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Hepatitis A after recovery. Various types of hepatitis during pregnancy. Areas with medium infection rates

Hepatitis A or Botkin's disease– spicy viral disease liver, which causes damage to organ cells. It is manifested by general intoxication and jaundice. Hepatitis A is transmitted through the fecal-oral route, which is why it is also called “dirty hands disease.”

Compared to other hepatitis (B, C, E), this disease is considered the most benign. In contrast, hepatitis A does not cause chronic damage and has a low mortality rate of less than 0.4%. In an uncomplicated course, the symptoms of the disease disappear within 2 weeks, and liver function is restored within a month and a half.

Both men and women of all ages are equally susceptible to the disease. Children from one to 10 years of age carry the disease to mild form, and infants and the elderly are severe. After the illness, a strong immunity remains, so people only get hepatitis A once.

Hepatitis A incidence statistics. According to WHO, 1.5 million people suffer from the disease every year. In fact, the number of cases is many times higher. The fact is that 90% of children and 25% of adults suffer from a hidden asymptomatic form of the disease.

Viral hepatitis A is common in developing countries with low sanitation^ Egypt, Tunisia, India, countries of Southeast Asia, South America and the Caribbean. Tourists going on vacation to hot countries should remember this. In some countries, the disease is so widespread that all children are ill before the age of ten. The territory of the CIS belongs to countries with an average risk of infection - 20-50 cases per 100 thousand population. Here, a seasonal increase in incidence is noted in August – early September.

Story. Hepatitis A has been known since antiquity under the name “icteric disease.” Large epidemics broke out during the war, when masses of people found themselves in unsanitary conditions, which is why hepatitis was also called “trench jaundice.” Doctors for a long time the disease was associated only with blockage of the biliary tract. In 1888, Botkin hypothesized that the disease has infectious nature, so it was subsequently named after him.
The hepatitis virus was identified only in the 70s of the twentieth century. At the same time, it became possible to create a vaccine that would protect against infection.

Properties of the hepatitis A virus

Hepatitis A virus or HAV belongs to the family Picornaviruses (Italian for “small”). It really differs from other pathogens in its very small size - 27-30 nm.

Structure. The virus has a round, spherical shape and consists of a single strand of RNA enclosed in a protein shell - the capsid.

HAV has 1 serotype (variety). Therefore after past illness Antibodies to it remain in the blood even when re-infection the disease no longer develops.

Sustainability in external environment. Despite the fact that the virus does not have an envelope, it persists in the external environment for quite a long time:

when drying on household items – up to 7 days;
in a humid environment and on food 3-10 months;
when heated to 60°C, withstands up to 12 hours;
When frozen below – 20°C, it is preserved for years.

The virus is neutralized by boiling for more than 5 minutes or with solutions of disinfectants: bleach, potassium permanganate, chloramine T, formalin. Considering the persistence of the virus, disinfection in the rooms where the patient was located must be carried out especially carefully.

HAV life cycle. With food, the virus enters the mucous membrane of the mouth and intestines. From there it penetrates the bloodstream and the liver.

From the moment the virus enters the body until the disease manifests itself, it takes from 7 days to 7 weeks. In most cases, the incubation period lasts 14-28 days.

Next, the virus penetrates into liver cells - hepatocytes. How he manages to do this has not yet been established. There it leaves the shell and is integrated into the ribosomes of cells. It rearranges the work of these organelles so that they create new copies of the virus - virions. New viruses enter the intestines with bile and are excreted in the feces. The affected liver cells wear out and die, and the virus moves into neighboring hepatocytes. This process continues until the body produces a sufficient number of antibodies that destroy the viruses.

Causes of hepatitis A

The transmission mechanism is fecal-oral.

A sick person excretes in feces environment a huge number of viruses. They can get into water, food, and household items. If the pathogen gets into the mouth of a healthy person susceptible to infection, hepatitis will develop.

You can become infected with hepatitis A in such situations

Swimming in polluted pools and ponds. The virus enters the mouth with fresh and sea water.
Eating contaminated foods. These are often berries that have been fertilized with human feces.
Eating raw shellfish and mussels from contaminated water bodies, where the pathogen can persist for a long time.
When using poorly purified water. Contaminated water is not only dangerous to drink, but also to use for washing hands and dishes.
When living together with a sick person, infection occurs through household items (door handles, towels, toys).
During sexual contact with a patient. This route of transmission is especially common among homosexuals.
At intravenous administration drugs with a non-sterile syringe. The virus circulates in the blood and is transmitted from one person to another through a needle.

Risk factors for developing hepatitis A

failure to comply with personal hygiene rules
staying in places large cluster people: boarding schools, barracks
staying in conditions where there is no running water or sewerage: refugee camps, field camps for military personnel
travel to areas with high incidence rates without prior vaccination
living with a person with hepatitis A
lack of access to safe drinking water

Symptoms of hepatitis A

Symptom	Development mechanism	How it manifests itself externally or during diagnosis
*The pre-icteric period lasts 3-7 days*
Signs of general intoxication appear at the end of the incubation period	The breakdown products of liver cells poison the patient’s body, including nervous system	Malaise, increased fatigue, lethargy, loss of appetite
Temperature increase. In the first days of illness in 50% of patients	The immune system's response to the presence of a virus in the blood	Chills, fever, temperature rise to 38-39
*The icteric period lasts 2-4 weeks*
Jaundice appears on the 5-10th day from the onset of the disease	The bile pigment, bilirubin, accumulates in the blood. It is a product of the breakdown of red blood cells in the liver. Normally, the pigment binds to blood proteins. But when liver function is impaired, it cannot “send” it into bile, and bilirubin returns to the blood	First, the mucous membrane under the tongue and the sclera of the eyes turn yellow, then the skin acquires a yellow, saffron color. This occurs when the concentration of bilirubin in the blood exceeds 200-400 mg/l With the appearance of jaundice, the temperature returns to normal
Darkening of urine	Excess bilirubin and urobilin from the blood are excreted through the kidneys in the urine	Urine takes on the color of dark beer and foams
Stool discoloration	With hepatitis, the flow of stercobilin with bile into the intestines decreases. It is a pigment from destroyed red blood cells that colors stool.	In the pre-icteric period, stool gradually discolors - it becomes spotted, then becomes completely colorless.
Pain in the right hypochondrium	Viruses infect liver cells and cause their death, and edema develops. The liver increases in size and stretches the sensitive capsule	Rubbing sensation, pain and heaviness in the right hypochondrium. The liver is enlarged; when palpated, the patient feels pain
Enlarged spleen	Associated with immune response to infection and enhanced clearance of toxins	When palpated, the spleen is enlarged
Dyspeptic phenomena	Digestive problems are associated with impaired liver function. Bile stagnates in the gallbladder and does not enter the intestines in sufficient quantities	Nausea, vomiting, heaviness in the stomach, belching, bloating, constipation
Pain in muscles and joints	Pain is associated with the accumulation of toxins caused by the death of the virus and liver cells	Body aches, muscle pain
Itchy skin	An increase in the level of bile acids in the blood leads to their accumulation in the skin and allergic reaction.	Dry skin that is accompanied by itching
*The recovery period lasts from 1 week to six months*
Symptoms gradually subside, liver function is restored

Treatment of hepatitis A

Treatment of hepatitis A with medications

There is no specific drug treatment for hepatitis A. Therapy is aimed at eliminating symptoms, removing intoxication and speeding recovery normal operation liver.

