Hepatitis B: causes, symptoms and treatment in an article by infectious disease specialist Aleksandrov P. A.

What is hepatitis B?

Hepatitis B is a virus that, upon entering the human body, begins to have a negative effect on vital internal organs. The liver, which is affected at the microcellular level, suffers most from this disease. Group B hepatitis may be asymptomatic or may be accompanied by pronounced symptoms. Having passed into the chronic stage, this viral infectious disease often provokes the development of liver cirrhosis and cancer.

For many years, statistics on this disease have been kept in all countries of the world, the results of which are published in specialized media:

Acute hepatitis B, detected in newborns, becomes chronic in 90% of cases;
The acute form of hepatitis B, detected in young people with a normal immune system, very rarely becomes chronic - in 1% of cases;
Acute group B hepatitis, detected in adults, becomes chronic in 10% of cases.

When vaccinated against hepatitis B, patients begin to develop immunity to this disease:

After the introduction of the first vaccine - in 50% of patients;
After administration of the second vaccine - in 75% of patients;
After the administration of the third vaccine - in 100% of patients.

The chronic form of hepatitis B is diagnosed in children:

The age of which ranges from 1 year to 5 years – in 25%-50% of cases;
Those who were infected during childbirth - in 90% of cases.

Types of hepatitis B

Group B hepatitis is classified as follows:

Fulminant. In the fulminant form of hepatitis, patients experience brain swelling and coma within a few hours. In most cases, the life of this category of patients is tragically interrupted a short period of time after the transition of fulminant hepatitis to the clinical stage;
Spicy. In the acute form of group B hepatitis, patients experience several stages of the disease. First of all, primary symptoms appear, after which the skin of patients acquires a yellow tint. The last stage of acute hepatitis B is characterized by liver failure;
Chronic. Group B hepatitis becomes chronic 1-6 months after the virus enters the human body. These few months are the incubation period, after which characteristic symptoms and signs begin to appear.

Manifestations of hepatitis B

After a viral infection enters the patient’s body, the incubation period of hepatitis begins, which on average ranges from 15 to 90 days, but can last up to 6 months.

The acute form of hepatitis can occur as follows:

Exacerbation stage;
Protracted course of the disease;
Relapses;
In rare cases, hepatic coma.

Why is hepatitis B dangerous?

If hepatitis B is diagnosed at a late stage, or if the disease is not treated promptly, the outcome is obvious: cirrhosis or hepatocellular carcinoma.

This category of patients may face other serious consequences of hepatitis B:

Myocarditis (inflammation of the heart muscle occurs);
Arthritis, arthrosis and other joint diseases;
Diseases of blood vessels and kidneys, etc.

Against the background of such complications, the risk of death increases significantly.

Currently, a list of people at risk who require mandatory vaccination against hepatitis B has been approved at the state level:

Schoolchildren and students;
Kindergarten students;
Healthcare workers who may come into contact with biological material from patients;
Patients requiring hemodialysis;
Patients requiring intravenous injections;
Persons serving sentences in places of deprivation of liberty;
Relatives and friends of patients with chronic hepatitis B;
People who have promiscuous sex;
Drug addicts;
Tourists planning to travel to populated areas where outbreaks of this disease have been recorded.

Prevention

The following measures will help reduce the risk of infection:

Use of disposable medical instruments;
Use of protective equipment for medical laboratory workers;
Using only your own hygiene products (brushes, manicure accessories);
Quitting drug use;
Safe sex acts;
Timely vaccination.

Causes of hepatitis B

The cause of the development of group B hepatitis is the penetration of the causative agent of this disease into the human body - a virus. Patients with a weakened immune system, which is influenced by negative factors: alcohol, nicotine, chemical and toxic substances, and medications, are especially susceptible to this disease. Immunity can also be affected by diseases suffered by the patient, which resulted in metabolic disorders in the body, lack of vitamins and minerals, etc.

People who suffer from group B hepatitis should not be in social isolation, since this viral infection is not transmitted by airborne droplets. Anyone who comes into contact with a sick person should take the necessary precautions and personal hygiene rules. According to data obtained by specialists from around the world as a result of many years of research, the course of this disease directly depends on the method of infection of the patient, as well as on his age. If a patient becomes infected with group B hepatitis naturally (for example, through sexual contact), the risk of the disease progressing to the chronic stage increases. This form of hepatitis is most often found in young people who do not take their health seriously and do not respond to alarm signals from the body.

How is hepatitis B transmitted?

