Hepatitis A - What is this disease? Symptoms, treatment and prevention of hepatitis A

Everyone wants to be healthy. However, sad as it may seem, none of us ever manage to avoid illnesses. And the man who once proclaimed himself "the king of nature" becomes completely defenseless against the smallest living beings on our planet - various bacteria and viruses.

One of their huge number, dangerous to humans, is the causative agent of such a disease as Hepatitis A. "What is this disease?" - you ask. In the common people, it is known as Botkin's disease, or jaundice. In this article, we will discuss this disease, in particular, about what a virus-agent is, how one can get infected, what signs and symptoms should make you wary and turn to a doctor, and, most importantly, how to successfully fight it.

General information about the disease. What is the hepatitis A virus?

As already mentioned in the introduction, the causative agent of jaundice is the enterovirus, that is, the virus with an acid-resistant membrane that is not susceptible to the destructive environment of the stomach. It does not make any effort together, for example, with unwashed vegetables, fruits or contaminated water to pass a protective acidic environment in the stomach and enter the intestines, which causes disease of the carrier of the virus. For those who have a weak idea (or none at all) of a disease such as hepatitis A, what it is and how it is transmitted, we inform you: this pathogen has a powerful immunity to the aquatic environment, which often provokes its transmission through the liquid. There is also a pleasant news: the virus has a very high immunogenicity, which contributes to the formation of a permanent lifelong immunity after the disease.

Prevalence

The statistics impartially testifies that, despite the fact that some people do not even know what hepatitis A is, what kind of disease it is, this is the most common infection, among those that pose a danger to human health. In countries that have a warm climate and poor sanitation, the incidence of type A hepatitis is very high. According to official data, in Central Asian countries almost 100% of the children's population is ill with this infection. In Eastern European countries, the level of infection with jaundice is 1: 400, that is, for example, 250 out of 100,000 people get sick there every year.

Of course, everyone wants to avoid infection, especially such as hepatitis A. How is the virus that causes it transmitted? With a high degree of probability, you can get sick during a holiday in countries with a hot climate, including favorite places for recreation and tourism. These are African countries, including Tunisia and Egypt, Asian states and islands, among which there are popular among Russians Turkey and India, as well as countries of South-East and Central Asia. There is a risk of infection when traveling to South American states located in the Caribbean.

Ways and mechanisms of infection and development

Strangely enough, even without leaving the borders of our homeland, you can easily pick up hepatitis A. How is it transmitted in this case? Infectious agents can be on the surface of vegetables and fruits. Therefore, before you eat them, be sure to wash them thoroughly under running water and dry them. This will give, though small, but a guarantee that you will not get sick by eating an apple or a tomato. If you have a weakness for seafood, then when buying them fresh or frozen, remember: before they get to you on the table, they must undergo a thermal treatment, in which all the bacteria and viruses that are on their surface will die.

The main source of hepatitis A is a person who has caught this virus and contracted jaundice. Together with its feces, a huge number of viruses are released into the environment, the bill of which goes to billions.

If a person does not comply with the generally accepted rules of hygiene, uses infected water and food (especially in the case of thermally poorly processed seafood), the virus can enter the intestine, and then, sucked into the blood, along with it enters the liver and is implanted into the hepatocytes - its Cells.

The multiplication of the virus particles occurs in the cytoplasm of the liver cells, leaving them and entering the bile ducts, they, together with the bile, enter the intestine of the patient.

The inflammatory processes that begin in the liver, leading to damage and even destruction of hepatocytes - its cells, are of an immunological nature. T-lymphocytes, cells of the human immune system, attack liver cells that infected the virus by recognizing them. As a result, infected hepatocytes die, normal liver function is disrupted and hepatitis A develops. How this disease is transmitted, we said earlier.

Probability of infection

In developing countries, where the level of both economic and social development is low, jaundice is primarily a child infection. Most of the children in such countries get it by the age of 10 years and get a permanent lifelong immunity to this disease.