Group of drugs	Mechanism of therapeutic action	Representatives	How to use
Vitamins	Reduce vascular permeability, reduce swelling of liver tissue, increase the body's resistance to the virus	Askorutin, Askorutin, Undevit, Aevit	1 tablet 3 times a day
Hepatoprotectors	Accelerate the recovery and division of damaged liver cells. Supply structural elements necessary for the construction of cell membranes of hepatocytes	Essentiale, Karsil, Hepatofalk	1-2 capsules 3 times a day
Enterosorbents	To remove toxins from the intestines and eliminate bloating	Smecta, Polyphepan	2 hours after each meal
Enzyme preparations For moderate and severe forms	Promote the breakdown of proteins, fats and carbohydrates and speedy absorption of food in the intestines	Creon, Mezim-Forte, Pancreatin, Festal, Enzistal, Panzinorm	With each meal, 1-2 tablets
Glucocorticoids With a sharp deterioration in condition	They have an anti-inflammatory anti-allergic effect, reduce the attack of immune cells (lymphocytes and leukocytes) on damaged liver cells	Prednisolone, Methylprednisolone	60 mg/day orally or 120 mg/day intramuscularly for 3 days
Immunomodulators	Improves immune function. Stimulates the production of antibodies to fight hepatitis A virus	Timalin, Timogen	Administered intramuscularly at 5-20 mg per day for 3-10 days.
Immunomodulators		T-activin	1 ml of 0.01% solution is administered subcutaneously for 5-14 days
Detoxification solutions	Binds toxins circulating in the blood and promotes them rapid elimination them with urine	Hemodez, Geopolyglyukin	Intravenously drip 300-500 ml per day
Choleretic agents	Eliminate stagnation of bile in the liver, help cleanse it and improve digestion	Sorbitol Magnesium sulfate	Dilute 1 tsp of the drug in a glass of warm boiled water and drink at night

Currently, doctors are trying to avoid unnecessary drugs, prescribing only the minimum necessary to eliminate symptoms.

Is hospitalization required for hepatitis A treatment?

For hepatitis A, hospitalization in the infectious diseases department is required in the following cases:

for complicated forms of hepatitis A
with the co-occurrence of Botkin's disease and other hepatitis
with alcoholic liver damage
in elderly patients and children under 1 year of age
in weakened patients with severe concomitant diseases

Diet for hepatitis A

Diet 5 is recommended for the treatment of hepatitis A. In the fight against infection, therapeutic nutrition plays an important role. It reduces the load on the liver and protects its cells. It is recommended to eat small meals 4-6 times a day.

dairy products : low-fat cottage cheese, kefir, yogurt, low-fat sour cream for dressing
lean meat: beef, chicken, rabbit
meat products: steamed dumplings, meatballs, meatballs, sausages and boiled beef sausages
lean fish: pike perch, pike, carp, hake, pollock
vegetables: potatoes, zucchini, cauliflower, cucumbers, beets, carrots, cabbage, tomatoes
side dishes: cereals (except legumes and pearl barley), pasta
soups low-fat vegetables, dairy with added cereals
bread yesterday's, crackers
eggs: white omelette, 1 soft-boiled egg per day
Dessert: mousses, jellies, jelly, marshmallows, marmalade, marshmallows, hard biscuits, honey, homemade jam dried fruits
fats: butter 5-10 g, vegetable oils up to 30-40 g
beverages: black tea, herbal tea, compotes, juices, uzvar, rose hip decoction, coffee with milk, alkaline mineral waters, 5% glucose solution.
rehydration medications To restore electrolyte balance, Regidron, Humana electrolyte, and Gidrovit forte are recommended.

Exclude from the diet:

fried smoked dishes
canned food fish, meat, vegetables
meat fatty varieties : pork, goose, duck
fatty fish: sturgeon, gobies, spicy herring, caviar
fats: lard, lard, margarine
bakery from butter and puff pastry, fresh bread
full fat dairy products: whole milk, cream, full-fat cottage cheese, salted cheese
soups on concentrated meat, fish broth, sour cabbage soup
vegetables: radish, radish, sauerkraut, sorrel, onion, parsley, pickled vegetables, mushrooms
Dessert: ice cream, chocolate, products with cream, sweets, steamed
beverages: strong coffee, cocoa, carbonated drinks, alcohol

The diet must be followed during illness and for 3-6 months after recovery. Limiting fats and simple carbohydrates allows you to prevent fatty degeneration liver. Easy-to-digest meals and split meals contribute to better bile flow and normalization of digestion.

It is very important to adhere drinking regime. To remove toxins, you need to consume at least 2 liters clean water without gas.

Can Hepatitis A be treated at home?

At mild flow hepatitis disease can be treated at home. This requires several conditions:

the patient has been examined, taken tests, and will regularly visit the doctor
the disease occurs in a mild, uncomplicated form
it is possible to isolate the patient in separate room
diet and bed rest

By the time jaundice appears, the patient becomes virtually harmless to others. He can eat at the same table with his family, use a shared toilet and bathroom.

Restrictions. It is not advisable to involve the patient in cooking. All family members must strictly observe personal hygiene rules and wash their hands thoroughly after using the toilet.

Mode. Pre-icteric period - bed rest is required. The patient experiences severe weakness and excess energy expenditure can lead to additional stress on the liver. And in a horizontal position, the diseased organ receives more blood, which promotes a speedy recovery.

Jaundice period– Semi-bed rest is allowed. Once the symptoms of the disease have subsided, you can gradually increase your activity. This helps restore physical and emotional state.

Consequences of hepatitis A

Complications are not typical for hepatitis A. Consequences occur in only 2% of cases. At risk are people who violate their diet, do not follow doctor’s prescriptions, abuse alcohol, or suffer from liver pathology.

The most common complications of hepatitis A

Biliary dyskinesia– impaired motility of the biliary tract, resulting in stagnation of bile. Symptoms: pain in the right hypochondrium, radiating to right shoulder, occurs after eating and physical activity. diabetes mellitus

Prevention of hepatitis A

Prevention of hepatitis A includes several areas.

