Hepatitis B virus, DNA (HBV, PCR) plasma, count. to Isfana

Hepatitis B

Jaundice

10195 03 September

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-treatment. In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Definition
Chronic hepatitis B is a chronic liver disease lasting more than 6 months, which is based on infection and liver damage by the hepatitis B virus (HBV), manifested by inflammatory, necrotic and fibrotic changes in the liver tissue of varying severity.

Acute hepatitis B is an acute infectious disease caused by the hepatitis B virus (HBV). It is characterized by acute liver damage and intoxication (with or without jaundice (35%) (65%)) and occurs with a significant variety of clinical manifestations and outcomes: from recovery (about 90% of patients) to the development of chronic hepatitis B, liver cirrhosis and hepatocellular carcinoma (hepatocellular carcinoma).

Hepatitis B is a potentially life-threatening disease and is a major health problem worldwide.
Causes of viral hepatitis B
The disease has a predominantly parenteral transmission mechanism, that is, the pathogen enters directly into the blood: for example, during blood transfusion, invasive research, surgical interventions, hemodialysis, etc.

In recent years, doctors have noted an increase in the sexual transmission of the virus. In 25% of patients, the source of infection cannot be determined.

The risk group includes homosexuals, medical workers, family members of an HBV carrier, and patients with chronic skin diseases. With the development of acute hepatitis B in the first and second trimesters of pregnancy, the likelihood of infection of the fetus is small; in the third trimester, infection is almost natural (vertical route of infection).

The causative agent of the disease is a virus from the hepadnavirus family containing DNA. Virus structure:

• nuclear antigen (HBcAg);
• infectivity antigen (HBeAg);
• surface antigen (HBsAg);
• surface proteins for binding to hepatocyte receptors (preS1-Ag and preS2-Ag);
• X antigen (HBxAg), a regulatory protein that enhances the synthesis of viral proteins.
  There is an assumption that it is he who is responsible for carcinogenesis and the development of hepatocellular carcinoma;
• DNA polymerase is an enzyme that is necessary for the construction of the viral DNA chain during the process of its replication (doubling).

Classification of viral hepatitis B
By severity:

• mild viral hepatitis B;
• viral hepatitis B of moderate severity;
• viral hepatitis B is severe.

According to the course of the disease:

• acute (fulminant) hepatitis;
• chronic hepatitis.

By periods of illness:

• exacerbation;
• remission.

Symptoms of viral hepatitis B
Viral hepatitis B goes through several periods of development, during which various symptoms are observed.

Incubation period The duration of the period ranges from 30 to 180 days on average. During this time, the patient may complain of headache, nausea, chronic fatigue, memory loss and loss of appetite. In some cases, there is a slight increase in body temperature in the evening.

Pre-icteric period

This period of development of the disease is characterized by the appearance of vomiting, heartburn, belching, bloating, joint and muscle pain, body temperature can rise to 38.00C.

Jaundice period

Skin itching, jaundice, hemorrhages on the skin and bleeding gums, darkening of urine and discoloration of feces, enlarged liver, disturbed sleep, the patient experiences severe headaches, decreased blood pressure, increased heart rate, and swelling of the legs are observed.

Chronic hepatitis

When hepatitis becomes chronic, symptomatic manifestations decrease and a period of remission begins. However, each new exacerbation of viral hepatitis B is more severe than the previous one, which is associated with the destruction of liver tissue, which gradually leads to the development of cirrhosis and liver failure.

Transition of hepatitis B to cirrhosis

This stage is characterized by mental disorder, bleeding is observed in the area of ​​the esophagus, stomach and rectum, ascites develops (free fluid is present in the abdominal cavity), the skin becomes pale, the liver shrinks and becomes dense.

Diagnostics

Laboratory research methods are the first stage in diagnosing the disease.

In a general blood test, an increase in leukocytes (more than 9-11*109/l), a shift in the leukocyte formula to the left and an increase in ESR (erythrocyte sedimentation rate) of more than 30-40 mm/h may be observed.

Chance of getting sick

In areas with a high prevalence of HBV, the virus is most often transmitted from mother to child during childbirth or from person to person in early childhood. Transmission of infection during the perinatal period or early childhood can also lead to the development of chronic infections in more than one third of those infected.

Hepatitis B is also spread through cutaneous or mucosal exposure to infected blood or various body fluids, as well as through saliva, menstrual, vaginal secretions and seminal fluid. Sexual transmission of hepatitis B can occur.

Transmission of the virus can also occur through the reuse of syringes and needles, either in health care settings or among injection drug users. In addition, infection may occur during medical, surgical or dental procedures, tattooing, or the use of razor blades or similar objects contaminated with infected blood.

Despite the fact that Russia is a country with a moderate rate of hepatitis B infection, the risk of becoming infected with this virus throughout life for each of us is 20-60%.

