Hepatitis B virus - what is it? The disease is a viral anthroponous, that is, its pathogen can parasitize exclusively in the human body. Hepatitis B virus has a pronounced hepatotropic effect. Cirrhosis and liver oncology most often provokes this particular pathogen.
According to statistics, in Russia annually up to 50 thousand cases of hepatitis B disease are detected, and chronic carriers - more than 5 million people. The prevalence of this disease throughout the world is very high - there are more than 350 million carriers of the virus, of which 250 thousand die every year from various liver pathologies.
Hepatitis B virus: characteristic
This prevalence of the disease is explained by the incredible resistance of the pathogen to various factors of chemical and physical effects. The hepatitis B virus is resistant to low temperature effects and even repeated freezing and thawing does not kill it. Boiling also on HBV (designation in the literature) does not work.
In a dry drop of blood at room temperature the virus persists for up to a month or more, it is stored in dry serum for up to 25 years, and in frozen (at a temperature of -20 degrees) - up to 15 years.
It can be neutralized (inactivated) by autoclaving for 30 minutes or sterilization in a dry oven for an hour at a temperature of 180 degrees.
Forms of Hepatitis B
What is the danger of hepatitis B virus? What is it and how is the disease manifested? Below we will try to answer these questions as fully as possible.
Hepatitis B can be acute and chronic. Acute develops immediately after infection and the end of the incubation period. It can last from several weeks to six months. In this case, the symptoms are clearly expressed only in half the cases:
- abdominal pain on the right, in the region of the costal arch;
- nausea and vomiting;
- fever (fever);
- headache;
- weakness;
- joint pain;
- yellowness of the skin and sclera of the eyes;
- dark urine (beer color);
- discolored feces.
The acute (icteric) form of hepatitis B, as a rule, in 80% of cases ends in recovery of the patient.
In children, and sometimes in adults, there may be an asymptomatic form of hepatitis B. With this course of the disease, severe symptoms are not observed. Mild malaise and fatigue can be noted, which patients often do not pay attention to. In this case, most often the presence of hepatitis B virus in the blood is detected absolutely by accident, for example, at the next physical examination. Such a mild course of the disease very often becomes chronic. Infection of a child with a virus during childbirth from a sick mother also often ends in a chronic form.
In some cases, fulminant (malignant) hepatitis develops - this is a very serious course of the disease, which can lead to cirrhosis or oncology of the liver.
How does infection happen?
Hepatitis B transmission can occur in many ways. The source of infection is sick people or, if certain rules are not followed, carriers. The hepatitis B carrier itself does not suffer from this disease (there is no symptomatology), but there is a virus in its blood.
The most common way to get this disease is through the blood. For example, through the needles of disposable syringes for drug addicts during their secondary use, through poorly sterilized instruments in manicure or hairdressing salons. A very small amount of blood containing the hepatitis B antigen is sufficient for infection. Even a microscopic dose of 0.00004 ml can cause infection. It was already mentioned above that this virus is very stable, and even in a dry blood drop at room temperature it persists for more than a month.
In addition, hepatitis B is sexually transmitted. It is found in absolutely all biological materials, including sperm.
The intrauterine infection of the fetus (from a sick mother) is also likely. But here it should be clarified that perinatal infection, i.e., before the onset of labor, is extremely rare. Most often, the infection of the child occurs precisely during childbirth, i.e., intrapartum. After the baby is born, infection is possible by breastfeeding.
What happens after infection?
After the hepatitis B virus enters the blood of a still healthy person, it reaches the hepatocytes (liver cells) with the bloodstream. They replicate (multiply) the virus, which infects an increasing number of new cells, while some sections of the virus’s DNA are embedded in the DNA of hepatocytes. The immune system does not recognize altered cells and perceives them as foreign. Antibody production begins to destroy altered hepatocytes. Thus, the destruction of the liver occurs, which leads to an inflammatory process and hepatitis.
Diagnostics
For the diagnosis of this disease, in addition to the usual biochemical analysis for bilirubin and ALT, specific markers of hepatitis B are used:
- HBsAg antigen;
- HBeAG antigen.
In addition, specific diagnostics use the detection of antibodies to these antigens and to a specific HBcore protein that appears in acute hepatitis B:
The listed antigens and antibodies at different periods of the disease are in certain proportions. Their comprehensive study helps to determine the stage of HBV, which allows us to predict the further course of the disease and build a treatment regimen.