Hepatitis A is considered a relatively benign disease, but requires serious attention and treatment. Otherwise, its effects may be felt for months and years.

The symptoms of hepatitis A are similar in both adults and children. The disease itself, in most cases, is accompanied by jaundice, but sometimes no signs may be present until liver inflammation occurs. Infection occurs through direct contact with a sick person or through consumption of food and water contaminated with feces. Only preventive measures and vaccination will help protect against hepatitis A.

A viral liver disease such as hepatitis A can be mild or severe with complications. This virus most often causes foodborne infections.

Throughout the world, the number of infected adults and children is constantly increasing, and there are even endemic areas where epidemics of the virus are observed. Outbreaks occur due to contamination of water or food, which leads to mass infection of people.

In addition to these reasons, direct bodily contact with a sick person also leads to infection of a healthy person. In case of accidental contact with a patient, infection will not occur, because the route of transmission is oral-fecal. The virus can be found in stool, urine and blood.

Important! Airborne the virus is not transmitted.

Outbreaks of hepatitis A epidemics occur in areas with poor sanitation and water contaminated with feces of a sick person. When traveling to a highly developed country, the likelihood of infection is much lower than to a developing country.

The virus can exist in the environment for a long time because it can withstand any temperature changes.

But there is also some good information. Patients with hepatitis A most often recover, because the virus does not lead to the development of a chronic form of the disease, as happens with types B and C. The percentage of deaths is very small, and the main cause is liver failure.

In rare cases, hepatitis A can cause a number of complications and provoke the development of diseases such as acute hepatic encephalopathy (brain damage), cholecystitis, gastritis, pancreatitis, stomach ulcers, and jaundice. As a result of such complications, adults develop arthritis and kidney damage.

Depending on the course of the disease and the presence of complications, there are several forms of manifestation of hepatitis A:

An acute form in which recovery occurs within three weeks after infection. This form manifests itself in almost 95% of patients.
A prolonged form is observed with hepatitis, which lasts more than six months. In this case, it takes a lot of time for the liver and spleen to recover and the symptoms of jaundice to disappear.
An aggravated form occurs with prolonged deterioration of the patient’s condition and the results of liver tests. As a result, after recovery, relapses may occur, with the addition of other types of hepatitis. Such exacerbations occur with low immunity, especially in children.
Defeat biliary tract occurs with moderate hepatitis due to the action of microbes. In this case, all symptoms appear with moderate strength.
The addition of an infection usually does not provoke the appearance of new symptoms, but causes an enlargement of the liver.

After an illness, the liver may not recover and remain enlarged for the rest of life.

Manifestation of hepatitis A in children

Among all patients, about 60% are children. In highly endemic areas, it is the youngest children aged 3 to 7 years who are most susceptible to infection as they often put dirty fruits and vegetables into their mouths.

Hepatitis A is popularly called Botkin's disease; in its manifestations, its first signs can be confused with jaundice.

The first symptoms of hepatitis A in children appear two weeks after contact with an infected child. The virus in the child’s body leads to an increase in bilirubin in the blood. Before the appearance of jaundice, a significant deterioration in well-being may occur, with symptoms resembling intestinal infection or cholecystitis.

The child’s body temperature rises to 39 degrees, weakness appears and appetite disappears. After some time, vomiting (sometimes diarrhea) begins, the child complains of abdominal pain in the right hypochondrium. After a few days, the temperature subsides, and the child develops jaundice. A week before yellowing skin The baby's urine darkens and the stool becomes lighter, which indicates a high level of bilirubin in the blood.

Important! Bilirubin in large quantities leads to poisoning of the body with toxins, so before jaundice the temperature rises and vomiting occurs.

The child turns yellow right before his eyes, but at the same time his health improves. On the tenth day after the appearance of jaundice, all symptoms begin to disappear. Despite the improvement in health, liver function deteriorates. If you take a liver test during this period, then all the values of the main indicators will be outside the normal range. The liver also gradually becomes enlarged.

For several months after this, the child may complain of mild discomfort or abdominal pain.

Hepatitis A in a child is determined after a blood test.

As a result of the tests obtained, treatment is prescribed, which includes taking choleretic drugs plant origin, vitamins, and diet.

A child who has suffered from hepatitis A should be observed by a doctor. The first examination should be done two months after recovery, and the second after six months. To restore the child’s strength, he should not perform physical exercise During the year, he is exempt from attending physical education classes at school.

What happens in a child’s body with hepatitis A?

The virus, entering the body with food or water, directly affects liver cells. Being in the blood, it starts the detoxification process. The virus provokes disruption of protein, lipid, fat and carbohydrate metabolism. As a result, absorption deteriorates useful substances and vitamins, the ability of blood clotting decreases.

Despite his Negative influence, the hepatitis A virus does not cause massive death of liver cells, and thus does not cause cancer or cirrhosis. Hepatitis A in a child can be cured even at home, but you must adhere to all doctor’s recommendations, in particular bed rest.

Manifestation of hepatitis A in adults

The first signs of the disease in adults may appear a month after infection. A sharp deterioration in health for no apparent reason, which is manifested by an increase in temperature, should alert you.

Men and women may experience typical signs: fever, which is accompanied by nausea and vomiting, pain in the stomach and jaundice.

In an adult, the symptoms are more pronounced than in a child. The temperature can last up to ten days, during which time vomiting and abdominal pain do not go away, in addition, weakness and muscle pain appear.

Once the liver is affected, changes in the color of the stool occur (as in children), and a few days later jaundice appears. The yellowness of the skin in men and women does not go away within two weeks.

Important! Long-term liver damage results in liver failure, which can lead to death in adults.

IN in rare cases in men and women, instead of a rise in temperature, other symptoms are observed, such as severe weakness, decreased performance, sleep disturbances, lack of appetite, and constipation or diarrhea.

Based on the results of the examination, complete recovery can be judged. In this case, the size of the liver returns to normal, and all liver test parameters are normalized.

At improper treatment or non-compliance with the diet, the disease can worsen, as a result of which men and women experience repeated jaundice, and all symptoms of intoxication resume.

Often, men and women can develop an acute form of hepatitis A. This happens with a concomitant infection.

Important! Approximately 30% of men and women have hepatitis A without symptoms of jaundice.

In some adults, the disease may be accompanied by obstructive jaundice, which goes away only after a month and a half. In this case, the skin may acquire a greenish tint, itching appears, and in this case there may be no signs of intoxication.

After an illness, both a child and an adult develop immunity for life.

