Chronic active hepatitis is a viral disease. The number of people suffering from it increases significantly. In medicine, even fatal cases have been recorded. Is it possible to live with him? Chronic hepatitis - how to treat and how? Let's take a closer look.
Disease feature
Chronic active hepatitis is an 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 about this disease has been collected. Doctors were able to understand the mechanism of development of hepatitis and develop effective methods of treatment. Several doctors are studying this issue, namely: the therapist, infectious disease specialist, gastroenterologist and others. The specific therapy and outcome depends on the form of the course of hepatitis, the age of the patient and the general condition of the body.
The number of patients with this disease is growing steadily. According to statistics, around 400 million people worldwide suffer from chronic hepatitis B. Nearly 170 million people have chronic hepatitis C. Moreover, about 100-200 million people are added to these figures every year.
The disease occurs most often in men with a frequency of 50 cases per 100,000 population.
Classification
Treatment depends on the form of the course of hepatitis. Chronic hepatitis is classified according to a number of criteria:
- degree of pathology activity;
- biopsy information;
- etiology.
Clinical chronic hepatitis has its own forms. They are classified for reasons of occurrence:
- active viral hepatitis B, C, D, A;
- drug - liver inflammation provoked by the use of hepatotoxic drugs (for example, during chemotherapy);
- autoimmune - a chronic liver lesion that has a wide area of inflammation;
- cryptogenic (etiology is still not clear);
- alimentary (alcoholic).
Hepatitis occurs more often in children, young people and pregnant women.
Chronic active hepatitis is divided into such forms, taking into account the degree of activity of the pathology:
- minimal form - a mild degree of disease development, which is limited only by the development of inflammation;
- active form - with this form of hepatitis, vivid symptoms appear, 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.
An autoimmune form of hepatitis most often affects women over 30 years old. As symptoms, 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 exhibit other pathologies: thyroid diseases, joint inflammation, skin diseases, 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 forms in the liver, which "attracts" blood cells to itself and activates inflammation.
Alimentary form of hepatitis is divided into two forms: chronic and acute. This type of disease is exacerbated if a man takes 200 g of vodka at a time, and a woman takes 100 g.
Chronic active hepatitis: symptoms
This form of hepatitis often occurs in childhood. Mostly girls suffer from this disease.
It is almost impossible to diagnose the signs of chronic hepatitis at an early stage, since the disease proceeds without pronounced symptoms. In the process of hepatitis development, the patient exhibits specific signs. Asthenia clearly manifests itself - this is a psychopathological disorder in which chronic fatigue, increased fatigue, instability, sleep disturbance and exhaustion are felt. In adult women, libido decreases.
Among the pronounced external symptoms, vascular asterisks are visible on the body, hyperemia of the palms is a disease in which the blood vessels in the palms expand, the hands turn red.
Signs of chronic hepatitis:
- asthenic syndrome;
- fatigue;
- unmotivated weakness;
- sleep disturbance;
- psycho-emotional instability;
- decreased performance;
- enlarged spleen.
Patients often complain of severe fatigue when performing simple household tasks.
If chronic active hepatitis was diagnosed in a man, then in addition to the above symptoms, gynecomastia can be added. This is a disease in which a man’s breast enlarges. The chest hurts to the touch and seems very heavy.
Both men and women suffering from this disease lose hair on the pubic part and armpits.
Active chronic hepatitis, as well as inactive, is accompanied by fever. Skin vasculitis (immune vascular inflammation) occurs, namely:
- erythema (severe redness of the skin);
- hives;
- purpura (small spotted capillary hemorrhages form in the skin 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 a dark urine. By the changed color, urine resembles black tea, and feces, on the contrary, become 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 mask as jaundice.
Causes
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 long enough.
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 previously transferred to the patient. 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 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, hormones, anti-TB drugs). Heavy metals and other chemicals can also cause intoxication.
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 responds to them.