Group B hepatitis can enter the human body only through contact with biological material of the patient:

Sexually. A carrier of hepatitis B contains the virus not only in the blood, but also in all secretions (vaginal secretions and male sperm), therefore, with unprotected sexual intercourse, the risk of infection increases significantly;
Through saliva, with a deep kiss. A person can become infected with the hepatitis B virus through a kiss if there are cuts or damage to his tongue;
Through blood. This method of infection is considered one of the most common. Most patients became infected with the hepatitis B virus during injections made with non-sterile syringes, as well as through blood transfusions. This virus is actively spreading among people who use drugs intravenously. The blood of a sick person infected with hepatitis B may remain on the instruments used by the dentist in his work. If dental offices do not properly sterilize equipment and instruments, patients are at risk of infection. Human contact with contaminated biological material of a patient can also occur in nail salons that do not carry out appropriate sanitary measures.
During childbirth, if the mother is a carrier of hepatitis. Despite the fact that the patient’s pregnancy proceeds without complications, during active labor the child will have direct contact with the mother’s biological material, and therefore will be at risk of infection. To prevent the development of this disease in newborns whose mothers are carriers of hepatitis B, such infants are vaccinated immediately after birth.

The hepatitis B virus is highly resistant to aggressive temperatures, acids and alkalis. For a long time, the virus can persist in dried blood that remains on instruments, both medical and manicure or shaving. Therefore, it is very important for every person to be extremely careful and take every possible care of their safety when visiting relevant institutions.

The hepatitis B virus is 100 times more contagious than HIV (human immunodeficiency virus).

Despite the widespread introduction of vaccination against hepatitis B, the prevalence of the disease remains high. In different regions of Russia, the prevalence of carriage of the virus ranges from 1.5% to 11.5%. As with hepatitis C, the source of infection is the blood of an infected person. The routes of infection are similar: the use of non-sterile needles, instruments for various medical and non-medical (piercing, tattoos, manicure/pedicure) manipulations, the use of personal hygiene items of an infected person in everyday life (razor, scissors, toothbrush, etc.), unprotected sexual contact, transmission of the virus from an infected mother to her child. The hepatitis B virus is more stable in the external environment and more contagious than the hepatitis C viruses and human immunodeficiency viruses. Therefore, the natural routes of transmission of the B virus (sexual transmission and mother-to-child transmission) are more significant for this virus.

Symptoms of hepatitis B

Many patients with hepatitis B do not experience any external manifestations of this disease for a long time. The virus can only be detected through a laboratory blood test, which is necessary for medical examination or pregnancy registration. In such cases, a special test is done - a blood test to detect the “Australian antigen”.

When hepatitis B develops in the human body and has external signs, patients may experience the following symptoms:

Nausea;
Dizziness;
Fast fatiguability;
Rhinitis;
Increased body temperature (often the temperature reaches 39-40 °C);
Cough;
General weakness;
Pain in the nasopharynx;
Severe headaches;
Change in skin color (jaundice);
Yellowing of mucous membranes, eye sclera, palms;
Change in the color of urine (it begins to foam, and the color resembles dark beer or strong tea);
Pain syndrome in the joints;
Loss of appetite;
Change in the color of stool (discoloration occurs);
Heaviness in the right hypochondrium;
Chills.

When hepatitis B enters the chronic stage, patients, in addition to the main symptoms, develop signs of liver failure, which causes intoxication of the body. If at this stage of the development of the disease the patient does not undergo comprehensive treatment, he will suffer damage to the central nervous system.

Vaccination against hepatitis B

To prevent hepatitis B infection, people are strongly encouraged to get vaccinated up to date. A specially developed vaccine must be stored at a certain temperature. Vaccination against hepatitis B, in accordance with the requirements of the Ministry of Health of the Russian Federation, is administered only intramuscularly. If the vaccination was given subcutaneously during vaccination, it should not be counted and the patient will need a second injection.

Not all people can take part in vaccination, as there are a number of contraindications. The vaccine should not be administered:

People who have food allergies (to beer, yeast, kvass and other food products that contain yeast);
Pregnant women;
Nursing mothers;
Premature babies.

Today, there are two vaccination schemes for hepatitis B:

Standard (0 – 1 month – 6 months). The first injection is given to the patient on the selected day. A month later, a second vaccination is given. The third injection is given 6 months after the first vaccine.
Alternative (0 – 1 month – 2 months). The first vaccination is given on the chosen day, the second after 1 month, the third - after two months. When vaccination is carried out according to this scheme, revaccination is performed 1 year after the first vaccine was administered to the patient. Revaccination is prescribed for a certain category of patients - people with problems with the kidneys or immune system.

After vaccination against hepatitis B, side effects may occur. In most cases, local body reactions are observed:

Redness of the skin in the area where the vaccine was administered;
Small compaction at the injection site;
Slight discomfort during movement;
Slight increase in temperature;
The appearance of a rash or hives (it goes away on its own after a short period of time);
Signs of a cold;
Development of pain in the muscles or joints.

