hepatitis infection, symptoms and diagnosis of all its types

hepatitis infection, symptoms and diagnosis

Hepatitis A

Mechanism of hepatitis A infection

If ingestion of contaminated water or food (especially poorly thermally processed seafood) viruses penetrate into the intestine, then soaked with the blood flow to the liver and incorporated into its cells and cause hepatitis A infection .

Viral particles multiply in the cytoplasm of liver cells. After exiting the liver cells they fall into the bile ducts and excreted in the bile into the intestine.

Inflammation in the liver, leading to damage to the hepatocytes . Cells of the immune system of the human T-lymphocytes recognize virus-infected hepatocytes and attack them.

This leads to the death of infected hepatocytes, the development of inflammation (hepatitis) and liver dysfunction .

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Hepatitis A symptoms

In its classic form of hepatitis A begins with an incubation period of 7 to 50 days and followed by prodromal phase of hepatitis A. The most common hepatitis A symptoms resemble flu symptoms :  headache , chills , fever and may cause feelings of weakness , skin rashes and joint pain .

Hepatitis A complicates the work of the gastrointestinal tract , decreased appetite to food, there are diarrhea and vomiting .

At the end of the prodromal period appears quite characteristic sign of hepatitis: dark beer color of urine (color becomes like a strong brewed black tea and much more foam) , and this means that the prodromal phase was replaced icteric phase of hepatitis A.

Contrary to popular belief, jaundice does not appear in all forms of hepatitis , but hepatitis A symptoms is very characteristic. Jaundice occurs when generated in the liver bile enters the bloodstream and gives the skin and whites of the eyes characteristic yellowish tint. That bile getting into the urine of the patient, making it dark, and feces, on the contrary, becomes discolored, losing bile.

Hepatitis A diagnosis

Hepatitis A diagnosis doctor performed. To start collecting history specialist to identify the source of infection. In recognition of the disease helps the doctor much information about the patient in contact with anyone in the last month, where he went, what he eats, comply with the rules of personal hygiene, whether drinking unboiled water, and so on.

In hepatitis A diagnosis is very important to conduct a full examination of the patient for disorders of the digestive system, fever, muscle toxicity. In daylight carefully examined mucous membranes and sclera of the eyes: if there is an easy yellowness, the diagnosis is not in doubt. Also in cases of suspected hepatitis performed palpation of the abdomen. Almost always, the doctor notes the increased size of the liver.


Laboratory hepatitis A diagnosis include urinalysis, stool and blood. Blood is investigated in the acute phase of the disease when hepatitis A  symptoms become more bright. The patient should pass and biochemical analysis, the results of the assistants detect the presence or absence of antibodies anti - HAV IgM.

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Hepatitis B

Mechanism of hepatitis B infection

The mechanism of transmission of hepatitis B - hematogenous, ie through the blood. Infection occurs from a patient with acute or chronic hepatitis B when infected blood into the body of a healthy person.

Blood infected with hepatitis B virus becomes contagious long before the first symptoms of the disease, and retains these properties in varying degrees for the duration of chronic hepatitis B infection.

The possibility of transmission through sexual contact and from mother to child during childbirth. HBV virus itself is large and does not pass through the placenta.
Through damaged skin and mucous virus HBV misses the bloodstream to the liver. Hepatitis B virus enters liver cells, hepatocytes, and begins to proliferate
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Hepatitis B symptoms

Hidden (incubation) period for hepatitis B is from 2 to 6 months. The first signs of hepatitis B occur, on average, at 12 weeks after infection. Hepatitis B symptoms appear in 70% of cases, they are found more often in adults than in children.Blood test for HBs-antigen becomes positive after 1-9 weeks after hepatitis B infection (median 4 weeks).This tiredness and fatigue, loss of appetite, jaundice, nausea, discomfort in the right upper quadrant, change in urine color (dark) and feces (lighter), pain in the joints.For the beginning of hepatitis B characteristic when sick on increased temperature and intoxication (sickness, unwell) appears dark urine and develops jaundice.Hepatitis B In addition biochemical signs of liver damage cells exhibit appropriate markers in the blood.If worried about feeling unwell, fever, joint pain appeared or indigestion while later significantly darker color of urine (like a strong brewed black tea and thus strongly foaming), we can assume viral hepatitis. Consult your doctor.