Complications of hepatitis B

One of the dangerous complications of hepatitis B is acute liver failure. It develops according to the following scenario:

1. Precoma I - the patient’s condition sharply worsens, a specific liver odor appears from the mouth, spatial and temporal orientation is lost, fine motor skills are impaired, and pain is possible.
2. Precoma II - impaired consciousness progresses, hemorrhagic and intoxication syndromes intensify, the liver shrinks and disappears under the ribs, tremor of the limbs and tongue appears.
3. Terminal stage - the creature is depressed, reflexes weaken and disappear completely. Death occurs as a result of acute cardiovascular failure.

Important! A complication of chronic hepatitis B is cirrhosis of the liver.

Characteristics of the virus

Hepatitis B is a dangerous disease

Hepatitis B is caused by the HBV virus. Its penetration into the body is facilitated by the increased resistance to environmental influences that this virus is endowed with. If a drop of blood remains at the end of the needle, the virus can live in it for a week.

In general, any drop of blood containing a virus is dangerous for infection during this period of time.

This disease is treated by several specialists. When choosing a gastroenterologist and hepatologist, one must take into account the doctor’s certificate and license. It is advisable to contact specialists of the highest category.

Forecast and prevention of viral hepatitis B

With timely and proper treatment, acute hepatitis B can have a favorable prognosis. However, the consequences are directly dependent on the response of the immune system and the aggressiveness of the virus. The circulation of viral DNA in the human body for more than six months is an unfavorable sign and indicates the chronicity of the pathological process. The prognosis for people with chronic liver disease depends on which part of the liver is damaged and how well the body responds to treatment.

General recommendations for the prevention of viral hepatitis B are to comply with sanitary and hygienic standards, which are aimed at reducing the risk of possible infection during medical procedures.

It is also very important to observe the rules of personal hygiene (do not use other people’s razors and toothbrushes), and avoid casual unprotected sexual contact.

The best way to prevent hepatitis B is vaccination - it is carried out in the first six months of a child’s life.

If infection with viral hepatitis B occurs, it is important to know that there is no specific treatment for this disease. An infected person must take precautions to prevent spreading the virus to others.

Ways to determine the risk of infection

To find out your condition, whether there is an infection, whether there is a risk of developing the disease, you need to undergo the appropriate tests. Firstly, tests are taken for antigens of the HBsAg virus, and antibodies to this virus - anti-HBs - are also detected. If both tests give a negative result, then there is a significant risk of infection, so you should get vaccinated.

If HBsAg itself is detected, then you need to see a doctor and conduct a full examination. It is no longer necessary to be vaccinated, but it is necessary to take measures to treat and prevent the development of the disease in full.

If a high titer of anti-HBs is detected, but HBsAg is not detected, this indicates that the disease has already been suffered in the past. In this case, vaccines are not needed.

Diagnostic measures

The first stage of diagnosing hepatitis B is laboratory research methods:

1. Clinical blood test - general, leukocyte formula, ESR. In the presence of pathological changes, microscopy of a blood smear is performed. In the general analysis, traces of protein and squamous epithelium may be present (15–20), and single red blood cells may also be observed in the field of view.
2. General urine analysis, analysis with sediment microscopy. A single morning urine sample is examined. Color, transparency, specific gravity, protein content, glucose, ketones, bilirubin, urobilinogen, hemoglobin, nitrites, leukocyte esterase are determined.
3. HBsAg is the main marker of the hepatitis B virus. In acute and chronic cases of the disease, an analysis is performed for specific immunoglobulins to the nuclear antigen.
4. HB-core Ag - with hepatitis B, these antibodies appear in the blood shortly after HBsAg. The presence of class M antibodies is a serological test for the differential diagnosis of acute hepatitis B and reactivation of its chronic form.
5. HBcoreAg is a serological marker of an acute process; the presence of antibodies to HBeAg is evidence of acute hepatitis B or the stage of remission in a chronic course of the disease.

Who is at risk

1. Those who are promiscuous and have a non-traditional sexual orientation. To minimize the chance of contracting hepatitis B, contraception should be used;
2. Injecting drug addicts using poorly disinfected syringes;
3. Infants born from sick mothers;
4. Those undergoing hemodialysis, if medical specialists do not follow precautionary measures;
5. Tourists vacationing in countries with unfavorable epidemiological conditions;
6. Family members of a hepatitis patient who do not follow hygiene rules;
7. Those working in the healthcare sector and in direct contact with infected people;
8. Those serving sentences in penitentiary institutions.

People at risk need to know exactly how hepatitis B is transmitted. They should undergo regular testing for the presence of the virus, and if it is detected, begin treatment immediately. Remember: the result of the fight against this dangerous pathology depends on the timeliness and adequacy of therapy.