Hepatitis A: symptoms and treatment, as transmitted

What it is? Hepatitis A - a disease caused by a virus from the family of enteroviruses, is transmitted only from person to person by a fecal-oral route.

Hepatitis A usually proceeds fairly easily( unlike other viral hepatitis), does not tend to develop a chronic process.

This pathology in everyday life continues to be called "Botkin's Disease".In some cases, hepatitis A can be treated even at home, and not in a hospital, under careful medical supervision.

How is hepatitis A transmitted?

What is it, and how is it transmitted? The path of transmission of the virus is fecal-oral. You can get hepatitis A with the following actions:

1. 1) The most common disease develops when you drink unboiled water: not only from water bodies, but also from the tap( the virus is resistant to chlorine, stored in cold water for months, destroyed at 100 ° C).
   
2. 2) When eating shellfish and other seafood that lived there, where wastewater came into.
   
3. 3) When eating fruits and vegetables that are watered by standing water or by the water into which the excrement of patients could get, without proper heat treatment.
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4. 4) When consuming those vegetables, berries or fruits that could have been washed with contaminated water.
   
5. 5) When using shared utensils and a toilet with a sick viral hepatitis A( a person becomes infectious even 2 weeks before developing any signs of it).
   
6. 6) Infection of the fetus during pregnancy is not proven.
   
7. 7) If in the last days of the incubation period or against a background of jaundice, transfer the patient's blood to another person.

People who live in countries with a low level of social culture are most often affected. Children and young people are most vulnerable. It used to be that life-threatening immunity forms after hepatitis A, but now this situation, like the possibility of virus carrying, is being revised.

The disease is characterized by seasonality - it develops hepatitis A most often in summer and autumn.

Symptoms of hepatitis A in women and men

The incubation period with hepatitis A is short - 14-30 days. Further the pre-egg period develops, which lasts 3-6 days, and includes such symptoms:

• temperature rises sharply, but this symptom may not be;
  
• weakness;
  
• aches in the body;
  
• headache;
  
• then decreases appetite, there is pain "under the spoon", nausea.

Immediately after the temperature drops( usually) or after 2-3 days, the icteric period develops, which lasts 1-2 weeks. Pre-zheltushny period in women and men can occur without temperature, when the main symptoms are weakness, reduced efficiency, fatigue, sleep disturbance, aversion to smoking. Bloating, diarrhea or constipation may be associated.


Then sclera turns yellow( this can first be seen only to an outsider, if you ask a sick person to look up), later - skin integument. Soon, light fade, and the degree of yellowing increases in intensity. The fact that recovery begins will be testified to: a change in the color of urine( it is already beginning to lighten by the evening), darkening of stool masses.

During the period of extinction of jaundice, appetite appears, weakness and drowsiness decrease, and jaundice gradually fades. A complete recovery is the period when the doctor notes a decrease in the liver, the normalization of all laboratory indicators. If the diet, regime, improper treatment is violated, there may be an exacerbation of the disease, which can be characterized either by repeated deterioration of the test, or by the resumption of jaundice and intoxication.

Viral hepatitis A can occur in the form of an icteric form, when all the described symptoms are observed, but the skin and sclera of a person do not turn yellow, the feces do not noticeably brighten;The morning urine may be slightly darker, but by the evening it has the usual staining.

Such jaundice forms are observed 3 times more often than icteric forms, and can be detected if, on the background of intoxication, a person passes an analysis of "liver tests", markers of viral hepatitis( including virus A) or a PCR test of venous blood for hepatitis RNAA.

Read also the symptoms of hepatitis B.

Treatment of hepatitis A

Therapy for the treatment of hepatitis A includes the following main points:

1. 1) Detoxification therapy. This introduction of polyionic solutions, 5-10% glucose, "Rhesorbilakta" intravenously, which is used for severe intoxication and high( above 100 mmol / l) bilirubin total numbers. If this level is less, the patient is advised to drink fluids about 40-50 ml / kg / day in the form of sweet tea, water without gas, poorly concentrated compote of dried fruits.
   
2. 2) Sorbents: "Atoxil", "Silix", "Polysorb", "Enterosgel", which drink 4 times a day, 1.5 hours after eating.
   
3. 3) Lactulose preparations( "Dufalac", "Normase", "Lactuvite"), which reduce the likelihood of formation of amino acids toxic to the brain. In addition, they cause loosening of the stool, which is important for any hepatitis( if there is no stool, an enema is necessarily put).
   
4. 4) Useful amino acids for the liver in the form of preparations "Glutargin", "Heptral".
   
5. 5) Inhibitors of proteolysis enzymes: "Contrikal", "Gordoks".
   
6. 6) Drugs that reduce the acidity of gastric juice: "Kwamatel" or "Ranitidine", "Omeprazole" or "Nolpaz".
   
7. 7) In the acute period, hepatoprotectors( Essentiale, Gepabene and others) are not assigned.

It is very important to adhere to the diet( table number 5).The following products are excluded:

• in the acute period - meat, eggs, fish;
  
• alcohol;
  
• strong tea, coffee;
  
• juices;
  
• fresh white bread;
  
• carbonated water, beverages;
  
• fresh vegetables, fruits, berries;
  
• fried and fatty foods;
  
• beans;
  
• confectionery;
  
• fungi;
  
• cabbage;
  
• canned food;
  
• soups or cereals on meat broths;
  
• fatty fermented milk products.

Allowed:

• porridge;
  
• dried bread;
  
• vegetable soups;
  
• not strong black tea with honey or sugar;
  
• is a very small amount of lightly hard cheese;
  
• biscuit cookies;
  
• low-fat cottage cheese and yogurt;
  
• small amount of sunflower oil;
  
• with 5-6 days - a small piece of butter.

The same diet is prescribed and with symptoms and treatment of hepatitis C

Bed or half-bed. It is very important to observe the golden rule - to sit less( so the liver practically does not receive blood supply).That is, you need to either lie down, or stand, walk. Sitting - only during meals.

Complications of hepatitis A

Lightning fastness, which almost always has a lethal outcome, with viral hepatitis A is extremely rare. Also, rarely develops and life-threatening brain damage, which is called "acute hepatic encephalopathy".

Against the background of hepatitis A, there may be an exacerbation or development of such diseases:

• cholecystitis;
  
• pancreatitis;
  
• gastritis of the stomach;
  
• peptic ulcer disease;
  
• Gilbert's disease.

For exacerbations of hepatitis A,

• arthritis develops;
  
• vasculitis;
  
• nephrotic syndrome( severe renal disease);
  
• formation in the blood of specific proteins - cryoglobulins.

In 90% of patients the process of recovery is normal, but in 10% there is a prolonged convalescence. Mortality in this disease is less than 0.05%.After hepatitis A, short-term carrier of the virus can develop, when it is found in the stool.

Hepatitis A prevention

Nonspecific prevention is:

• compliance with the rules of hygiene;
  
• drinking boiled water;
  
• watering your garden and vegetable garden with not standing water;
  
• washing fruits, berries, vegetables with boiled water;
  
• treatment of utensils and toilets after a patient with hepatitis A.

Emergency specific prevention consists in the introduction of a normal human immunoglobulin to a person who has been contacted with a hepatitis A patient not later than 2 weeks after infection.

Planned prophylaxis - vaccination of children from 2 years of life. Such vaccines are used:

• Havriks 1440;
  
• Avksim;
  
• Havriks 720( for children);
  
• Vacta;
  
• domestic vaccine "GEP-A-in-Vac".

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