The third important reason is malnutrition, abuse of alcohol and drugs. Infectious diseases, malaria, liver diseases 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 - there is no fibrosis;
- Stage 1 - peripheral minor fibrosis is noticeable (connective tissue grows around the liver cells and bile ducts);
- Stage 2 - relatively moderate fibrosis develops: connective tissue grows, septa form. They connect adjacent portal tracts, which are located at the corners of the liver lobule. It takes on a hexagonal shape;
- Stage 3 - severe fibrosis, port-portal septa are formed, which violate the structure of the liver;
- Stage 4 - visible signs of a violation of the liver structure.
Connective tissue completely grows and the structure of the liver changes dramatically.
Diagnostics
Diagnosis of a chronic form of hepatitis should be timely. The doctor can make a final diagnosis only on the basis of the clinical picture, the results of instrumental and laboratory examinations.
Necessary analyzes:
- blood test for markers;
- Ultrasound of the abdomen;
- 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, to prescribe an effective method of 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. According to the analysis, the doctor looks at how many times the amount of transaminase (enzymes that accelerate the chemical metabolic 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, with the help of a special tool in this procedure, the doctor makes a clarification of the presence of surface nodes. If they are, then the patient has portal hypertension. This syndrome indicates a violation of blood flow and acts as a complication of cirrhosis.
How does the disease progress?
Chronic active hepatitis is quite difficult and difficult. The patient aggravates the pathological condition, clinical and laboratory manifestations intensify.
If the disease worsens, then this is fraught with death.
During the disease, signs of liver failure appear.
In some cases, with the active stage of hepatitis, cirrhosis of the liver is formed. If the doctor is experienced, then he will detect cirrhosis at the first diagnosis.
The disease is dangerous. During its active stage, hepatic cell failure and hypertension gradually develop. With this symptom, blood pressure in the portal vein rises. Cirrhosis is a leading symptom. In this case, surgical intervention is necessary, but it is impossible to do this, 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 causes of 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 interconnected. The course of therapy should be comprehensive. Typically, patients are assigned a basic course, which aims to reduce the load on the liver. Inactive lifestyle, bed rest and a minimum amount of drugs are indicated. It is important to follow a special diet, in which there will be 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 develops constipation, the doctor prescribes mild laxatives to improve digestion - enzyme preparations that do not contain bile. Therapy includes the protection of liver cells and the acceleration of recovery processes. For this, the doctor prescribes hepatoprotectors, which must be taken within 2-3 months and repeat the course of administration 2-3 times a year.
If the patient has viral chronic hepatitis, then the 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 onset of chronic hepatitis provoked intoxication, then detoxification therapy should be carried out immediately, and make sure that toxins do not enter the bloodstream. For example, stop taking the drug, alcoholic beverages and change jobs (if the patient worked in a chemical industry).
With hepatitis C, such drugs for treatment are effective: Prednisol, Laferon, Timalin.
A patient treating chronic active hepatitis should be monitored 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 the doctor once a month. If possible, then investigate antibodies in chronic active hepatitis. In the first year of treatment, it is necessary to hospitalize the patient at 6 and 12 months in order to make adjustments to therapy.
Prevention
People suffering from any form of hepatitis do not pose a danger to others. The myth that this disease is transmitted by airborne droplets or in everyday life remains an invention.
There is one option of infection: after contact with blood and other body fluids.
What are the safety recommendations for chronic hepatitis? Very simple:
- it is necessary to use contraception during intercourse;
- Do not use other people's hygiene items;
- check the processing of tools in medical institutions and beauty salons.
Emergency prevention of hepatitis B is possible on the first day after infection. Doctors use human immunoglobulin, vaccination against hepatitis Form B. A special preventive measure against this disease has not yet been developed.
Forecast
The 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 is transformed into cirrhosis.
When combining several pathogens (for example, hepatitis B and D), a severe form of the disease develops. In 70% of cases, cirrhosis begins.
Your safety is in your hands! Take care and be careful.