The viral hepatitis, colloquially called "jaundice" or "infections jaundice", is a disease caused by one of several well-linown hepatotropic viruses, it means the viruses specialized in attacking the liver cells - hepatocites. These days, the well-linown types of viruses responsible for causing the viral hepatitis are named with letters of alphabet to begin with A.The list of viruses,which is still opened,attacking the liver ends on G,at present.(with the omission of F).
The symptoms of the disease occuring in course of the vivral
hepatitis are simiral in all types of this disease,regardless of the type of the virus
causing it.These are:
- jaundice(as symptom)accompanied by darkening of urine,less often decolourizing of
excrements,
- flu-like symptoms (little fever, pains of muscles, joints and bones),
- dyspeptic symtoms (lack of appetite, nausea, vomitting),
- weakness,
- aches and pains, dilation in the right hypochondrium caused by enlargement of the liver,
- less often - itching of skin,
- very seldom - bleeding from nose and gums, hepaticum coma
The longest well-known, and at the same time the most often occuring from of the viral hepatitis colloquially called " alimentary jaundice" is caused by the HAV virus - hepatitis A virus, constantly present in the environment, passing by alimentary way. For this reason, the viral hepatitis of type A bolongs to a group of diseases of "dirty hands". Classical symptoms of the disease that allow its comparatively easy diagnosis, well-linown ways of transfer and protective vaccinations often used, cause that from several years the number of the viral hepatitis of type A systematically diminishes in our country. Such decrease has however one negative effect. More and more less people get natural resistance in their childhood be the contact with the virus, and in effect the age of people falling ill increases, what is disadvantagous for them, because adlut persons pass the disease more heavy. In the cause of adlut persons, complications are also more frequent and the hospitalization of an ill person is often needed
He or she can become infected with the viral hepatitis of type A by consumption of infected water or food especially raw, or by the contact with an ill person in early, without any symptoms, phase of disease. The danger of infection increases in regions or countries where the hygiene rules are bad.
The efficient way of protection against the viral hepatitis of type A is a protective vaccination, two doses of the vaccination accepted in distance from 6 to 12 monts assure long-standing immunity.
Considerable part of people susceptible to the viral hepatitis of type A is also very susceptible to the viral hepatitis of type B (passing from one person to another by infected blood)
The viral hepatitis of type B is can infections disease standing out by its
extensive, without any pus from, caused by the hepatitis virus of the type B (HBV). This
is the most frequent form of the viral hepatitis. It is said that there are 300-400
milions of infected people in the world. The least number of infected people in found in
Northern Europe, in Northern America and in Australia (<0.1%)and biggest number of
infected people (>20%)is found in Africa, Asia and some countries of Pacific Ocean. In
Poland, the number of carries is middle increased (1-2%) but about 20% of the population
passes antibodies testifying past infection. It is said that the viral hepatitis of type B
is one of the most common infections disease. At the same time, that disease is very
dangerous, because apart from its sharp forms whose number diminishes in last years,
it causes the protracted form of hepatitis, often with very little symptoms or even witout
any symptoms. There is also the danger of cirrhosis and primary liver cancer caused by the
HBV virus. The virus is present in almost every secretion and excretion of a infected man
e.g. in blood, saliva, sweat, urine. He or she can become infected:
- during delivery from infected mother,
- by using badly sterile madical equpment (neglect in agencies of the Health Servive,
drug addicts),
- through sexual relations
The viral hepatitis of type A and B is especially dangerous for people having constantly problems with the liver. In this case, the jaundice is more dangerous as usual and the cases of death are more frequent
Changes in the liver caused by the viral hepatitis of type B (HBV) are complex and depend on what effect the virus has on the whole organism of an ill person. The virus has no direct effect on the state of the liver. Its stste depends on the immune system. Good working and efficient immune system causes that, even when we are seriously ill, we are able to overcome the viral hepatitis of type B without any special treatment.
Other forms the disease depend on irregular relationships between the development of the disease and the immune system. In this case, it is possible that the virus will survive and the person will become a carrier of the virus which occures in 5-10% of cases when talkinf about adluts. The carriers of the antigen HBs may not show any symptoms of the disease (70-90% of all ill persons) or develop symptoms of the protracted hepatitis (10-30% of all ill persons). The protracted hepatitis can be recognized if after 6 months from the beginning of the treatment the patient is still ill, it means if there is the antigen HBs and some indicators of the replication of the virus (antigen HBe and DNA of the HBV virus) and there is a lack of antibodies anti-HBe and anti-HBs. The risk of a primary liver cancer in case of caries of the HBsAg is 400 times bigger than in the case of the whole population.
The viral hepatitis of type C (hepatitis C) in an infections disease, standing out by its extensive, without any pus form, caused by the hepatitis virus of type C (HCV). There are 6 gene-types of the virus and a dozen subtypes, from which the most known is the subtype 1a which causes about 60% of all casues of the disease.
About 80% of the infected people are carriers of the virus, and 40-90% of the infected people are touched by its protected form. HCV is a virus connected with the primary form of the liver cancer whose development is preceded by the cirrhosis.
Ways of infection of the HCV:
- by transfusion of blood and blood-like products,
- as a result of tissues damages during some medical interventions,
- during hemodializ,
- during the childbirth,
- trough sexual realtions,
- by an unknown way, called a sporadic hepatitis of type B.
The viral hepatitis of type C can have some symptoms of the jaundice or, in case of children often, without these symptoms. A sharp form of the hepatitis can have no symptoms.
The basic sifting test consist in finding antibodies anti-HCV. Detection of these
antibodies, using the ELISA test, requires a confirmation by another test and the detection
of the RNA of the virus is also necessary. According to the fact that antibodies anti-HCV
can be detected only 1 to 5 mnoths after the bedinning of the contamination, this examination
hasn't got any importance in recognizing a sharp form of the viral hepatitis of type C.
Because of the complexity and the multiplicity of the liver functions in different biochemical
processes, it is not possible to find an universal test which could tell us how much the
liver is damaged nor just to tell us whether it is damaged in general or not. To state it,
it is necessary to do a number of examination and tests and also to interview an ill
person. One of the factors taken in consideration to state the liver state is the time of
coagulation od blood, because the liver produces protrombine, one of the plasma's protein,
from where coagulability problems appear. The other way to define the liver state is the
hormons level examination prodeced by the liver. The level of hormons present in an ill
person blood allows to describe not only state of the liver but also damages degree. In
some cases to define the degree of liver damages it is necessary to do the examiantion
of the bilirubine level in the organism, because the liver is responsible for decaying
it in the organism, and a damanged liver decays less bilirubine than the healthy one.
Too much bilirubine causes yellowish skin, one of the hapatitis symptom. Unfortunately, it
is possible to become infected without any symptoms; neither jaundice nor the bigger
level of the bilirubine appear.
The main method of healing pepole touched by a sharp form of the viral hepatitis of type C, which causes recovery in 50% of causes, is a treatment with interferon alfa. In addition, the rest is recommended. During very sharp periods of the disease, an ill person itself limits his or her actuvity because of the weakness and pains. During the periods, he or she has no hunger and we shouldn't force them to eat. After the hospital period, the patient should be on a diet according to his or her feeling. He or she should avoid dishes causing pains of the abdominal cavity e.g. inflations, nausea, belches, pains next to the right ribbs.
The thundering viral hepatitis demands a very intensive pharmacological treatment, which could diminish disturbances caused bu the damanged liver, and even the transplantation of this organ.