Infection occurs from a patient with acute or chronic hepatitis B. The concentration of the pathogen in the blood of hepatitis B in the midst of the disease is very high: 1 ml of blood contains 1000000000000 viruses. One drop of this blood is enough to infect hundreds of people. Hepatitis B is transmitted not only blood but also in other biological fluids: saliva, vaginal secretions, semen. Therefore, the main routes of infection is hematogenous and sex. In addition, the virus can be transmitted from mother to child during childbirth.
Hepatitis B virus is extremely stable in the environment. In the dried stains of blood on the razor’s edge, the end of the needle virus can persist for weeks. After contact with the virus on broken skin and mucous membranes of another person is a risk of infection. Often doctors can be difficult to determine the route of infection the patient. After contracting hepatitis B can be stepped on an invisible needle from the syringe on the beach or clutching the handrail in transport.
High-risk groups are: drug users, practitioners promiscuity, health care providers, patients requiring dialysis or blood transfusions, prison inmates, family members of a person infected with hepatitis B. Even a single ignore the rules of safe sex, the sharing of sharps (manicure set, shaving machines), or the introduction of a narcotic substance stranger syringe can lead to infection with hepatitis B virus.
Special care is needed in hairdressing (during the manicure, pedicure), body piercing and tattoo salons, dental clinics.
However, it should be understood that in intact integument (skin, mucous membranes) The virus does not penetrate. This means that the contact-household by hepatitis B is transmitted. They can not catch the conversation, or with food. So for others with hepatitis B is not dangerous. He should not be in social isolation.
It is known that the character of hepatitis B depends on the age and the mode of infection. The transition to the chronic form of the disease is more common in infection by so-called natural means. In addition, chronic hepatitis often formed in young people: known pattern – than in younger patients become infected with hepatitis B virus, the more likely the formation of chronic hepatitis. The likelihood of chronic infection is much higher in children aged 1 to 5 years is 25-50% in children who contracted hepatitis during childbirth – 90%. That is why it is important to abide by the terms of vaccination in children.
Symptoms of hepatitis B
Infection with hepatitis B virus, in most cases lead to acute hepatitis B. Less commonly, people with lowered immunity or children infected at birth, acute hepatitis is not observed, and the disease assumes the character of primary chronic smoldering disease.
Latent (incubation) period for hepatitis B is from 2 to 6 months. Acute hepatitis B can manifest itself in different forms: subclinical or anicteric, jaundice, cholestatic and protracted.
The disease begins with fever, headache, general malaise, body aches. Symptoms of the disease appear slowly in the first stage are similar to the manifestations of acute respiratory disease. After a few days of decreased appetite, jaundice, right upper quadrant pain, nausea, vomiting, dark urine, feces discolored. Typically, after the appearance of jaundice condition of the patients improved. Gradually, over several weeks, there is a regression of the symptoms.
In most cases when an adequate immune response in acute hepatitis B ends in complete recovery (90% of cases). In asymptomatic, anicteric course, the disease can become chronic.
For chronic hepatitis B is characterized by enlargement of the liver, pain or a feeling of heaviness in the right upper quadrant, various dyspeptic symptoms, rarely revealed jaundice, itching, low-grade fever. Patients complain of loss of appetite, belching, nausea, bloating, unstable chair, general weakness, sweating, reduced ability to work. Chronic hepatitis B leads to a gradual withering away of liver cells and the proliferation of on-site dead cells of the connective tissue cirrhosis. Thus gradually the liver does not function in detoxification, protein synthetic and other.
Complications of hepatitis B
When actively progressive course of chronic hepatitis B, when the activity of liver transaminases is growing, the risk of transition hepatitis to cirrhosis can exceed 20%. The development of primary liver cancer is possible in 10% of patients with cirrhosis. If a person with chronic hepatitis B is also abuse alcohol, the frequency of the rapid formation of unfavorable outcomes of hepatitis is significantly increased.
Fatal outcomes in acute hepatitis B are possible with the development of fulminant (lightning) forms of the disease, in which cells die very quickly the liver, which is manifested in the form of severe acute liver failure. Fulminant forms are rare.
In passing hepatitis B to cirrhosis, possible death of the patient from the symptoms of the disease.
What you can do?
If you’ve been paying attention to the symptoms of hepatitis you or your loved ones, you should immediately consult a doctor.
Hepatitis B is a very dangerous disease. In this connection it should precisely follow the instructions of the doctor. Also an important part of therapy is dieting and complete abstinence from alcohol.
What can a doctor?
For the diagnosis of hepatitis B doctor usually collects detailed medical history and conducts a thorough examination of the patient. Suspicion of the disease the patient is prescribed blood chemistry (in hepatitis in the peripheral blood were found to increase the number of liver enzymes), a blood test for markers of HBV (HBsAg, anti-HBc IgM, anti-HBc total, HBeAg, anti-Hbe, HBV- DNA), abdominal ultrasonography and other studies.
Treatment of hepatitis B requires a comprehensive approach and depends on the stage and severity of the disease.
The treatment of any form of hepatitis include a special diet with restriction of greasy, salty, spicy, fried and canned food. Should exclude alcohol. In the case of acute hepatitis B is assigned only supports detoxification and therapy aimed at the elimination of toxins and restore the liver tissue. Antiviral treatment is not carried out.
For the treatment of chronic hepatitis B antiviral use of alpha interferon and nucleoside analogues. These drugs significantly reduce the rate of viral replication, prevent their assembly in the liver cells. Treatment lasts from 6 months to several years. Furthermore, hepatitis B may be used hepatoprotectors (drugs, protect liver cells) and means acting on the immune system.
However, to achieve a complete cure (cleansing of the body of the virus) in chronic hepatitis B with the help of modern techniques can be no more than 10-15% of cases. The task of the doctor – to do everything possible so that the patient was among them. If the disease is not running, then there is no cirrhosis, antiviral treatment that helps to restore the functions of the liver cells.
It should guard against unreliable and questionable treatments that promise a quick and full recovery. Unfortunately easy, fast and cheap method for the treatment of chronic hepatitis B does not exist yet. Drugs significantly affecting liver fibrosis (cirrhosis), liver (other than interferon) are not yet established.
Prevention of hepatitis B
Against hepatitis B protected only vaccinated persons and persons who previously had been ill with hepatitis B.
The most effective protection against infection and hepatitis B vaccination is. Now all children vaccinated against hepatitis B is planned, according to the immunization schedule (0-1-6 month of life).
It is compulsory immunization of adults at risk (including family members of patients with chronic hepatitis B, health care workers and medical students, all persons working with blood products and producing them, patients on dialysis or receiving blood products, etc.). Hepatitis B vaccination is recommended for all adults, because Earlier this immunization is not included in the calendar of mandatory vaccinations.
It should be borne in mind that in some cases may require re-vaccination.