Hepatitis D is a viral disease of the liver caused by the delta virus (HDV). A feature of the disease is that it occurs only in the presence of hepatitis B. That is, it is possible to become infected with form D only in the presence of the B virus or after it. Without a companion, hepatitis D viruses cannot reproduce. This is a favorable feature of microorganisms, which allows to somewhat contain the number of cases.
Hepatitis D is not common in Russia. This virus is the most destructive and causes cirrhosis of the liver. Pathology is transmitted through blood or sexual intercourse. Today, there are about 15 million people in the world with this diagnosis. Most of the patients are young people.
Distribution routes
Viral hepatitis D does not exist separately from hepatitis B. It is simply impossible for them to become infected alone, therefore, infection with viruses usually occurs in turn, and form B must be primary. It is also possible to become infected with two forms of hepatitis at the same time.
The sources of the disease are people with pathology in acute or chronic form. Microorganisms are not transmitted by airborne droplets. Only themdirect exposure to the internal environment of the body can cause this disease.
Hepatitis D transmission routes are as follows:
- Blood transfusion. A person until a certain period may not be aware of his infection and at the same time be a blood donor. Errors and negligence in taking tests from a donor or in the subsequent processing of the collected material sometimes occur, so he althy people can become infected during transfusion. Patients who undergo this procedure multiple times are more likely to get hepatitis D.
- Multiple use of syringes. There is always remnants of infected blood at the tip of the needle, the use of the same instrument increases the risk of infection. Most often, drug addicts are infected in this way.
- Any manipulation that violates the integrity of the skin - tattoos, trimmed manicure, piercing, acupuncture, treatment by a dentist or cosmetologist. With insufficient disinfection of instruments, the remnants of the virus can enter the blood of a he althy person.
- Sharing hygiene products, hygiene items. Eyebrow tweezers, razors, toothbrushes, nail clippers and scissors are carriers of infection from the sick to the he althy.
- Sexual contact without the use of protective equipment (condom) is one of the main ways of getting infected with viral hepatitis D.
- Childbirth and feeding. The child becomes infected with the virus from the mother, passing through the birth canal, as well as through cracks in the nipples, which canappear when breastfeeding.
- The entry of the blood of an infected patient to the site of damage to the skin of a he althy person. The situation can occur due to an incredible coincidence or as a result of professional activity. Doctors are the most at risk of infection, because they have to work with blood, with sick patients, etc.
Hepatitis D virus is not transmitted through kissing, touching, coughing, sneezing.
Symptoms
From the moment the virus enters the body, its incubation period begins. The average period from infection to the first manifestations is one and a half months, and the maximum is six months. There are cases of superinfection when symptoms become apparent after 20 days. Strong immunity significantly delays the first symptoms of hepatitis, suppressing its development and extending the incubation period of the virus.
Once in the bloodstream, viral hepatitis D is carried by a stream to the liver and begins to multiply there, which affects the liver cells and the immune system that produces antibodies. The immune attack is aimed at destroying the B virus. When it is defeated, the D virus cannot reproduce either. At the same time, liver cells (hepatocytes) are already damaged by the attack of antibodies on the infection that they contained.
Hepatitis D symptoms:
- Discoloration (yellowing) of the whites of the eyes, skin, mucous membranes.
- Urine turns darker, stool gradually turns white.
- The patient experiences pain in muscles, joints.
- Body temperaturerising.
- Severe pain is felt in the region of the right hypochondrium.
- The skin is periodically covered with small pink blisters. The rash appears quickly and quickly disappears without the slightest trace.
- On palpation of the abdomen, the doctor detects an increase in the size of the liver and spleen.
- The patient constantly experiences fatigue, performance decreases, severe itching of the skin appears.
- Without any prerequisites, bruises appear on different parts of the body, a bitter taste appears in the mouth, appetite disappears, heartburn and belching torment.
The same symptoms appear when hepatitis B is affected. A blood test for antibodies and other studies can reveal which infection caused the deterioration of he alth and formidable signs.
