Hepatitis B – what is it like?symptoms, treatment of acute and chronic hepatitis B

Viral hepatitis B – an inflammatory viral disease,
which mainly affects liver tissue. After
man will recover from this disease, he forms a stable
lifelong immunity. But the transition is possible acute form
chronic progressive.

Next, we look at what the disease is, how it is transmitted
among adults, the first signs and symptoms of hepatitis B, and
also what are the consequences for the body if treatment is started
at a wrong time.

Hepatitis B: what is it?

Гепатит AT (Б)

Hepatitis B (B) is a viral infection, mainly
damaging liver and leading to chronic progressive form
diseases, carriage of the virus, the development of cirrhosis and cancer
the liver.

The main signs of hepatitis B are:

  • nausea,
  • loss of appetite,
  • increased fatigue
  • jaundice,
  • discomfort in the right hypochondrium,
  • dark urine.

What are the features of hepatitis B virus?

  1. A few minutes the virus can easily withstand temperatures of up to 100 ºC,
    resistance to temperature rises if the pathogen is in
  2. Repeated freezing does not affect its properties, after
    thawing it will still be contagious.
  3. The virus is not cultivated under laboratory conditions, which makes it difficult
    his study.
  4. The microorganism is in all biological fluids.
    human, and his infectiousness even exceeds HIV a hundred times.

Inactivation of the virus is carried out during treatment in autoclaves with
heating to 120 ° C for 45 minutes, or in a dry heat oven
at 180 ° C for 60 minutes.

The virus dies when exposed to chemical disinfectants
agents: chloramine, formalin, hydrogen peroxide.

Causes and transmission paths

WHO estimates that in the world over 2 billion people are infected with
Hepatitis B, 75% of the world’s population lives in regions with
high incidence rates. Annually acute infection
diagnosed in 4 million people

After вирус гепатита AT попал в кровь еще здорового
human, he reaches the hepatocytes (liver cells) with the bloodstream. AT
they replicate (multiply) the virus, which infects
an increasing number of new cells, with some sections of DNA
the virus is inserted into the hepatocyte DNA.

The immune system does not recognize the altered cells and perceives them.
as alien. Antibody production begins to destroy
altered hepatocytes. Thus, destruction occurs.
liver, which leads to inflammation and hepatitis.

Подавляющее большинство заболевающих гепатитом AT – это лица в
age 15-30 years. The proportion of deaths from this disease
addicts is 80%. Injectors
narcotic substances have the greatest risk of infection.

Как передается гепатит AT?

A person should know how hepatitis B is transmitted. So that he could
take action if will be located next to the carrier of the virus.
ATирусная инфекция находится в:

  • blood;
  • vaginal discharge;
  • sperm

It is in these biological carrier fluids that the concentration
The virus is found in large quantities.

There are several ways to transmit the hepatitis B virus:

  • if you pour infected blood to a healthy person;
  • use several times the same syringe;
  • through medical equipment if not produced properly
    purity: during sexual intercourse;
  • newborn from mother:
  • infection in everyday life.

Основной путь заражения гепатитом группы AT – через кровь, любую
another biological fluid. The virus is very active,
infection can go away after a few days, after the blood,
for example, it will completely dry on clothing or a piece of hygiene.
Therefore, the danger of being infected is wherever there may be contact with
biological fluids of other people.

Риск получить гепатит AT появляется при посещении:

  • beauty salons
  • manicure procedures,
  • pedicure
  • tattooing, piercing or tattoo
    not sterile enough.

Способ передачи гепатита AT во время родов ребёнку происходит от
mothers. To reduce the risk of further infant virus
vaccinated. Hepatitis B is able to manifest itself in the future.

In contact with skin and mucous membranes of healthy
with any fluids of the patient the probability of infection is not very high,
что говорит о том, что в быту вирус гепатита AT практически не
spreads. Microdamages to the skin increase the risk
infection several times. The patient’s fluids are dangerous even when dry.

ATирус передается через слюну, поэтому присутствует вероятность
get infected while kissing if you have a healthy partner in your mouth
there are microtraumas, diseases of the teeth and gums, accompanied by

Risk group

The specialist will quickly determine how hepatitis B was transmitted, ascertaining
sphere of activity and lifestyle of the person being diagnosed.

Objects of virus infection:

  • Hepatitis is transmitted from a homosexual practitioner
    and promiscuity.
  • Health workers.
  • Drug addicts.
  • Persons serving a conclusion in penitentiary institutions.
  • Hemodialysis patients.
  • Recipients of blood.
  • Младенцы, родившиеся от зараженной вирусом mothers.
  • Family members are infected.
  • Tourists who have chosen endemic areas for recreation.