According to the severity of symptoms in men and women, the following forms of the disease are distinguished:

Light form characterized by a slight increase in temperature, mild intoxication and a slight enlargement of the liver. Jaundice lasts no more than 10 days, and after a month the size of the liver decreases to normal.
A form of moderate severity occurs in 30% of patients. All symptoms are of moderate severity. Together with the liver, the spleen also enlarges, and they return to normal only after a year and a half. The jaundice goes away after two weeks.
The severe form is diagnosed very rarely, in approximately 1-3% of patients. Symptoms of intoxication, like jaundice, are very pronounced. The patient suffers from vomiting, weakness, dizziness, and nosebleeds. This form is dangerous for the child, since the liver and spleen become greatly enlarged and return to normal after a few years. When palpated in the liver area, severe pain occurs.

Who is at risk for this disease?

Every adult and child can become infected if they have not completed the course, but the likelihood of infection increases in the following cases:

drug injections;
inability to drink clean water not contaminated with feces;
poor epidemiological environment and sanitary conditions in the area;
Cohabitation with the sick;

visiting highly endemic areas without being vaccinated against the virus;
intimate relationship with a partner who has acute form hepatitis disease.

Men and women who belong to the risk group for infection must monitor their health and go to the hospital at the first sign of illness.

Prevention in adults and children

After contact with an infected person, the first symptoms may appear within two weeks. During this period, it is important to get tested every three days to begin immediate treatment in case of infection.

Since the virus can be transmitted not only from a sick person, but also through food and water, you need to adhere to following rules: before eating vegetables and fruits, wash them well, wash your hands with soap after going outside, visiting the toilet and before eating. It is best to drink boiled water.

If there is a sick person in the family, special precautions are needed. All dishes and toilets must undergo special treatment; this is the only way to protect all family members.

The risk of contracting the hepatitis A virus depends on the frequency of travel to highly endemic areas and good hygiene when preparing food or drinking water.

Prevention measures:

When organizing a trip, you should try to avoid rural areas, since there is a high probability of contamination of water and food.
Do not eat raw shellfish, vegetables and fruits if there are doubts about the sanitary conditions of their storage.
Maintain personal hygiene, wash your hands.
When traveling or on vacation, it is best to prepare food yourself.

Hepatitis A, also called Botkin's disease, is a pathology of liver cells of viral origin, which is often accompanied by intoxication and jaundice. Many people confuse toxic hepatitis and the disease we are considering. This form of hepatitis differs significantly from others in that it does not cause chronicity harmful influence on liver cells and extremely rarely can be fatal. Hepatitis A therapy is relatively short-term. Typically, it takes about two weeks for symptoms to subside and another one to two months for liver function and structure to normalize.

Who can be a carrier of the disease?

There are no categories of citizens who would be most at risk of contracting hepatitis. These can be men, women, children of different ages And social status. At the same time, children from one to ten years of age tolerate the disease relatively easily. For older people and children under one year of age, the disease is much more difficult, and the recovery process may be delayed.

A person who has had hepatitis A has no chance of becoming infected again, since the body develops a strong immunity to the virus. Viral hepatitis only complicates infectious diseases, which is logical. Virus of this type characterized by very small sizes, only 27-30 nm. The shape of the virus is spherical, without a protective shell and is presented in only one form. The virus has increased resistance to the environment. It can last on food or damp surfaces for up to a year. The virus can survive in dried blood for up to a week. It can withstand temperatures up to 60 degrees above zero for 12 hours and up to minus 20 years. Prolonged boiling, as well as formaldehyde, chlorine, manganese, etc. can help prevent it. So what is hepatitis A? Let's try to answer this question using the material presented.

Latent period

Considered infectious hepatitis- the disease of dirty hands, as it is often called. This is due to the fact that the virus penetrates into circulatory system adults and children along with food.

Cases of infection through water are quite common. Attached to the mucous membranes of organs gastrointestinal tract, the virus is absorbed into the blood and, upon reaching the liver, stops.

After entering the body, it takes up to seven weeks before manifestation primary signs infection. Most often, the incubation period of the virus is within one month.

Having settled in the liver through entry into the blood, hepatitis disease penetrates the ribosomes of hepatocytes and causes them to function in such a way as to constantly create copies of the harmful microorganism. They are then released through bile into the intestines and excreted naturally. Hepatocytes, exhausted by such work, die as a result, and the virus continues to search for new ones. healthy cells. Symptoms of hepatitis will appear as long as it takes the body to synthesize the level of antibodies against hepatitis necessary to fight the virus. Only in this case will it be possible to resist the disease.

Methods of infection

Hepatitis A is transmitted through fecal-oral contact. That is why it is called the disease of dirty hands. However, it is not only dirty hands that can cause illness. There are other reasons:

1. Violation of personal hygiene rules.

2. Eating foods that have not undergone the necessary processing.

3. Swimming in polluted, unrenewed water bodies.

4. Ignoring vaccination.

5. Eating shellfish caught in polluted waters and not subjected to heat treatment.

6. Carrying out hygiene and drinking contaminated water, especially in places where there is no sewerage or running water.

7. Presence of a family member with hepatitis in the family.

8. Living in a large group, for example, in places of detention, barracks or boarding schools.

9. Drug addiction in needle form.

10. Sexual contact with an infected person.

11. In the first year of life, a child can become infected with poor-quality water or if the sippy cup or bottle is poorly treated.

Signs of hepatitis A

After the incubation period has passed, the first symptoms of hepatitis after infection begin to appear. The most common of them include:

1. Increased body temperature. This symptom occurs in every second patient even before the onset of icteric syndrome. The temperature rises up to 39 degrees and does not drop until signs of jaundice appear. This symptom is accompanied by chills, drowsiness, lethargy, apathy towards work and loss of appetite.

2. Intoxication. It manifests itself characteristically and is accompanied by nausea, muscle, joint and headache.

3. Pain in the right hypochondrium. Appears as a result of an increase in the size of the liver. For this symptom characterized by a feeling of fullness and heaviness, as well as aching Blunt pain in the area of the right hypochondrium. Palpation is also painful for the patient.

4. Increase in size of the spleen. Most often, this is attributed to signs of a reaction from the immune system to a harmful virus and intoxication.

5. Jaundice syndrome. It most often appears on the fifth day after infection with the virus. Yellowness becomes visually distinguishable due to the fact that the pigment flows into the blood instead of remaining in the bile. For this reason, the mucous membranes, skin and sclera of the eyes become stained. With the appearance of icteric syndrome, the temperature drops.

6. Dryness and itching of the skin. It occurs as a result of the development of an allergic reaction and an increase in the amount of bile acids.

7. Darkening of urine and lightening of stool. The first occurs due to an excess of bilirubin in the blood, and the second due to stercobilin, which, together with bile, lightens the stool.

8. Disruption of the gastrointestinal tract. Occurs due to stagnation of bile, which is released into the intestines in insufficient quantities. Manifested by nausea and vomiting, as well as frequent belching, constipation, bloating and flatulence.

