GeneralChronic hepatitis - a disease that is characterized by inflammation and necrosis of the liver parenchyma, persisting for six months or more. In mild cases, the disease does not progress or progress slowly. In severe cases of chronic hepatitis leads to progressive fibrosis and cirrhosis of the liver. Allocate chronic viral hepatitis, chronic toxic hepatitis, chronic autoimmune hepatitis, idiopathic chronic hepatitis. In addition hepatitis can develop in hereditary metabolic disorders. Clinical manifestations of chronic Hepatitis B are very similar.
Causes of the diseaseChronic viral hepatitis can cause hepatitis B, C, D. Diagnosis and treatment of these diseases are described in the relevant sections.
Reasons chronic autoimmune hepatitis is not completely clear. Typically, there is a genetic predisposition to autoimmune diseases. In laboratory studies are found in the blood of autoantibodies to various proteins of the liver. These antibodies, via binding to the target and cause damage to liver cells.
Chronic alcohol abuse - one of the main causes of toxic hepatitis. In addition, chronic toxic hepatitis can occur with prolonged use of drugs which have hepatotoxic action (halothane, methyldopa, carbamazepine, isoniazid and other antituberculosis drugs, sodium valproate, zidovudine, captopril, indomethacin). Currently there are more than 1,000 medical drugs that cause drug in the treatment of hepatitis. From time of exposure to the drug prior to the development of hepatitis varies from a few days to a few years.
SymptomsClinical manifestations of hepatitis depends on the degree of disturbance of liver function. In the initial stages can be changed only laboratory values (elevated liver enzymes ALT, AST). In the later stages, after the accession of liver failure, there is a general weakness, nausea, tightness in the right upper quadrant, jaundice with pruritus, increased liver.
DiagnosticsIf you suspect a chronic liver disease doctor conducts a thorough examination with palpation of the abdomen, and the definition of the size of the liver and spleen, collects detailed history (going to the doctor should make a list of all the medicines you are taking or have taken recently). Further analyzed for viral hepatitis (see related article), a detailed biochemical analysis of blood and indicators of liver function (ALT, AST, bilirubin, gamma-GGT, alkaline phosphatase, protein, albumin, and others), the analysis for autoantibodies. Spend an abdominal ultrasound, CT scan if indicated, a liver biopsy.
TreatmentThe tactics of treatment depends on the variant of chronic hepatitis.
In the treatment of viral hepatitis are alpha-interferons, corticosteroids, cytotoxic drugs, symptomatic therapy. Autoimmune hepatitis also require hormonal and cytotoxic therapy. In severe cases, the liver.
Treatment of toxic gapatitov based on the impact of the termination of the toxic factor. The fact that the liver is a unique body. It is able to restore its function even after a relatively heavy defeats. Therefore, termination of exposure to toxic agents in combination with hepatic reception in most cases allows to cure the patient. Repeated dose of drugs that have had a toxic effect, or the resumption of alcohol hepatitis can occur again.
PreventionPrevention of hepatitis B drug - it is a question that should be addressed. If your doctor prescribes any medication for a long period of time (anticonvulsants, antipsychotics, and other hormonal contraceptives.), Specify what side effects these drugs have. In the case of their liver toxicity must be discussed with your doctor how often to monitor the biochemical parameters of the liver (and kidneys if the drug has renal toxicity).
Prevention of autoimmune hepatitis is not developed.