of boiling. Vegetables and grains are added to soups. For dressing, you can use sour cream (10 g) or butter (5 g).
• Cereals: rice, buckwheat, oatmeal, semolina. Porridge is cooked in water or half and half with milk. They should be liquid or viscous in consistency. Boiled pasta is allowed.
• Meat. Low-fat varieties: beef, veal, rabbit, chicken. The fat and skin are cut off. Soft meat is prepared in pieces. Products made from minced meat without adding lard are recommended: beef stroganoff, cutlets, meatballs. In limited quantities, cabbage rolls and dumplings without spicy sauce. Milk sausages once a week.
• Fish. Low-fat species: pike perch, cod, tuna, hake, pollock. Up to 3 times a week. Small quantities of oysters, squid, mussels, lightly salted salmon.
• Eggs no more than 1 per day: soft-boiled, steamed egg white omelettes.
• Vegetables. Potatoes, zucchini, beets, carrots, tomatoes (in limited quantities), onions. All vegetables must be peeled. After this, it is advisable to boil or bake them.
• Dairy with a low fat content of up to 2%: milk, yogurt, kefir, low-fat cottage cheese and products made from it.
• Fruits and berries: sweet apples, bananas, pomegranate, dried fruits.
• Bread: yesterday's or dried, dry sponge cake.
• Dessert. Caramel, marshmallows, marmalade, honey, dry or biscuits.
• Beverages. Rosehip decoction, weak tea, diluted juices, fruit drinks, jelly.

Diet for viral hepatitis excludes

• Broths strong rich mushroom, meat and fish, as well as soups based on them.
• Cereals. Millet, pearl barley, corn and barley cereals, peas, beans, lentils.
• Meat. Fatty varieties: pork, lamb, goose, duck, liver, brains.
• Fish. Fatty varieties: sardine, tuna, trout, mackerel, salmon, caviar, shrimp.
• Dairy: cream, full-fat sour cream, yogurt, cheeses.
• Vegetables. Cabbage, sweet peppers, radishes, radishes, green onions, sorrel, garlic, spinach, parsley, pickled vegetables, mushrooms. Salted, pickled and canned vegetables are prohibited.
• Fruits and berries. Pears, sour apples, gooseberries, raspberries.
• Dessert. Chocolate, cream confectionery, butter and puff pastries.
• Beverages. Strong tea, coffee, carbonated drinks, alcohol.
• Seasonings and spices. Pepper, horseradish, mustard.

Strictly prohibited

• Alcohol;
• canned food;
• smoked meats;
• fried foods.

What is the incubation period for hepatitis?

The incubation period is the time that passes from the moment the virus enters the body. During this time, the pathogen penetrates the liver and begins to multiply in its cells.

Type of virus	Incubation period of hepatitis
Hepatitis A	15-30 days, variations from 7 to 50 days are possible.
Hepatitis B	From 50 to 180 days. On average about 85 days.
Hepatitis C	45-60 days. In some cases, the incubation period of hepatitis C ranges from 14 to 180 days.
Hepatitis D	4-5 days if infection with hepatitis B and D viruses occurred simultaneously. The incubation period of hepatitis D increases to 20-50 days if the virus enters the body of a patient with hepatitis B.
Hepatitis E	On average 40 days, in practice it can range from 20 to 60 days.
Hepatitis F	It practically never occurs on its own; it accompanies hepatitis A, B and C. It can somewhat shorten their incubation periods.
Hepatitis G	14-20 days, in some patients it increases to 30 days.