Chronic active hepatitis is a viral disease. The number of people suffering from it is increasing exponentially. In medicine, even fatal cases have been recorded. Can you live with it? Chronic hepatitis - how to treat and how? Let's take a closer look.
Feature of the disease
Chronic active hepatitis is inflammation of the liver cells. Fibrous and necrotic tissues and liver cells are affected. Patients with this disease often complain of pain in the right hypochondrium, nausea, loss of appetite and stool.
Over the past 25 years, a huge amount of information has been collected about this disease. Doctors were able to understand the mechanism of hepatitis development and develop effective methods of treatment. Several doctors are studying this issue, namely: a therapist, an infectious disease specialist, a gastroenterologist and others. Specific therapy and outcome depend on the form of hepatitis, the age of the patient and the general condition of the body.
The number of patients with this disease is steadily growing. According to statistics, around 400 million people worldwide suffer from chronic hepatitis B. About 170 millionchronic hepatitis C has been recorded. At the same time, about 100-200 million people are added to these figures every year.
The disease occurs most often in men with an incidence of 50 cases per 100,000 population.
Classification
Treatment depends on the type of hepatitis. Chronic hepatitis is classified according to a number of criteria:
- degrees of pathology activity;
- biopsy information;
- etiology.
Chronic hepatitis clinical have their own forms. Classified by reason of occurrence:
- active viral hepatitis B, C, D, A;
- drug - inflammation of the liver caused by the use of hepatotoxic drugs (for example, during chemotherapy);
- autoimmune - chronic liver damage that has an extensive area of inflammation;
- cryptogenic (etiology still unclear);
- alimentary (alcoholic).
Hepatitis is more common in children, young adults and pregnant women.
Chronic active hepatitis is divided into the following forms, taking into account the degree of activity of the pathology:
- minimal form - a mild degree of development of the disease, which is limited only by the development of inflammation;
- active form - this form of hepatitis exhibits vivid symptoms, and the effect on the liver is manifested by fibrosis and necrosis;
- lobular form - the inflammatory process in the liver is actively developing, if not treated, it will flow into necrosis.
Autoimmune form of hepatitis most often affects womenover 30 years old. As a symptomatology, characteristic weakness, increased fatigue, yellowness of the skin and pain on the right side of the body are noted. In addition to hepatitis, 50% of patients also have other pathologies: thyroid disease, inflammation of the joints, diseases of the skin, colon mucosa, diabetes mellitus and hair loss.
Alimentary (alcoholic) hepatitis occurs due to the ingestion of toxic and chemical elements. The name of the form of hepatitis indicates the causes of its development. Due to the intake of alcohol, poison accumulates in the liver, and in parallel with it, plasma lipoprotein is actively synthesized. Gradually, a glassy transparent substance is formed in the liver, which "attracts" blood cells to itself and activates inflammation.
The alimentary form of hepatitis is divided into two forms: chronic and acute. This type of disease is aggravated if a man takes 200 g of vodka at a time, and a woman - 100 g.
Chronic active hepatitis: symptoms
This form of hepatitis often occurs during childhood. Girls mostly suffer from this disease.
It is almost impossible to diagnose signs of chronic hepatitis at an early stage, since the disease proceeds without pronounced symptoms. In the course of development of hepatitis at the patient specific signs are shown. Asthenia clearly manifests itself - this is a psychopathological disorder in which chronic fatigue, increased fatigue, instability,sleep disturbance and exhaustion. In adult women, libido decreases.
Among the pronounced external symptoms are noticeable spider veins on the body, hyperemia of the palms - a disease in which the blood vessels in the palms expand, the hands become red.
Signs of chronic hepatitis:
- asthenic syndrome;
- fatigue;
- unmotivated weakness;
- sleep is disturbed;
- psycho-emotional instability;
- decrease in performance;
- enlarged spleen.
Patients often complain of extreme fatigue while doing simple household work.
If chronic active hepatitis was diagnosed in a man, then in addition to the above symptoms, gynecomastia may be added. This is a disease in which a man's mammary gland enlarges. The chest hurts to the touch and feels very heavy.
Both men and women with this condition experience hair loss on their pubic area and armpits.
Active chronic hepatitis, like inactive, is accompanied by fever. Skin vasculitis (immune vascular inflammation) occurs, namely:
- erythema (severe reddening of the skin);
- urticaria;
- purpura (small patchy capillary hemorrhages form in and under the skin).
During the development of this pathology, patients are often diagnosed with glomerulonephritis, a chronic kidney disease.
Many patients complain to the doctor about the darkening of the urine. The changed color of the urine resembles black tea, and the stool, on the contrary, becomes light cream.
Often during the course of the disease, subrenal jaundice occurs. Brown pigmentation on the skin signals this.
Chronic hepatitis can sometimes occur without pronounced symptoms. Pathology may masquerade as jaundice.
Reasons
Chronic hepatitis entails damaged tissue and liver cells. A certain immune response is formed, including aggressive autoimmune mechanisms. It is these components that cause the development of a chronic inflammatory process that lasts for a long time.
Doctors determined the dependence of the disease on the etiological factor.
The primary cause of chronic hepatitis is active viral hepatitis B, C, D, A, which was transferred to the patient earlier. Each of these pathogens affects the liver. Hepatitis B does not provoke the destruction of liver cells, but develops along with the immune response by affecting microorganisms in the liver and other tissues. Hepatitis C and D viruses have a toxic effect on hepatocytes (liver cells, which make up 60-80% of the total mass of the liver). As a result of exposure, they die.
The second common cause is intoxication of the body, which is caused by alcohol poisoning or taking medications (antibiotics, hormonal drugs, anti-tuberculosis drugs). Heavy metals and other chemicals can alsocause intoxication of the body.