Hepatitis B diagnosis

Consult your doctor to help diagnose the disease by one or several blood tests. It tests for the presence of antibodies or antigens that will help determine whether you are sick of acute or chronic form of hepatitis B, have immunity to hepatitis B , you need a vaccination or a history of hepatitis B in the past.For the diagnosis of hepatitis B doctor usually collects detailed medical history and conducts a thorough examination of the patient. If you suspect the presence of disease patient is prescribed blood chemistry (hepatitis in peripheral blood determined increase in the number of liver enzymes), a blood test for hepatitis B markers (HBsAg, anti-HBc IgM, anti-HBc total, HBeAg, anti -Hbe, HBV-DNA), abdominal ultrasound and other tests.Treatment of hepatitis B approach requires complex and depends on the stage and severity of the disease.Treatment of any form of hepatitis B include a special diet with restriction of fatty, salty, spicy, fried and canned food. Should exclude alcohol.In case of acute hepatitis B is assigned only supports detoxification and therapy aimed at the elimination of toxins and restore the liver tissue. Antiviral treatment is not carried out.For the treatment of chronic hepatitis B using antiviral drugs group alpha-interferons and nucleoside analogues. These drugs significantly reduce the rate of viral replication, prevent their assembly in the liver cells. Treatment lasts from 6 months to several years. Furthermore, hepatitis B may be used drugs that protect liver cells and means acting on the immune system.However, to achieve a complete cure (cleansing the body of the virus) in chronic hepatitis B with the help of modern techniques can be no more than 10-15% of cases.
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Hepatitis C

Mechanism of hepatitis C infection

The main mechanism of hepatitis C infection - hematogenous, parenteral (through blood). Most often infected with hepatitis C virus when injected enough infected blood of needle injections.

Possible contamination with body piercing and tattooing instruments contaminated with blood of the patient or carrier of infection, perhaps - when sharing razors, nail accessories, and even toothbrushes (ranked them infected blood can cause infection), when they bite.

Hepatitis C infection through blood products administered during operations and injuries, administering medications and mass vaccination in dental offices are less likely in developed countries.

To hepatitis C infection was carried out, it is necessary that the material containing the virus (the blood of an infected person) got into the bloodstream of another person. Viruses entered the bloodstream to the liver where penetrate the cells of the liver and begin to multiply there.Liver cell damage can occur due to the activity of viruses themselves, and in the immunological reaction - the body response, sending the immune cells to kill cells infected liver cells containing foreign genetic material.May be acute or chronic form of hepatitis C.The acute form is often asymptomatic and diagnosed only by chance when found in the blood markers of acute hepatitis C - anti-HCV-IgM, which is stored in the blood is not more than 6 months after hepatitis C infection .

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Hepatitis C symptoms

In general, hepatitis C - an asymptomatic disease, which is often diagnosed incidentally. But in the meantime, you can select non-specific symptoms of hepatitis C, which can not indicate disease. These include asthenia, fatigue and weakness. In any case, it is necessary to periodically review for hepatitis, because early detection of disease is treated easily and quickly.
Differentiation of individual stages of hepatitis C is of practical importance because of the need to define the indications for interferon:
Acute phase of infection: asymptomatic patients are not aware of the source of infection and contamination;
Progression in chronic hepatitis B: 85% of the patients after the acute phase will develop chronic hepatitis C, which can occur at first hidden (latent phase), and then start to progress (reactivation phase), when already identified clinical and laboratory signs of exacerbation.
Transformation in cirrhosis - a serious illness, against which may develop complications and liver cancer, leading to death.

Hepatitis C diagnosis

The diagnosis of acute hepatitis C infection based on clinical (increased hepatic manifestations, liver palm size of the liver and spleen), virological (presence of viral RNA in the blood and / or anti-virus), biochemical (elevated levels of transaminases, ALT and AST) data having clear link with parenteral manipulations in the first months to its development: surgical operations, blood transfusion, the first injection of narcotics, etc. Unfortunately, most patients show no signs of acute hepatitis and viral RNA detection can not distinguish acute hepatitis from chronic hepatitis. In this case, the diagnosis of hepatitis C should be based on the availability of relevant data epidemic history for 1-4 months before the first detected signs of hepatitis C, which are antibodies to hepatitis C virus and levels of enzyme. The criteria for the diagnosis of chronic hepatitis C are enlarged liver and spleen, as well as the presence of antibodies to hepatitis C virus in the blood within 6 months. The exact nature of liver - fibrosis and degree of necrosis and inflammatory changes - allows you to define a liver biopsy, which is by far the most accurate and informative method of diagnosis of chronic hepatitis C. In addition, the procedure is carried out for a few seconds and is completely safe for the patient. Note that the presence or absence of HCV RNA is not diagnostic of chronic hepatitis C, but only determines the phase of the process (active, inactive).

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Determination of hepatitis C virus RNA

diagnosis of hepatitis C Install using only classical methods of laboratory diagnosis is not possible. This is due to HCV infection flow, which is characterized by: asymptomatic during the initial stages of the disease is low, normal ALT levels are often late appearance of antibodies (up to 2 years the onset of illness) leading role in the laboratory diagnosis of HCV infection occupy methods allow: directly detect the genetic material of the virus in the blood and tissues of the human body (mononuclear cells, hepatocytes, bone marrow tissue, etc.) to evaluate the replicative activity of the virus in tissues quantify concentration of virus in the blood serum to establish the genotype and to monitor the variability of HCV Biochemical analysis of blood biochemical blood analysis criteria: not specific do not characterize the etiology of viral hepatitis are essential for the assessment of the functional state of the liver bilirubin metabolism Performance Indicators exchange bilirubin (the basis of biochemical analysis of blood, urine and feces) for the diagnosis of viral hepatitis only play a role in the development of jaundice. anicteric form of viral hepatitis in the majority remain unrecognized.
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