Diagnosis and treatment

An infectious disease doctor can diagnose hepatitis A in both children and adults, despite the first symptoms of hepatitis, only if the results of the following examinations are available:

Biochemical examination of urine.

Biochemical blood test, including AST and ALT indicators.

Blood test for hepatitis markers.

Ultrasonography.

Despite the fact that the disease is not a severe disease and is not the most terrible diagnosis that exists, you need to think about how to treat hepatitis A. A universal drug for hepatitis A has not yet been invented, so the first goal is drug therapy is to exclude symptoms. For this purpose, the following may be prescribed:

Also important point in the treatment of hepatitis A is the maintenance of therapeutic nutrition. This will help improve the patient's condition and promote liver recovery.

Hospitalization or treatment at home?

Hepatitis A therapy can be carried out in a day hospital setting, but in some cases complete hospitalization may be required. Such situations include:

1. In addition, the patient was found to have another form viral hepatitis. By the way, Botkin's disease is hepatitis A.

2. The patient's medical history includes serious illnesses in a chronic form or during an exacerbation, which were provoked by infections of various types.

3. The disease is poorly tolerated by the patient, and the patient’s condition worsens.

4. The sick people are children under two years of age or the elderly.

5. Liver damage from alcohol, especially if there is a history of cirrhosis.

However, if the disease is tolerated by the patient and he is able to perform all the procedures recommended by the specialist, hepatitis A can be treated at home. The only important condition is frequent visits to the supervising doctor.

It must be remembered that the patient must be isolated until the manifestation of icteric syndrome. The fact is that the risk of infection after the appearance of this symptom is significantly reduced. In addition, the following recommendations should be observed:

1. Balanced diet and bed rest.

2. The patient should not cook or wash dishes.

3. Regular wet cleaning, especially in the bathroom area.

4. All residents of the house should wash their hands frequently, especially before eating and after using the toilet, take a shower and ensure that children follow these rules.

Drug treatment

Conservative therapy involves taking drugs from several groups, each of which is aimed at eliminating the symptoms of hepatitis A and restoring liver function.

1. Hepatoprotectors. Aimed at protecting and restoring hepatocytes. The active substances of such drugs can normalize the functionality and structure of the liver. Such drugs include “Karsil”, “Essentiale Forte”, “Hepatofalk”, “Phosfoniale”, etc. They are usually taken three times a day. The duration of the course is determined by the attending physician depending on the degree of liver changes.

2. Choleretic medicines. Necessary to prevent bile stagnation. They are also capable of normalizing digestive process. To achieve a choleretic effect, doctors recommend taking Magnesium Sulfate or Sorbitol. They drink one teaspoon at night. The duration of treatment is determined by a specialist.

3. Sorbents. They are necessary to detoxify the body and eliminate various reactions from the gastrointestinal tract. For this, doctors prescribe Enterosgel, Smecta, Atoxil, etc. Sorbents should be taken two hours after meals.

4. Infusion solutions. Administered intravenously only by qualified physicians. Therefore, it is better to carry out the procedure in inpatient conditions. The effect of such solutions begins quite quickly, so toxins can be removed quickly. Similar drugs include “Sorbilact”, “Reosorbilact”, “Hemodez”. Droppers are placed for up to five days. You can support this direction of therapy by taking Regidron and Humana Electrolyte.

5. Enzymes. Similar drugs promote the absorption and breakdown of beneficial substances that enter the body with food. In addition, enzymes normalize the functioning of the gastrointestinal tract. As a rule, Festal, Mezim, Pancreatin, Creon, etc. are prescribed.

6. Glucocorticoid drugs. Prescribed for a sharp deterioration of the patient's condition. These medications relieve inflammation and fight allergy symptoms. Prednisolone is most often prescribed for intramuscular injection. The duration of the course is no more than three days.

7. Vitamins and immunostimulants. Designed to boost the immunity of a person infected with hepatitis A. Taking vitamins involves general strengthening body, and also has a beneficial effect on tissues and blood vessels. This group of drugs should be taken for several months. The specialist will select the best option vitamin complex for specific purposes. But the most often prescribed immunostimulants are “Timalin” or “T-activin”.

Complications of hepatitis A

In most cases, hepatitis A is mild, but complications can occur after it. Most often they occur in patients who do not follow the doctor’s recommendations, ignoring necessary medications and diet. Complications are also typical for patients with congenital liver diseases. So what is hepatitis A in terms of consequences?

The most common complications of hepatitis A are:

1. Pancreatitis.

2. Cholecystitis.

3. Biliary dyskinesia.

Medical nutrition

The diet for hepatitis A consists of dietary table No. 5 and includes eating at least five times a day. Many people ask whether it is possible to eat baked goods, lamb, pork, etc., which are so beloved by many, if you have hepatitis. You should only consume foods that are on the approved list. These include:

1. Steamed dishes made from low-fat meat and fish.

2. Dairy and fermented milk products with a minimum amount of fat.

3. Fresh vegetables in minimal quantities; it is better to replace them with boiled, stewed and pureed vegetables.

4. Porridge and durum pasta.

5. Vegetarian, liquid, not rich soups.

6. Egg whites in the form of a steamed omelet.

7. Homemade crackers.

8. Yesterday's bread.

9. Jam, mousses, marshmallows, honey, marshmallows, etc.

10. You should drink weak teas, including those with milk, non-acidic juices, sweet compotes, rosehip decoction, herbal teas and still mineral water.

Is it possible to drink alcohol if you have hepatitis? The answer to this question is negative, especially in the acute period.

Preventive measures

It is possible to prevent infection with the hepatitis A virus in a comprehensive manner by taking certain measures. Basically, preventive measures can be divided depending on the factors that help avoid infection:

1. Vaccination. There are special vaccines that reduce a person’s susceptibility to the hepatitis A virus. This vaccination is not included in the special calendar, since its cost is quite high. There are two types of preventive vaccinations:

Introduction of a neutralized virus that provokes the disease.

Immunoglobulin, which contains antibodies obtained from donor blood. It is administered intravenously to all family members of an infected patient. This should be done in the first days of hepatitis A manifestation. This measure will significantly reduce the risk of infection. Immunoglobulins are also administered to those groups of the population who have an increased risk of infection with hepatitis A. These categories of citizens include military personnel, refugees, medical workers traveling to third world countries, as well as those involved in food production.

2. Hygiene. This point applies to every person without exception. Prevention of hepatitis A in this case consists of following simple and well-known rules:

Wash your hands after using the toilet, going outside and before eating.
Thorough water treatment of vegetables, fruits and herbs.
Cooking food until fully cooked.
Drinking boiled water.
Avoiding swimming in polluted waters.

It is very important to consult a doctor when you notice the first signs of infection.