Forms of development

Hepatitis b
lightning fast AT этом случае симптоматика патологии развивается стремительно,
accompanied by severe cerebral edema and coma.
The treatment is not effective. ATесь патологический процесс занимает всего
several hours and ends with the death of the patient.
острый гепатит AT This form has several stages of development: the stage of manifestation
common symptoms, jaundice and stage of resolution or further
progression of pathology.
chronic Chronic form may occur after acute hepatitis, and
may be initially without the acute phase of the disease. Manifestations of it can
vary from asymptomatic (carriage of the virus) to active
hepatitis with the transition to cirrhosis.

Какая вероятность, что острый гепатит AT станет

  1. ATероятность зависит от возраста, при котором человек
    gets infected. The younger the age when the infection occurs
    вирусом гепатита AT, тем больше вероятность развития
  2. Almost 90% of infected babies develop chronic
    infection. The risk decreases as the child matures. At about
    25% -50% of children infected between the ages of 1 and 5 will be
    develop chronic liver disease caused by a virus.
  3. The risk of chronicity in adulthood is about 10%. ATо
    worldwide, most people with chronic hepatitis have been infected
    at birth or in early childhood.

The first signs in women and men

Первые признаки гепатита AT:

  1. Weakness, slight fever, headache,
    lack of appetite.
  2. Then join signs caused by the violation.
    пищеварения: nausea, боль в животе, рвота. Exchange violation
    Bilirubin causes darkening of the urine and stool discoloration.
  3. After эти симптомы начинают постепенно исчезать,
    jaundice develops – appropriate staining of the skin and sclera

Most patients have no signs of the disease.
Therefore, doctors consider any person as potentially
infected, while observing the necessary medical procedures during medical procedures
precautions and using disposable tools.

Симптомы гепатита AT у взрослых

Инкубационный период вирусного гепатита AT колеблется в довольно
wide limits, the period from the moment of infection to the development
The clinical symptoms can range from 30 to 180 days.
Evaluate the incubation period of the chronic form often
is impossible.

Острый вирусный гепатит AT начинается нередко аналогично
viral hepatitis A, however, its preicter period may
leaking and arthralgic form, as well as asthenovegetative
or dyspeptic option.

For any kind of intoxication, the first to suffer
central nervous system. Clinically this is manifested by the appearance
following cerebrotoxic symptoms:

  • sleep disturbance;
  • increased fatigue weakness;
  • apathy;
  • disturbance of consciousness.

In severe forms of the disease can develop hemorrhagic.
syndrome – occasionally nasal bleeding, increased
bleeding gums.

Hepatitis in acute form can be completed with full recovery from
образованием стойкого иммунитета либо перейти в хроническую
a form that is often accompanied by undulating periods
exacerbations, often of a seasonal nature.

AT остром течении заболевания можно выделить три периода:

  • preicteric phase;
  • icteric period;
  • recovery.

Anicteric period

AT этом периоде специфических проявлений патологии ещё нет. On
the foreground symptoms that are characteristic of
most viral diseases:

  • headache;
  • human well-being gradually deteriorates;
  • loss of appetite;
  • lethargy;
  • weakness;
  • muscle and joint pain;
  • respiratory manifestations are observed (cough,
    runny nose).

Jaundice is associated with the accumulation of bilirubin in the blood – the product
the breakdown of red blood cells (red blood cells). AT норме билирубин
enters the liver, where it binds to proteins and in the composition of bile
enters the intestine, and then is removed from the body.


If the liver is damaged, this function deteriorates, leading to
accumulation of bilirubin in the blood and soft tissues, due to which the latter
acquire a yellow tint.

Желтушный период гепатита AT

Gradually, the symptoms pass into the icteric period. They
also appear in a certain sequence:

  • darkening of urine occurs, the color resembles dark beer;
  • yellow sclera and mucous membranes of the mouth, especially if you raise
    tongue to the palate;
  • stained hands and skin.

По мере появления желтухи общие симптомы интоксикации
decrease, condition improves. May disturb pain or
тяжесть в правой подреберной области в месте проекции the liver.
Occasionally, there may be a cleansing of feces due to bile blockage.

AT случае своевременного использования специфических препаратов
symptoms gradually disappear, there comes convalescence. If a
the body does not cope with the infection, there is a chronic form
pathology, нередко переходящая в цирроз the liver.