According to epidemiological studies, manifest forms in which jaundice, it is hepatitis A, the symptoms are typically manifested, are now much less common. More common is the course of infection in the so-called anemia-free form, in which it is impossible to diagnose the disease.

Residents of developed countries refer to jaundice as "a disease of dirty hands". The likelihood of infection is extremely low, which is facilitated by high-quality work of housing and communal services and high culture of the population. In this regard, most people do not have antibodies to the infection in the body, which makes the risk of infection very high.

Even those who do not know about a disease such as hepatitis A, what it is and how it is transmitted, are not immune from infection if they go on vacation and work in warm countries of Africa and Asia, while not following the generally accepted rules of hygiene.

If you need to find out the probability and risk of getting sick, and also decide on the introduction of the vaccine, you should donate blood for an analysis that detects antibodies to the hepatitis A virus - immunoglobulin G (anti-HAV IgG). If the result showed their presence in the biomaterial, then the person has immunity to the virus, the probability of infection is zero and vaccination is not required. In the event that antibodies have not been found, there is a risk of getting jaundice. To avoid this, you need to get vaccinated.

Who is at risk?

Epidemiologists distinguish several groups of people who are highly likely to be diagnosed with hepatitis A. What does this mean? If you identify yourself with any of the following groups, it is highly recommended that you pass an analysis for the presence of antibodies to the virus and, if necessary, get vaccinated. This list includes:

• Family members and family members of a person infected with the hepatitis A virus;
• Persons who have entered into intimate relations with patients;
• People (especially children) who live in places where hepatitis A is widespread;
• Persons who are sent to countries with a high incidence rate;
• Men who enter into homosexual intimate relationships.

When the house is sick. Answers to Common Questions

People who do not fully understand the specifics of such an infection as hepatitis A, what kind of disease it is and how it is transmitted, sometimes there are questions that require an answer within the framework of this article. Especially acute are these issues, when one of the family members gets jaundice.

First of all, most people are worried about the question: is it possible to not get infected with an infected person? Of course, yes, if you adhere to the generally accepted rules of hygiene. But it should be remembered that it is better to limit the contacts of children with the patient to a minimum, and ideally to stop until full recovery.

The second important issue concerns the possibility of contracting jaundice without a disease. In this case, a person does not become ill only if he has been vaccinated against hepatitis A and the level of antibodies in his blood is sufficient to fight the infection. If the antibodies in the blood are not present, but the virus has already got into it, then the person will inevitably get sick.

In order to protect themselves from possible infection in the short term or prevent the development of an illness in the event of infection, a special drug, an immunoglobulin, is administered to a person shortly before possible infection or within 14 days after it. Such a measure can be considered not only as one of the methods of treatment, but also as the prevention of hepatitis A. If you have already been ill with it, then the probability of re-transferring it is negligible.

As mentioned earlier, the detection of antibodies in the blood is able to assay for the presence of immunoglobulin G (anti-HAV IgG). Their presence indicates the infection or vaccination of a person. It is recommended that all members of the family where there is an infected person be examined for the presence of immunoglobulin in the blood, and vaccination if necessary.

And, of course, one should not forget the basic rules of hygiene: wash hands with soap after visiting the toilet, after taking care of young children, before cooking and eating.

Consequences of infection and duration of illness

If the virus of a person who has not been vaccinated gets a hepatitis A virus, he will inevitably get jaundice. However, it is rather difficult to accurately determine the time of infection, if it is not an epidemic, caused, for example, by an accident in sewerage networks.

The incubation period lasts about a month from the date of the alleged infection, after which hepatitis A begins to manifest itself. Symptoms by which it can be recognized to the layman are: fever, dyspepsia (disruption of the normal functioning of the stomach), discoloration of the skin.