3. Treatment of the patient's environment. This refers to the disinfection of the room where a sick or recovering patient is located. In this case, it is necessary to carry out the following activities regularly during the acute period of the disease and for a certain time after recovery:

4. Quarantine. This is a necessary measure if the sick person was in a group and had contact with healthy people. Kindergartens and schools are closed for 35 days, while health workers must regularly examine all potentially infected people. Blood is taken from adults to test for the presence of antibodies to the hepatitis A virus. What this is is now known.

Every person wants to be healthy. However, sadly, none of us can ever avoid illness. And the person who once proclaimed himself the “king of nature” becomes completely defenseless against the smallest living creatures on our planet - various bacteria and viruses.

One of their huge number, dangerous to humans, is the causative agent of a disease such as Hepatitis A. “What kind of disease is this?” - you ask. In common parlance it is known as jaundice. This article will talk about this disease, in particular, what the causative virus is, how you can become infected, what signs and symptoms should make you wary and see 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 an enterovirus, that is, a virus with an acid-resistant shell that is not susceptible to the destructive environment of the stomach. It is not difficult for him to go through a protective screening together with, for example, unwashed vegetables, fruits or contaminated water. acidic environment, located in the stomach, and end up in the intestines, which causes illness in the carrier of the virus. For those who have little (or no) idea about a disease such as hepatitis A, what it is and how it is transmitted, we inform you: this pathogen has powerful immunity to the aquatic environment, which often provokes its transmission through liquid. There is also good news: the virus has a very high immunogenicity, which contributes to the formation of stable lifelong immunity after an illness.

Prevalence

Statistics impartially show that, despite the fact that some do not even know what hepatitis A is or what kind of disease it is, it is the most common infection among those that pose a danger to human health. In countries with warm climates and poor sanitation, the incidence of hepatitis A is very high. According to official data, in Central Asian countries almost 100% of the child population suffers from this infection. In Eastern European countries, the rate of infection with jaundice is 1:400, that is, for example, every year out of 100,000 people there, 250 get sick.

Of course, everyone wants to avoid infection, especially one like hepatitis A. How is the virus that causes it transmitted? There is a high probability of getting sick while on vacation in countries with a hot climate, which include favorite places for recreation and tourism. These are African countries, including Tunisia and Egypt, Asian states and islands, among which there are Turkey and India, popular among Russians, as well as countries of Southeast and Central Asia. There is a risk of infection when traveling to South American countries located in the Caribbean Sea.

Pathways and mechanisms of infection and development

Oddly enough, even without leaving our homeland, you can easily catch hepatitis A. How is it transmitted in this case? Infectious agents may appear on the surface of vegetables and fruits. Therefore, before eating them, be sure to wash them thoroughly under running water and dry them. This will give, albeit a small, guarantee that you will not get sick by eating an apple or tomato. If you have a weakness for seafood, then when buying it fresh or frozen, remember: before it gets to your table, it must undergo heat treatment, which will kill everything on its surface.

The main source of hepatitis A is a person who catches the virus and develops jaundice. Together with his feces, a huge number of viruses are released into the environment, numbering in the billions.

If a person does not follow the generally accepted rules of consuming infected water and food (this is especially true for thermally poorly processed seafood), the virus can penetrate the intestines, and after that, being absorbed into the blood, it enters the liver along with it and is introduced into hepatocytes - its cells.

Reproduction of virus particles occurs in the cytoplasm of liver cells, leaving which and entering the bile ducts, they, along with bile, enter the patient’s intestines.

Starting in the liver inflammatory processes, 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 have been infected by the virus, recognizing them. As a result, infected hepatocytes die, and normal functioning liver and hepatitis A develops. We talked earlier about how this disease is transmitted.

Probability of infection

In developing countries, where the level of both economic and social development is low, jaundice is primarily a childhood infection. Most of Children in such countries become ill with it by the age of 10 years and acquire stable lifelong immunity to this disease.

According to epidemiological studies, the manifest forms in which jaundice, also known as hepatitis A, typically exhibit symptoms, are now much less common. The infection has become more common in the so-called anicteric form, in which it is impossible to diagnose the disease.

Residents of developed countries call jaundice nothing more than “the disease of dirty hands.” The likelihood of infection is extremely low, which is facilitated by the high-quality work of housing and communal services and the high culture of the population. In this regard, the majority of the population does not have antibodies to this infection in their bodies, 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 to warm countries in Africa and Asia, without observing generally accepted rules hygiene.

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

Who is at risk?

Epidemiologists have identified several groups of people who are most likely to be diagnosed with hepatitis A. What does this mean? If you consider yourself to be in any of the following groups, we strongly recommend that you get tested for antibodies to the virus and, if necessary, get vaccinated. This list includes:

household and family members of a person infected with hepatitis A virus;
persons who entered into intimate relationships with patients;
people (especially children) who live in areas where hepatitis A is widespread;
persons traveling to countries with high incidence rates;
men engaging in homosexual intimate relationships.

When there is a sick person in the house. Answers to common questions

People who do not fully understand the specifics of an infection such as hepatitis A, what kind of disease it is and how it is transmitted, sometimes have questions that require answers within the framework of this article. These issues become especially acute when one of the family members falls ill with jaundice.

First of all, most are concerned with the question: is it possible not to become infected when in contact with an infected person? Of course, yes, if you adhere to generally accepted hygiene rules. But it should be remembered that it is better to limit contact between children and the sick to a minimum, and ideally stop until complete recovery.

The second important question concerns the possibility of contracting jaundice without the disease. In this case, a person will not get sick only if he has had it done and the level of antibodies in his blood is sufficient to fight the infection. If antibodies are not present in the blood, but the virus has already entered it, then the person will inevitably get sick.

In order to short time To protect yourself from possible infection or prevent the development of the disease in case of infection, a person is given a special drug - immunoglobulin - shortly before possible infection or within 14 days after it. This measure can be considered not only as one of the methods of treatment, but also as a prevention of hepatitis A. If you have already had it before, then the likelihood of having it again is negligible.

As mentioned earlier, a test for the presence of immunoglobulin G (anti-HAV IgG) can detect antibodies in the blood. Their presence indicates infection or vaccination of a person. It is recommended that all family members with an infected person be examined for the presence of immunoglobulin in the blood, and vaccinated if necessary.

And, of course, we should not forget about basic hygiene rules: wash your hands with soap after visiting the toilet, after caring for small children, before preparing and eating food.

Consequences of infection and duration of illness

If the hepatitis A virus enters the blood of a person who has not been vaccinated, he will inevitably develop jaundice. However, it is quite difficult to accurately determine the time of infection unless it is an epidemic caused, for example, by an accident in the sewer networks.