Chronic form

Хронический гепатит AT проявляется такими симптомами:

  • increased fatigue;
  • weakness;
  • drowsiness;
  • decreased appetite;
  • nausea, рвотные позывы;
  • bloating;
  • характерные симптомы хронического гепатита AT, такие как
    потемнение мочи, jaundice, проявляются значительно позже, чем при
    acute form.

ATстречаются атипичные формы болезни:

  • anicteric;
  • erased;
  • subclinical (with almost no symptoms);
  • mild, moderate and severe;
  • malignant.


According to statistics, up to 90% of people after infection
get rid of the disease almost forever. But their “complete”
recovery is considered relative, as most often
accompanied by residual effects in the form:

  • contrast normal skin and yellowed dyskinesia or
    inflammation of the biliary tract;
  • residual astheno-vegetative syndrome;
  • infection can be the impetus for the development of Gilbert syndrome.

Острый вирусный гепатит AT редко приводит к летальному исходу
(only in cases of severe lightning current), prognosis
significantly worsens with concomitant chronic pathologies
liver, with a combined lesion of hepatitis C and D viruses.

Смерть инфицированных гепатитом AT чаще наступает спустя
several decades as a result of chronic course and development
цирроза и рака the liver.


If a человек выявил у себя симптомы, свидетельствующие о
He has developed form B hepatitis, or has reason to believe
that he could be infected with this disease, he needed to
urgently visit a medical facility. ATо время
a specialist will conduct an inspection by palpation
examines the area of ​​the liver and collects a history of the disease.

To confirm or deny the primary diagnosis will help
laboratory study of blood and urine.

For the diagnosis of this disease, in addition to the usual biochemical
analysis of bilirubin and ALT, use specific markers
гепатита AT:

  • HBsAg antigen;
  • HBeAG antigen.

In addition, in specific diagnostics use the identification
antibodies to these antigens and to the specific protein HBcore, which
появляется при остром гепатите AT:

  • anti-HBcore;
  • anti-hbe.


Treatment гепатита начинается с посещения врача и обязательного
passing the survey. This will allow you to assign an exact map.
treatment, and also to identify other possible diseases, if they
are present. AT любом случае, гепатит Б лечиться комплексно.

Treatment гепатита Б включает в себя:

  • detoxification therapy;
  • maintenance therapy;
  • strengthening the immune system;
  • diet;
  • symptomatic suppression therapy.

Treatment острого гепатита AT

  1. При легких формах гепатита AT назначается щадящая диета, дробный
    diet – 5-6 times a day, half-bed mode (allowed
    get out of bed for eating, visiting the toilet,
    hygiene procedures).
  2. For moderate hepatitis, an intravenous drip is prescribed.
    the introduction of solutions for detoxification. Connect to the treatment
    hepatoprotectors – drugs that protect the liver cells from
    destruction, vitamins, sorbents – drugs that remove from the body
  3. AT случае развития тяжелого гепатита AT пациента переводят в
    resuscitation department, where, depending on the state of conduct
    symptomatic therapy.

The period of rehabilitation – recovery from acute viral
liver damage – in each patient occurs in different ways. Someone
cured in a few weeks, someone to improve
health may take 4-6 months.

  • AT целом прогнозы у острого гепатита AT благоприятные: полным
    recovery of the disease is completed in 90% of patients.
  • AT 5-10% случаев при сохранении HBsAg в организме развивается
    chronic disease with high risk
    development of complications (cirrhosis, hepatocellular carcinoma,
    dysmotility of the gallbladder, sphincter of Oddi).

Interestingly, the transition to the chronic form of the disease is more
characteristic of hepatitis light severity (anicteric, with latent

How to treat chronic hepatitis B?

Когда диагностируется chronic гепатит Б, лечение проводится

  • Antiviral medications are used, such
    как ламевудин, адефовир и прочие;
  • drugs are prescribed that inhibit the growth of liver sclerosis, that is,
  • immunomodulators are also needed to normalize immune responses.
    the body of the patient;
  • hepatoprotectors are important to help the liver fight cellular
  • can not do without vitamins and minerals.

Также больным рекомендуют каждый день обильное питье, чтобы
to detoxify the body.