After the appearance of jaundice is an improvement in the general condition and well-being of the patient. For 3-6 weeks, and sometimes longer, it holds, and after its disappearance, in most cases a person recovers. The following photo is intended for those who have not come face to face with an infection such as hepatitis A. What is it? The photo clearly shows how the skin of a sick person looks like in comparison with the skin of an infected jaundice.

Many are concerned about the danger of disease for certain people. The most difficult to tolerate hepatitis is children under 1 year, elderly people and adults. In the latter, infection is often accompanied by pronounced intoxication and jaundice, and its duration is on average about three months.

In most cases, a person is ill just over a month - 40 days. But the duration of the disease depends on many factors: this is the age of the patient, the state of his immunity, concomitant chronic diseases (their presence or absence). A very important role is played by the strict implementation of the recommendations and prescriptions that will be given by the doctor. In 15% of the total population chronic form of hepatitis is noted, which can last from 6 to 9 months.

The possibility of death and self-treatment

The question of the possibility of a lethal outcome in case of a disease is also of interest. Many people think that this is impossible, thinking: "Lethal outcome and hepatitis A? What is it? Jaundice? What kind of danger can it carry? "Indeed, the fatal outcome in this disease is a rarity, but it is possible if the infection is fulminant (fulminant). In this case, there is a rapid development of acute liver necrosis, which accompanies acute liver failure.

Statistics show that hepatitis A ends in a lethal outcome in 0.1% of the child population, 0.3% is the death rate from infection in adolescents and adults under 40, and already 2.1% in those over 40.

Often, patients and their relatives ask about the possibility of self-recovery of the patient without treatment. In most cases, this is the case, because modern methods of treatment are not aimed at fighting the virus. It will not surprise people who know the specifics of such an infection as hepatitis A, what it is and how it is transmitted, a treatment aimed at removing from the body harmful substances that appear as a result of damage and disruption of the normal functioning of the liver. The fight against the infection itself then falls on the patient's immune system.

Signs and symptoms of the disease, the time of their appearance, tests

As already mentioned above, the first signs on which it is possible to suspect the presence of a virus in the human body appear after about 30 days, but this period can vary from 15 to 50 days.

The first signs that should alert you are the deterioration of overall health, an increase in body temperature and significant changes in the color of urine. Sometimes after going to the toilet people do not understand what happened to her coloring, and are surprised, yet not suspecting hepatitis A, what is it. The photo of the color of urine, presented below, is a vivid example of how it looks like a sick person. As you can see, it resembles a strong brewed black tea and very much foams.

If you have these symptoms, you should immediately call a specialist. Remember that only a qualified doctor will be able to determine if the patient actually has hepatitis A. What is it? Symptoms in this case speak for themselves: the fever that accompanies the dyspeptic syndrome (nausea, a feeling of heaviness in the right hypochondrium and stomach, vomiting), weakness, darkening of the urine, of which we spoke earlier, jaundice (yellowing of sclera, skin, discoloration of feces ). When the latter appears, there is a slight improvement in the general condition and well-being of the patient. Similarly, there are other acute hepatitis of any type.

To identify a patient with the hepatitis virus, the biomaterial is taken from the blood in the blood, which shows the presence of antibodies, which belong to the immunoglobulins of class M (anti-HAV IgM). They can be detected only during a relapse (an acute period during the course of the disease), with an improvement in the patient's condition, their blood content becomes lower.

The process of diagnosis

The first point in this procedure is the elucidation of an epidemiological anamnesis that will allow either to confirm or to refute hepatitis A. What does this mean? The doctor finds out what places the person has visited during the last time, what food and water he used, whether there were contacts with the patient jaundice.

After this, the doctor in the daylight carefully examines the patient, noting:

• General health and condition of the patient, possible signs of intoxication;
• The presence of digestive disorders - dyspepsia;
• Presence of fever - fever, sweat, chills;
• Presence of jaundice of the skin, tongue, eyes.

This is how the skin of a person who is diagnosed with hepatitis A looks like, that this photo, presented below, clearly demonstrates.