The incubation period lasts about a month from the moment of suspected infection, after which hepatitis A begins to appear. Symptoms by which it can be recognized by a non-specialist: fever, dyspepsia (impaired normal functioning of the stomach), change in skin color.

Improvement occurs after jaundice appears general condition and the patient's well-being. For 3-6 weeks, and sometimes longer, it lasts, and after it disappears, in most cases the person recovers. The following photo is intended for those who have never come face to face with an infection such as hepatitis A. What is it? The photo clearly shows what the skin of a sick person looks like compared to the skin of someone who is not infected with jaundice.

Many people are concerned about the danger of the disease for certain individuals. Hepatitis is most severely affected by children under 1 year of age, the elderly and adults. U recent infection often accompanied clearly severe intoxication and jaundice, and its duration is on average about three months.

In most cases, a person is sick for a little more than a month - 40 days. But the duration of the disease depends on many factors: the patient’s age, the state of his immunity, concomitant chronic diseases (their presence or absence). Strict implementation of the recommendations and prescriptions given by the doctor also plays a very important role. 15% of the total population have chronic form hepatitis, which can last from 6 to 9 months.

Possibility of death and self-treatment

An interesting question is about the possibility of illness. Many people think that this is impossible, thinking: “Death and hepatitis A? What is this? Jaundice? What danger can it pose? Indeed, death with this disease is rare, but it is possible if the infection occurs in a fulminant (fulminant) form. In this case, there is a rapid development of acute liver necrosis, which accompanies acute liver failure.

Statistics show that hepatitis A is fatal in 0.1% of the child population, 0.3% is the mortality rate from the infection in adolescents and adults under 40, and 2.1% in those over 40.

Often patients and their relatives ask about the possibility of the patient recovering independently without treatment. In most cases, everything happens this way because modern methods Treatments 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, treatment aimed at removing harmful substances from the body that appear as a result of damage and disruption of the normal functioning of the liver. In this case, the fight against the infection itself falls on the patient’s immune system.

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

As mentioned above, the first signs by which one can 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 deterioration general well-being, increased body temperature and significant changes in the color of urine. Sometimes, after visiting the toilet, people do not understand what happened to its coloring, and are surprised, not yet suspecting that they have hepatitis A, what it is. The photo below is a clear example of how it looks in a sick person. As you can see, it resembles strongly brewed black tea and foams very strongly.

If these signs are present, you should immediately consult a specialist. Remember that only a qualified doctor can determine whether a patient actually has hepatitis A. What is it? The symptoms in this case speak for themselves: fever, which is accompanied by dyspeptic syndrome (nausea, a feeling of heaviness in the right hypochondrium and stomach, vomiting), weakness, darkening of urine, which we talked about earlier, jaundice (yellowing of the sclera, skin, discoloration of feces ). When the latter appears, there is a slight improvement in the general condition and well-being of the patient. Others appear in a similar way. acute hepatitis any type.

To identify the hepatitis virus in the patient's blood, biomaterial is taken and tested, showing the presence of antibodies that belong to class M immunoglobulins (anti-HAV IgM). They can be detected only during a relapse (acute period during the course of the disease); as the patient’s condition improves, their content in the blood becomes lower.

Diagnosis process

The first point in this procedure is to find out the epidemiological history, which will either confirm or refute hepatitis A. What does this mean? The doctor finds out what places the person has visited recently, what food and water he has consumed, and whether there have been contacts with a person with jaundice.

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

general health and condition of the patient, possible signs intoxication;
the presence of digestive disorders - dyspepsia;
the presence of elevated body temperature - fever, sweat, chills;
the presence of jaundice of the skin, tongue, eyes.

This is exactly what the skin of a person diagnosed with hepatitis A looks like, as this photo below clearly demonstrates.

In addition to all of the above, the doctor evaluates the condition of all internal organs and the patient’s systems, in accordance with generally accepted diagnostic methods, both the color of the patient’s urine and stool are noted. When palpating (feeling) the abdomen, an enlarged liver may be detected.

After this, the results of the analyzes are studied, which include:

UAC - general analysis blood;
TANK - biochemical analysis blood;
kaogulogram - a blood test for its coagulability;
OAM - general urine analysis.

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

Treatment and prognosis after recovery

In previous parts we talked about what hepatitis A is and what it is. How to treat it - here main question, which excites everyone who encounters it. If the disease occurs in the lungs and moderate form, then the body is able to independently cope with the infection that has entered it. the main objective treatment in this case is to reduce the concentration of toxins and provide liver cells with material for their restoration and energy. An important part therapy is the introduction of detoxification solutions, glucose, vitamins and hepatoprotectors (drugs that protect liver cells). There is no antiviral treatment. If the disease is severe, then great attention is given, along with detoxification, and symptomatic therapy.

The above methods are the most modern today. Together, these two therapies help reduce intoxication that occurs as a result of liver damage, dilute the blood with toxins and remove harmful substances, and eliminate the symptoms of the disease. All this leads to an improvement in the general condition and well-being of the patient.

During a relapse, you should adhere to diet No. 5 according to Pevzner. This is a large amount of vegetables, fruits, cereals, lean meat, fish and cottage cheese, egg white, soybeans, apples, which provide the body with fiber, lipotropic substances, pectin. Consumption is also shown large quantity fluids and maintaining complete physical and mental rest.

Many parents do not know how to treat their child in case of infection, although they are well familiar, and sometimes first-hand, 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 treatment tactics for a patient of any age are the same, it is strongly recommended to consult a local pediatrician who will examine the child and prescribe medications that will help successfully fight the disease and will not cause further harm. more harm health.

After recovery, doctors, as a rule, give the most favorable prognosis, since the normal functioning of the liver is fully restored.

Protection against disease: vaccination and its effectiveness

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

Today, the most effective method of preventing infection is vaccination, and several fairly effective vaccines have been created that adequately protect against jaundice.

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 6 to 12 months.

Most people develop antibodies ready to fight the virus within about 14 days of receiving the first dose of vaccine. This method is by far the most effective and, perhaps, the only prevention of hepatitis A.

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

Who is vaccinated?

Vaccination against jaundice must be given to persons who have not previously had hepatitis type A - both adults and children, as well as those who have an increased risk of infection.

Among them:

tourists and military personnel traveling to areas with a high incidence of hepatitis A;
honey. personnel working in infectious diseases departments;
persons working in preschool institutions;
location staff Catering and water supply.

Regulatory documents provide for vaccination of children living in the territory where high level morbidity. They begin to receive the vaccine starting at the age of 3 years. Patients suffering from chronic liver diseases are also required to be vaccinated.

I would like to believe that all of the above will help those who have already had the misfortune of getting sick to cope with the infection, and those who have not yet experienced this attack to make the right decision and protect themselves from it in a timely manner. Be healthy!