AT зависимости от тяжести заболевания терапия может проводиться
both outpatient and inpatient. Decision whether needs
the patient is hospitalized, or not, the doctor accepts individually in
depending on the clinical manifestations of hepatitis and severity

For patients who have been diagnosed with the disease
Hepatitis B, there are several scenarios:

  • A person undergoes complex therapy and gets rid of viral
    infections, acquiring resistant immunity to this disease;
  • In a patient, the acute form of hepatitis B becomes chronic,
    which may be accompanied by serious complications for
  • After treatment, the patient becomes a carrier of hepatitis B antigen,
    which for decades will not cause him
    anxiety. For 20 years, this virus may
    be present in the patient’s blood without visible clinical
  • A patient who has not turned to medical
    учреждение, развивается цирроз или рак печени, который требует
    emergency surgery.

After completion of treatment in individuals in the blood for long
Years produced a virus antigen. These people become carriers
of this infection and must be systematically examined, as well as
be sure to take tests.

Diet and proper nutrition

In the acute period, bed rest and strict dietary regimen are shown.
nutrition. The acute hepatitis B diet is aimed at
maximum schazhenie body with good nutrition. Acute process
requires compliance with Diet number 5A, in which food is prepared only
ground or well boiled. Soups can be made with finely
chopped vegetables. Separate meals are prepared in baked
form, but without a pronounced crust. Diet – 5 times a day.

In chronic hepatitis B, diet 5 is not compulsory,
but in drawing up the menu it is worth keeping a reference point on it. The specialists
argue that in the chronic stage it is important to stick to a healthy
power supply. Proper healthy eating implies eating
enough protein, fat, carbohydrates and healthy
trace elements

What not to eat?

It is forbidden to use:

  • fresh and rye bread;
  • products from fancy or puff pastry;
  • millet and all legumes;
  • broths;
  • fatty meats, fried meat, sausages, smoked meats;
  • offal and canned food;
  • cream and fat cottage cheese;
  • mushrooms, legumes, pickled vegetables, turnips, radishes, radish,
    cabbage, sorrel, garlic, onions;
  • sour fruits and rich in fiber;
  • cocoa, coffee, chocolate, carbonated drinks.

Permitted food

Meals and food permitted for use in acute and chronic
form of hepatitis B:

  • yesterday’s bread;
  • fresh pastries with various fillings;
  • biscuits, marshmallows;
  • soups cooked in water, milk, low-fat broth;
  • chicken ham and sausages;
  • from meat – chicken, veal, rabbit meat;
  • from fish – pollock, hake, whiting;
  • steam and baked omelets;
  • steamed meatballs and patties;
  • milk, low-fat dairy products;
  • all types of cereal porridge;
  • pasta and pasta;
  • vegetable salads, seasoned with sunflower oil or low-fat
    sour cream;
  • vegetable fats;
  • Bee Honey;
  • fruits and vegetables in baked, boiled, raw;
  • non-acidic vegetable, berry and fruit juices;
  • green tea.

When hepatitis disrupts the process of bile formation, which leads to
violation of absorption in the digestive tract of vitamin K and its insufficiency.
Products containing vitamin K:

  • parsley,
  • watercress
  • basil,
  • cilantro,
  • cabbage (broccoli, Beijing, white),
  • celery root,
  • prunes,
  • avocado,
  • cashews, pine nuts.


  1. Acute viral hepatitis B is rarely fatal.
    Forecast ухудшается при микст-инфекции с вирусами гепатитов С, D,
    the presence of concomitant chronic hepatobiliary diseases
    system, fulminant course of the disease.
  2. In chronic form, patients die in a few dozen.
    years from the onset of the disease as a result of their development
    primary cancer or cirrhosis of the liver.

Is Hepatitis B Reinfected?

No, after you had hepatitis B, you developed
antibodies that protect you from the virus for life. Antibody –
this substance is contained in the blood that the body produces in
response to the virus. Antibodies protect the body against diseases associated with
viruses and destroy them.

Hepatitis B prevention

To avoid infection with hepatitis B, doctors recommend
adhere to the following recommendations:

  1. vaccinate the baby, but separate, costly
    medicine, instead of the standard, planned.
  2. follow the rules of personal hygiene – do not use others
    hygiene products;
  3. try to eat food enriched with vitamins and
    trace elements as well as discard harmful products
  4. give up alcohol, smoking;
  5. do not take various drugs without need,
    because many of them impair liver function;
  6. try to avoid visiting beauty salons doubtful
  7. try not to have a baby at home, in resorts and

Hepatitis B is a liver disease that can cause
serious consequences for the whole body. In the event of
unpleasant symptoms, be sure to make an appointment to
Gastroenterologist for the diagnosis and setting accurate

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