In medical institutions located on the territory of the Russian Federation, the following types of vaccines against hepatitis B are used:

Indian vaccine Shanvak B;
South Korean vaccine Euvax B;
Belgian vaccine Engerix B;
Cuban vaccine Eber-Biovac;
Dutch vaccine HB-Vax-II;
Russian vaccines Bubo-M, Bubo-Kok.

Before administering the vaccine, a healthcare worker needs to check its expiration date and correctly calculate the dosage, which directly depends on the patient’s age. All modern vaccines against hepatitis B are interchangeable. Thanks to this, after the first injection, you can use drugs from other companies for the next two vaccinations.

Vaccination can also be carried out for preventive purposes when there is a possibility of infection of the patient. After any contact with the biological material of a patient with hepatitis B, the vaccine should be administered along with immunoglobulin (this specific drug consists of ready-made antibodies that are resistant to the virus). This category of patients is vaccinated according to an alternative schedule: 0 – 1 month. – 2 months - 1 year.

How long do you need to wait for an answer?

When conducting a PRC examination, the analysis results will have to wait at least 3 days. But after this period of time, you can only get an answer about the absence or presence of the virus. In order to find out the viral load on the body, you will have to wait about a week.

It is not possible to speed up the process, since it takes a certain time to grow a DNA virus chain.

ELISA response time depends on the test option and the size of the laboratory. In the second case, small centers try to recruit the largest number of patients in order to fully utilize the reagent plate. In this case, waiting for a response may take up to 10 days. Under normal circumstances, a response is issued within 1-2 days.

Diagnosis of hepatitis B

If a person has identified symptoms indicating that he has developed hepatitis B, or he has reason to believe that he could be infected with this disease, he urgently needs to visit a medical facility. During the appointment, the specialist will conduct an examination, examine the liver area using palpation and collect an anamnesis of the disease. Laboratory testing of blood and urine will help confirm or refute the primary diagnosis.

In all similar cases, the patient is given a referral to:

Clinical and biochemical blood tests (elevated bilirubin, or AST or ALT levels can show problems with the liver);
General urine analysis;
A blood test that detects the virus antigen of this form of hepatitis;
Blood test for IgG, IgM antibodies.

Very often, patients who are suspected of having group B hepatitis are prescribed a clinical laboratory test called an immunogram, thanks to which it is possible not only to study how exactly the body reacts to this disease, but also to make a prognosis for the near future. To determine the genetic material of this infectious viral disease and determine the rate of replication, the attending physician may prescribe an additional test - PCR. In severe cases of the disease, when the doctor suspects complications developing against the background of hepatitis B, patients are prescribed a liver biopsy. Through this analysis, it is determined how much the structure of the liver is changed, and whether there is a malignant degeneration of its cells.

Dispensary registration

In case of treatment in a hospital setting, the patient is discharged 30-35 days from the start of therapy. At this time, body functions are restored, transaminase levels are slightly reduced. The doctor gives the patient a note. It describes how to eat properly and what the recommended regimen is.

The first examination after the patient’s discharge is carried out after 30 days, then after 3, 4, 5 months. They are removed from the dispensary register if the indicators of general clinical tests and biochemistry are within normal limits twice in a row, and HBsAg is absent.

Patients are interested in whether hepatitis can be treated with folk remedies. On websites devoted to the treatment of viral liver damage, you can find reviews that someone was/was treated using traditional medicine recipes. However, it should be remembered that such drugs cannot replace full-fledged drug treatment. They can only be used as a supplement to support the functioning of liver cells and accelerate their regeneration.

Treatment of hepatitis B

If acute hepatitis B is mild, the sick person can undergo treatment at home. First of all, the body should be detoxified, for which it is necessary to use clean water in large quantities.

The attending physician should prescribe medications to the patient that will help destroy the infection and restore liver function. During treatment, the patient must remain in bed and exclude any physical activity. Without fail, he should adhere to a dietary diet, thanks to which the recovery processes in the liver will take place much faster.

Acute hepatitis B goes away on its own in most patients, so they are not prescribed a special course of drug therapy. Specialists may recommend maintenance therapy for such patients, which will make it easier for the body to cope with the viral infection. If during the development of the disease the patient’s body has undergone severe intoxication, the attending physician will prescribe special solutions that are administered intravenously by drip. Through droppers with hemodesis, toxins will be removed from the blood more quickly, and the patient’s general well-being will improve.

When hepatitis B enters the chronic stage, patients are prescribed complex treatment:

Medicines that have an antiviral effect (adefovir, lamevudine, etc.);
Drugs that can slow down the development of liver sclerosis (interferons);
Immunomodulators, thanks to which immune reactions are normalized in the patient’s body;
Hepatoprotectors, the functions of which are to increase the liver’s resistance at the cellular level to the hepatitis B virus (List of the best hepatoprotectors for liver restoration);
Special vitamin and mineral complexes.

This category of patients is recommended to drink a large amount of liquid daily, through which the body will be detoxified.