Among the damage to liver cells, taking into account viral and non-viral hepatitis, viral hepatitis A is considered less complex. Easily tolerated and treated, course clinical manifestations rarely lasts more than 14 days. Liver cells recover within 30 days after treatment. Mortality from the disease ranges from 0.1 to 0.4% of all global cases, and even then they occur in cases that accompany complications.

general information

Many people are familiar with infectious hepatitis A as Botkin's disease. According to international classification ICD-10 pathology code was assigned: B 15.9 - hepatitis A (renal coma excluded). Virology identifies the culprit of the pathology as the hav virus, which affects the renal parenchyma. The prevalence of pathology among children is greater than among adults. Doctors also noted that among the adult population, hepatitis A during pregnancy is 5 times more common.

A small percentage accounts for the external manifestation of virus A - icteric pathology. A significant portion of the remaining carriers experience the disease without visible symptoms. Among adults, this part is 25−30%. People who have had the A virus develop immunity. Chronic course hepatitis A does not exist.

Causes of hepatitis A infection

The simplicity, strength and structure of the virus that provokes inflammation in the liver are the main reasons for the process of death of organ cells. The etiology of the virus is characterized by resistance. It is perfectly preserved in the external environment at temperatures from - 4 to + 22, adapts to acidic and aqueous environments, so anyone can get sick. To understand how an infection is transmitted, information is needed to track its transmission routes.

Epidemiology

The main source of hepatitis infection is the carrier (sick person). The concentration of microbes in the intestines determines their removal from the body of a patient with feces(sometimes vomiting). Then virus A enters the body of a healthy person through the mouth, usually with water. Contaminated water, dishes, and unprocessed food are the main mechanisms for transmitting microbes.

The pathology is characterized by seasonality. Summer - favorable time, to spread the virus.

Pathogenesis

Infected water or products entering the human body become a source of infection. The hepatitis A virus easily withstands the acidic environment of the stomach, and once in the intestines, it penetrates through its walls into the blood. Together with the bloodstream, it seeps into the liver, infecting its cells. The development of the virus in the liver provokes inflammation. The immune system begins to fight foreign microflora, destroying infected liver cells. The functionality of the organ is impaired, which threatens the development of liver failure.

Incubation period

The time from pathogenic microbes entering the body until the first symptoms appear takes from 15 to 50 days. Average duration The incubation period is about 1 month. At this time, the hepatitis virus, penetrating the blood, spreads throughout the body and accumulates in it. The person does not feel any signs of pathology and continues to consider himself healthy. But at the same time it already becomes a threat to others.

Symptoms of hepatitis

The clinical picture of the onset of infection is similar to many inflammatory pathologies. With the development of inflammation, the first symptoms of hepatitis A are different and depend on the severity of the infection. In addition, men and women get sick differently and the appearance of signs of pathology in men and women differs. Women's defenses are more effective, so the healing process occurs much faster.

Factors influencing the severity of infection:

age characteristics;
immunity;
concentration of viruses.

Types of hepatitis and symptoms

View	Symptoms	Processes	Manifestation
Light form	Intoxication	The picture of poisoning has been erased.	Decreased appetite; weakness.
	Temperature	It rises, then returns to normal (low-grade fever).	37,2-37,5
	Liver	There is an increase in the organ, from the edge of the costal arch by 2-3 cm.	Pulls in the hypochondrium; slight sensitivity.
Medium form	Pre-icteric period
	Intoxication	The decomposition of cells causes poisoning of the body.	Decreased appetite; weakness; malaise.
	Temperature	Inflammation activates the immune system.	Alternation of heat and cold; temperature increase.
	Jaundice period
	Jaundice	Bilirubin is caused by the breakdown of red blood cells.	The whites of the eyes and oral mucosa turn yellow; With a high concentration of bilirubin, the skin turns yellow.
	Urine	The kidneys excrete bilirubin.	Urine darkens (the color of beer); foam appears.
	Feces	The amount of pigment affects the color of stool.	At first, the stool becomes stained; then colorless.
	Discomfort in the hypochondrium	The death of liver cells leads to swelling of the liver, the membrane stretches.	Heaviness; pain in the right side; when palpated.
	Digestion	Bile stagnates and the digestive process is disrupted.	Nausea; flatulence.
	Muscle pain	Accumulation of poisons in the body.	Drawing pain.
	Allergy	Irritation from acids increases, causing skin rashes.	Skin irritation.
	Recovery phase
	Symptoms decrease, organ functions return to normal.
Severe form	Intoxication	Vomiting with bile appears.	Repeated vomiting; nosebleeds.
	Temperature	Increases alternate with decreases.	Temperature 40 degrees.
	Jaundice and liver	Jaundice appears after a change in the color of urine. The liver is enlarged.	The pain is moderate; the severity is determined by tests.

Diagnostic procedures

The early stages of viral hepatitis A are difficult to diagnose, so you need to focus on the epidemiological environment. As a rule, already during this period the doctor will see the first signs (liver enlargement) and changes in biochemical parameters. Unfortunately, in most cases, diagnosis of hepatitis is carried out with clearly expressed icteric syndrome. In such cases, significance becomes laboratory methods diagnostics that determine the genotypes of the virus, the severity of organ damage and the causes of the development of pathology:

Blood analysis:
- general;
- biochemical.
General urine analysis.
Marker test.

Treatment

Bed rest is an important basic condition of treatment.

Spontaneous recovery of a person with hepatitis is not uncommon. Once diagnosed, there is no need to use specific therapy and you don't need to stay in the hospital. Treatment of viral hepatitis A of mild to moderate severity can be carried out on an outpatient basis. Hospital treatment required for patients with severe, protracted pathology or if complications are associated with hepatitis A.

Treatment at home for hepatitis A is aimed at eliminating symptoms and signs of poisoning of the body, as well as restoring liver functionality. Basic therapy covers the basic standards of treatment of pathology:

Bed rest. Limiting physical activity.
Diet food. Table No. 5 is assigned with the exception of fried, flour, strong tea and coffee, alcohol, and fatty foods. The diet is followed during the treatment of hepatitis and after recovery for about six months.
Medicines that restore intestinal microflora and enzyme agents. They help break down proteins, fats, carbohydrates and accelerate their absorption (“Lactulose”, “Normaze”, “Creon”, “Festal”).
Medicines that restore liver function (hepaprotectors) are the standard of therapy. The medicine provides the presence of structural components that are necessary to restore the cell membrane (Karsil, Essentiale).
Folk remedy. Herbal infusions have choleretic and anti-inflammatory properties (mint, calendula, knotweed, St. John's wort).
Physiotherapeutic procedures.

Treat hepatitis using a minimum of medications, avoiding ineffective medications - treatment principles.