Classification
Hepatitis D has two main forms of pathology:
- Acute - occurs when the two hepatitis viruses HBV and HDV are simultaneously infected. This form of the disease is successfully treated, despite its severe course. The spread of the infection is easily stopped, the body develops strong immunity to both types of the virus.
- Chronic hepatitis D is formed when the patient was already a carrier of the HBV virus, and later became infected with the delta virus. The disease will have bursts and decays. Exacerbations can occur against the background of the use of junk food, alcohol, a decrease in the protective functions of the body, in the absence of conservative therapy.
When a severe phase occursthe patient's pathology is haunted by severe headaches, dizziness, insomnia, sudden loss of consciousness, disorientation in time. There are also symptoms of pathology on the skin. Among them are spider veins, bruising and bruising, frequent and heavy bleeding from the nose.
Diagnosis
For treatment and diagnosis, they turn to an infectious disease specialist. Hepatitis A, B, C, D and other forms of pathology leave individual markers of their presence in the body. They help to determine the degree of development of the disease, the stability of the immune system, to predict the further progress of the disease.
Types of tests:
- Venous blood for the detection of 5 types of antibodies.
- Biochemical blood tests.
- Ultrasound to study the state of internal organs, primarily the liver and spleen.
- Puncture biopsy. The method examines the liver cells and allows you to most likely confirm or refute the diagnosis. The material is taken by inserting a needle into the liver area, the procedure is performed under local anesthesia.
Blood for hepatitis D analysis is taken from a vein. A prerequisite is the need to take it on an empty stomach, preferably in the morning. Antibodies produced by the immune system, antigens and RNA of the virus are detected in the blood.
What the study reveals
A disease such as hepatitis D has been studied quite well. How it is transmitted from person to person is also known reliably. But medical science cannot predict how eacha specific patient will respond to therapy, whether his body will be able to completely overcome the disease, how long the patient will live with strict adherence to all recommendations of conservative treatment.
When conducting a study, a specialist pays attention to antibodies that determine the stage of the disease:
- Immunoglobulins M anti-HDV. Their presence in the blood means that the disease is in an acute phase. They are produced by the body's immune system to neutralize the action of the virus and signal the mobilization of other members of the internal defense. The result of activity should be the dissolution of the virus by enzymes and its absorption by macrophages.
- Immunoglobulin G anti-HDV is a practical victory over the virus. If they are found in a blood test, it means that the body has successfully coped with hepatitis and even developed a strong immunity to the disease.
The absence of group M antibodies in the blood indicates that the disease has passed into the chronic stage. Hepatitis D will require a long and painstaking therapy from the patient and the doctor. Treatment aims to mobilize the immune system and create conditions for activating the internal reserves of the body so that it can overcome the disease. How long this will take, the specialist cannot predict.
Treatment
How to treat hepatitis D, the doctor will tell. After diagnosing the disease, the patient begins a long process of therapy, part of which is implemented in the infectious disease inpatient department of the hospital. Treatment is carried out in threemain destinations:
- Antiviral therapy. Drug treatment consists in the use of the drug "Interferon alfa". Until recently, other drugs were also used (Lamivudine, Famciclovir, etc.), but they did not show significant results. "Interferon alpha" strengthens the immunity of he althy liver cells, increasing their resistance to the penetration of the virus. Also, the drug supports macrophages (immune cells) to fight the virus, has a negative effect on the ability of the virus to reproduce. Interferon alfa is introduced into the body in the form of rectal suppositories. Duration of admission in some cases is 48 weeks.
- Liver functions are supported by taking hepatoprotectors. These drugs include - "Essentiale", "Essentiale-forte", "Phosphogliv", etc. The composition of drugs includes substances that serve as the building material of the liver. Hepatoprotectors are taken for a long period, at least 3 months at a dosage of 1 capsule 3 or 4 times a day.
- Normalization of the liver is also necessary for the life of the body, so the specialist prescribes drugs to regulate bile secretion and protect liver cells from toxins (Gepabene, Tykveol, etc.). To normalize metabolic processes, preparations based on amino acids ("Geptral", "Hepa-Merz", etc.) are prescribed.