What factors increase the risk of infection?
Statistics show that most often a virus infection occurs between the ages of 15 and 30 years. Who is affected by a disease like hepatitis B? What is it - we already understood, now we will discuss what factors contribute to infection. So, the risk group includes:
- patients of dental offices;
- people resorting to the services of manicure and hairdressing salons;
- clients of piercing and tattoo parlors;
- drug addicts;
- sick people whose treatment involves frequent blood transfusions or the use of hemodialysis ("artificial kidney" apparatus) ;
- homosexuals;
- people who often change sexual partners.
Significantly reduce the risk of the disease will help vaccination against hepatitis B. It can be done in the vaccination room of any clinic.
How to treat hepatitis B virus?
Therapy is aimed at preventing the development of cirrhosis and liver oncology. This is achieved by suppressing the multiplication of the virus in the liver cells and normalizing the level of transaminases.
The decision on how to treat hepatitis B virus is made by an infectious disease doctor. Recovery is a long process. The choice of treatment method depends on the activity of the virus and the risk of developing cirrhosis and oncology of the liver.
Acute viral hepatitis B most often resolves on its own, and the patient will recover completely. The exception is the severe fulminant form of hepatitis B, but this, fortunately, is extremely rare. Therapy of acute hepatitis B is aimed at removing toxins from the body (detoxification) and restoration of hepatocytes.
Antiviral drugs are used to treat chronic hepatitis B. For example, the medication "Interferon alfa-2a" is used 1 time per week, for one year (for adults, the dose is 180 mcg). Nucleoside analogues are widely used: Entecavir, Lamuvidin, Adefovir. These drugs stop the spread of the virus in the liver cells and contribute to their recovery.
For maintenance therapy, hepatoprotectors and immunomodulators are used, for example, the drug Zadaxin (injection).
In the treatment of viral HB, as a rule, diet No. 5 is prescribed. It consists in refusing any fatty, spicy, salty and canned foods. Semi-finished products and sausages are also better to exclude from the diet.
If chronic hepatitis B takes a severe course, and there is a serious risk of developing cirrhosis or liver oncology, an organ transplant may be decided.
Prevention
Is it possible to somehow protect the body from such a pathogen as the hepatitis B virus? What is it, we found out. It's time to talk about prevention. It is divided into specific and non-specific. The first is carried out by vaccination. Only people who have been vaccinated and have had hepatitis B are protected from the disease. Nonspecific prevention involves a series of global epidemiological measures that impede the transmission of viral HB. For example, mandatory testing of blood donors and its preparations for HBV markers, the implementation of a comprehensive program to combat drug addiction, in the end, the banal observance of the rules of personal hygiene. We will talk about this a little lower. Now we only note that the prevention of viral hepatitis B is of great importance in the fight against the prevalence of this disease.
Specific prophylaxis of hepatitis B
Vaccination against hepatitis B is mandatory:
- all children aged 0-1-6 months (routine vaccination);
- all family members of patients with chronic hepatitis B;
- Doctors
- medical students;
- persons working with blood products;
- patients forced to undergo hemodialysis systematically;
- patients receiving blood products.
This vaccination can be done by any adult. Previously, it was not among the mandatory. In order to be vaccinated, it is enough to contact the clinic of your area. All children and adults under 55 can get this vaccine for free. Older people can be vaccinated at their own expense.
The procedure is available on any day you choose. After the first vaccination, you will need to do two more. One - in a month, the second - in half a year. Vaccination is the most reliable way to protect against viral hepatitis B.
Non-specific prophylaxis of hepatitis B
Non- specific HBV prophylaxis includes careful observance of personal hygiene rules:
- use only your toothbrush, manicure tools, a razor, comb, etc.
- even personal belongings (the same manicure set) must be periodically disinfected;
- apply effective disinfectants;
- pierce ears, get tattoos and piercings only in proven salons with a good reputation;
- protected sex, although it does not give a 100% guarantee (saliva, sweat and all biological fluids are the habitat of the virus), therefore, you should not lead a promiscuous sex life;
- use only disposable syringes for injection.
We have discussed the danger of the hepatitis B virus. What is it now is clear. Like any other disease, it is easier to prevent it than to undergo a long course of treatment. Compliance with simple preventive measures will help protect against hepatitis B. Stay healthy!