In addition to all of the above, the doctor assesses the condition of all internal organs and patient systems in accordance with generally accepted diagnostic methods, both the color of the urine and the stool of the patient are noted. When palpation (probing) of the abdomen, an increase in the liver can be detected.

After that, the results of the tests, including:

• UAC - a general blood test;
• LHC - biochemical blood test;
• Kaogulogram - a blood test for its coagulability;
• OAM is a general urine test.

If antibodies to hepatitis A (anti-HAV IgM) are detected in the blood, which is accompanied by pronounced changes in the liver tests, the diagnosis of "hepatitis A" is fully confirmed.

Treatment and prognosis after recovery

In the previous parts, we talked about what hepatitis A is, what it is. How to treat it - this is the main question that worries all those who ran into it. If the disease is mild and moderate, then the body is able to cope with the infection itself that has got inside it. The main goal of the treatment in this case is to reduce the concentration of toxins and provide the liver cells with the material for their recovery and energy. An important part of the therapy is the introduction of detoxification solutions, glucose, vitamins and hepatoprotectors (drugs that protect liver cells). No antiviral treatment is performed. If the disease proceeds in severe form, then much attention is paid, along with disintoxication, and symptomatic therapy.

The above methods are the most modern for today. Together, these two therapies contribute to reducing intoxication, which occurs as a result of liver damage, diluting blood with toxins and removing harmful substances, eliminating the symptoms of the disease. All this leads to an improvement in the general condition and well-being of the patient.

During the relapse should follow the diet number 5 for Pevzner. This is a large number of vegetables, fruits, cereals, low-fat meat, fish and cottage cheese, egg white, soy, apples that give the body fiber, lipotropic substances, pectin. It also shows the consumption of large amounts of fluid and the observance of complete physical and mental rest.

Many parents do not know how to treat their child in case of infection, although they are well known, and sometimes not by hearsay, with a disease such as hepatitis A, what it is and how it is transmitted. In children, as we said earlier, the disease can be more severe than in adults. And although the tactics of treatment in a patient of any age are the same, it is strongly recommended that a pediatrician who examines the child and prescribes those drugs that will successfully fight the disease and not cause even greater harm to health.

After recovery, doctors, as a rule, give the most favorable predictions, as the normal functioning of the liver is restored in full.

Protection from disease: vaccination and its effectiveness

Earlier we talked about a virus that causes a disease such as hepatitis A, what kind of infection, how it is transmitted and how to treat it. It's time to talk and how to prevent it.

To date, the most effective method of preventing infection is vaccination, and several effective vaccines have been created that protect against jaundice at the proper level.

Such a vaccine is nothing more than killed hepatitis viruses with high immunogenicity. It is administered twice, and the interval between the first and second vaccination is from 6 to 12 months.

In most people, after the first dose of the vaccine was delivered, after about 14 days, antibodies appear ready to fight the virus. This method - to date, the most effective and, perhaps, the only prevention of hepatitis A.

The introduced vaccine stimulates the production of a large number of antibodies, which provides reliable protection against infection for both children and adults. The vaccine lasts from 6 to 10 years.

Who is vaccinated?

The vaccination against jaundice must necessarily be made to people who have not previously had hepatitis type A - and adults, and children, as well as those who have increased risk of infection.

Among them:

• Tourists and servicemen who are sent to areas with high incidence of hepatitis A;
• honey. Staff working in infectious disease departments;
• Persons working in preschool institutions;
• Employees of places of public catering and water supply.

Normative documents provide for the vaccination of children living in the territory where there is a high incidence rate. They start to administer the vaccine, starting from the age of 3 years. Vaccination is also mandatory for patients suffering from chronic liver diseases.

I want to believe that all of the above will help those who already had the misfortune to fall ill, cope with the infection, and those whom this misfortune will by-pass, make the right decision and defend against it in time. Be healthy!