- The removal of toxins that violate the protective functions of the liver is carried out by taking adsorbents ("Enterosgel", "Polysorb"). Together with toxins, they collect and remove decay products in the intestines, improving the general condition of the patient. Preparationstake courses lasting 14 days with a break of 2-3 weeks. Reception of adsorbents is indicated during the entire period of treatment.
Diet
Viral hepatitis D is accompanied by disorders of the liver, so it is important for the patient to follow the diet and strictly adhere to the recommended diet. The treatment table No. 5 (according to Pevzner) is taken as the basis of nutrition. Fried foods are completely excluded from the diet. Attention is paid to the amount of liquid drunk per day (at least 2 liters).
Products are boiled or steamed, stewed. Also, you can not eat fatty meats, fish, rich broths, pickled and smoked foods, confectionery, sour berries and fruits, muffins, chocolate, eggs.
The daily table should contain a large amount of fiber (cereals, vegetables), dairy products, dietary meat and fish. The size of the portions is small, the reception is carried out fractionally (5-6 times a day) at equal intervals. The duration of the diet is determined by a specialist. The transition to diet number 4 is carried out when signs of recovery appear.
Recipes of traditional medicine
Any medicines of folk healers are aimed only at strengthening the immune system and supporting liver functions. They cannot cure the disease, but they will give a significant relief of the condition and speed up the process of recovery with the emerging progress.
Phytotherapy Recipes:
- Inelecampane root. Powdered dry rootplants take a small pinch (at the tip of a knife) 2 times a day, half an hour before meals.
- Horseradish root tincture to restore the antitoxic functions of the liver: chop 250 g of horseradish root in a blender or grate and pour warm boiled water (0.5 l). Insist during the day, strain, Tincture drink 1 dessert spoon 3 times a day (20 minutes before meals). The course is up to 3 months.
- Reception of beekeeping products (perga or flower pollen) 30 g daily in the morning. The duration of therapy is unlimited.
- Phyto tea - sage leaves, wormwood, juniper berries mix in equal amounts and take 0.5 cups of dry composition. Pour boiling water over the herbs (3 cups), insist and strain. Drink all the brewed tea during the day.
Vaccination
Vaccination against hepatitis B is the best prevention of hepatitis D. Vaccination reduces the risk of infection by 90%, it creates stable immunity for decades. This step will not help patients with chronic hepatitis B.
For stable immunity, vaccination is carried out three times. After the introduction of the first dose, the next patient receives a month later, and the last one 4 or 6 months after the first stage of vaccination. In Russia, all newborns are vaccinated against hepatitis D. There are certain population groups that are at risk. Regardless of previous vaccination, they should be vaccinated additionally.
Who needs a preventive vaccination:
- The family of a person diagnosed with hepatitis B.
- Patients requiring continuous blood transfusions.
- People who frequently change sexual partners.
- Injection drug users.
- Patients with HIV, AIDS, chronic liver pathologies, STDs.
Knowing all the ways of spreading hepatitis D, it is not difficult to guess what rules can protect against infection:
- Use only personal hygiene products (tweezers, tweezers, scissors, shaving accessories, toothbrushes, etc.).
- Safe sex.
- Rejection of bad habits (alcohol, drug addiction).
- Requirements for clinic workers in the careful processing of instruments.
For patients diagnosed with hepatitis D, as medical practice shows, moderate physical activity is very beneficial. Under loads, metabolism is normalized, recovery processes are launched, oxygen supply to tissues improves, and immunity is strengthened. At the first signs of remission, it is necessary to start playing sports. Preference is given to cardio, cycling, walking, etc.
Forecast
The acute form of hepatitis D responds well to treatment. The disease, diagnosed in the early stages, recedes with adequate treatment, the patient recovers in 95% of cases. At the same time, the functions and cells of the liver are fully restored, and the body develops a stable form of immunity.
Chronic hepatitis is almost incurable, only 15% of patients recover fully. The success of therapy and the achievement of complete remission depends on the timeliness of diagnosis,compliance with all conditions of treatment, the mood of the patient. How long the treatment may last, no one can predict.