Chronic hepatitis group B has several stages of development that occur cyclically:

Replication - at this stage the virus begins to actively multiply in the patient’s body;
Remission - when entering this phase, the virus begins to integrate its DNA into the genome of the hepatocyte.

To get a positive result from drug therapy, it is very important for the doctor to carry out a set of therapeutic measures precisely at the replication stage. To do this, it is necessary to correctly determine the phase of the disease by prescribing a laboratory examination for the patient. Thanks to a serological blood test, a specialist will determine the stage of chronic hepatitis.

The choice of treatment technique directly depends on the patient’s individual characteristics. Many domestic specialists use in their work the practice of world-famous doctors who have achieved great success in the fight against the hepatitis B virus. In order to fully control the patient’s condition, he must be admitted to a hospital.

In some cases, in patients who have successfully undergone treatment for group B hepatitis, the virus antigen remains in the blood for many years. This category of people are carriers of this infection, who must undergo regular medical examinations, including mandatory tests.

For patients who have been diagnosed with hepatitis B disease, there are several options for the development of events:

A person undergoes complex therapy and gets rid of a viral infection, acquiring lasting immunity to this disease;
In a patient, the acute form of hepatitis B becomes chronic, which can be accompanied by serious complications for the body;
After treatment, the patient becomes a carrier of the hepatitis B antigen, which will not cause him concern for decades. For 20 years, this virus can be present in the patient’s blood without visible clinical manifestations;
A patient who does not go to a medical facility in a timely manner develops cirrhosis or liver cancer, which requires emergency surgical intervention. For this category of patients, the risk of death increases significantly.

After completing a course of drug therapy, each patient who has suffered from group B hepatitis will be registered for several years at the medical institution where he was treated. To exclude the occurrence of any complications, patients should carry out preventive measures at regular intervals, as well as carefully monitor their diet and lifestyle.

Diet for hepatitis B

Group B hepatitis is a disease that affects the liver. As a result of the development of infectious and inflammatory processes, this vital organ is affected at the microcellular level. In order to facilitate liver function during treatment, the patient must adhere to a diet. Experts recommend that patients use a specially designed dietary program.

First of all, a person will have to divide his daily food intake into 5-6 meals, equal in volume and amount of nutrients. During therapy, it is strictly forbidden to take part in mass feasts, which are usually accompanied by the consumption of large amounts of junk food and alcoholic beverages. In the evening, the patient should eat light foods that will not put a strong burden on the digestive system.

The following foods should be excluded from the daily diet of a patient with hepatitis B:

Spicy dishes and seasonings;
Smoked meats and pickles;
Vegetables that contain essential oils in large quantities;
Alcoholic and carbonated drinks;
Cold drinks and ice cream;
Fatty types of meat and fish;
Waterfowl meat, as it puts a lot of stress on the pancreas;
Lard and other foods high in cholesterol.

This category of patients is recommended to eat daily:

Cereals, especially oatmeal;
Dairy products;
Soybean, olive and vegetable oil;
Chicken egg white;
Lean meats and fish.

Dishes should be steamed, as during such processing the maximum nutrients are retained in the products. The daily diet should contain no more than 3,500 kcal (100 g of proteins, 100 g of fat, 450 g of carbohydrates).

Read more: Diet for hepatitis C

Complications of hepatitis B

With severe hepatitis B, patients may develop various complications:

Brain swelling;
Many patients have hepatic encephalopathy. The patient begins to experience anxiety, hallucinations, and fear. Over time, the functions of the nervous system become impaired, resulting in a depressed state, loss of sleep, etc. At the very last stage of encephalopathy, the patient may fall into a coma.
Liver or respiratory failure;
Cirrhosis or hepatocellular liver cancer.

When infected with hepatitis B, people should undergo prompt treatment to prevent the disease from becoming acute or chronic. The average life expectancy of patients will directly depend on the rate of disease progression.

Asoratlari

Gepatitning ogir kechishida bemorlarda turli khil asoratlar rivozhlanishi mumkin:

Miyaning yalliglanishi;
Kўpgina bemorlarda gigar ensefalopathysi kuzatilady. Bemor bezovtalik, hallucination, qўrkuvni boshdan keciradi. Vaqt ўtishi bilan asab tizimining vazifalari buziladi, natijada avolning emonlashuvi, uyku buzilishi va boshkalar kuzatiladi. Ensephalopathy sўnggi boskichida bemor komaga tushishi mumkin;
Jigar yoki nafas olish yetishmovchiligi;
Jigar sirrozi yoki hepatocellular saraton.

Kasallik ўtkir yoki surunkali boskichga ўtishiga yўl қўymaslik uchun ўz vaktida davolanish kerak. Kasallikning rivozhlanishi bemorlarning ўrtacha died kўrish darazhasiga boglik bўladi.