Toxins and metabolic products accumulate in the liver cells. Over time, their work fails, bile, fats and metabolic disorders accumulate. They provoke necrosis of hepatocytes. In addition, metabolic products (metabolites) are antigens, the immune system actively reacts to them.
The third important reason is poor nutrition, alcohol and drug abuse. Infectious diseases, malaria, liver disease and endocarditis (inflammation of the inner lining of the heart) can also provoke chronic hepatitis.
Chronic hepatitis: stages
Based on histological examination and biopsy, four stages of the disease are distinguished separately:
- 0 stage - no fibrosis;
- 1 stage - slight periportal fibrosis is noticeable (connective tissue grows around liver cells and bile ducts);
- 2 stage - relatively moderate fibrosis develops: connective tissue grows, partitions form. They connect adjacent portal tracts, which are located at the corners of the hepatic lobule. Takes on a hexagonal shape;
- 3 stage - severe fibrosis, porto-portal septa are formed that disrupt the structure of the liver;
- 4 stage - there are signs of a violation of the structure of the liver.
The connective tissue grows completely and the structure of the liver changes dramatically.
Diagnosis
Diagnosis of chronic hepatitis should be timely. The doctor can make a final diagnosisput only on the basis of the clinical picture, the results of instrumental and laboratory examinations.
Required tests:
- blood test for markers;
- Ultrasound of the abdominal cavity;
- study of blood supply to the liver;
- liver biopsy.
The most accurate research method is a liver biopsy. Thanks to this method, it is possible to accurately determine the form and stage of the disease. Therefore, prescribe an effective treatment.
In order for the doctor to make the correct diagnosis, the patient must pass a series of tests. First of all, it is necessary to functionally examine the liver. Based on the results obtained, the doctor looks at how many times the amount of transaminase (enzymes that accelerate the chemical exchange reaction in the body) has increased.
Often the doctor prescribes laparoscopy to the patient. During this study, you can see how much the liver has grown.
Also, using a special tool in this procedure, the doctor clarifies the presence of superficial nodes. If they are, then the patient has portal hypertension. This syndrome indicates a violation of blood flow and acts as a complication of liver cirrhosis.
How is the disease progressing?
Chronic active hepatitis is quite difficult and difficult. The patient's pathological condition worsens, clinical and laboratory manifestations intensify.
If the disease worsens, it is fraught with death.
During illnessthere are signs of liver failure.
In some cases, cirrhosis of the liver is formed in the active stage of hepatitis. If the doctor is experienced, then he will detect cirrhosis at the first diagnosis.
The disease is dangerous. During its active stage, hepatocellular insufficiency and hypertension gradually develop. With this sign, blood pressure in the portal vein rises. Cirrhosis of the liver is the leading symptom. In this case, surgical intervention is necessary, but this cannot be done, since the disease is fraught with gastrointestinal bleeding.
What to treat?
If the doctor has diagnosed chronic active hepatitis, treatment should be aimed at eliminating the cause of the development. Then it is necessary to prescribe therapy to stop the symptoms and improve the general condition of the patient.
Chronic hepatitis, symptoms and treatment are interrelated. The course of therapy should be comprehensive. Usually, patients are prescribed a basic course, which is aimed at reducing the load on the liver. An inactive lifestyle, bed rest and a minimal amount of medicines are shown. It is important to follow a special diet that will have enough protein, vitamins and minerals. Fatty, fried, smoked, canned, spicy, alcohol and strong drinks (tea, coffee) should be excluded.
The doctor must prescribe a vitamin course in injections. The following vitamins are directly shown: B1, B6 and B12.
If the patient has constipation, the doctor prescribes softlaxatives to improve digestion - enzyme preparations that do not contain bile. Therapy includes protecting liver cells and accelerating recovery processes. For this, the doctor prescribes hepatoprotectors, which must be taken for 2-3 months and repeated 2-3 times a year.
If a patient has viral chronic hepatitis, then treatment will be more difficult and longer, since this form of the disease is difficult to treat. Here, the main role is played by immunomodulators, which indirectly affect microorganisms, activating the immune system.
If the occurrence of chronic hepatitis was provoked by intoxication, then it is necessary to immediately carry out detoxification therapy, and make sure that toxins do not penetrate into the blood. For example, stop taking the drug, alcoholic beverages and change jobs (if the patient worked in the chemical industry).
For hepatitis C, such drugs for treatment are effective: Prednisol, Laferon, Timalin.
A patient treating chronic active hepatitis should be followed up by a hepatologist or gastroenterologist for about 3 years. After discharge from the hospital for the first six months, the patient should be observed by a doctor once a month. If possible, then examine the antibodies in chronic active hepatitis. In the first year of treatment, it is necessary to hospitalize the patient at 6 and 12 months to make adjustments to therapy.
Prevention
People with any form of hepatitis are not at riskfor those around you. The myth that this disease is transmitted by airborne droplets or household transmission remains a fiction.
There is one variant of infection: after contact with blood and other body fluids.
What are the safety recommendations for chronic hepatitis? Quite simple:
- must use contraceptive methods during intercourse;
- do not use other people's hygiene items;
- check the processing of instruments in medical institutions and beauty salons.
Emergency prevention of hepatitis B is possible on the first day after infection. Doctors use human immunoglobulin, hepatitis B vaccination. A specific preventive measure against this disease has not yet been developed.
Forecast
Prognosis depends on the form and stage of the disease. The drug and autoimmune form of hepatitis is completely treatable, and viral hepatitis is practically not treated and transforms into cirrhosis of the liver.
When several pathogens (for example, hepatitis B and D) are combined, a severe form of the disease develops. In 70% of cases, cirrhosis of the liver begins.
Your safety is in your hands! Take care and be careful.
