Can hepatitis be sexually transmitted? Is it possible to get infected at home? The liver is a delicate organ

The hepatitis C virus is found in the blood and body fluids of a sick person. Hepatitis C is transmitted when infected blood enters the blood or damaged skin and mucous membranes of another person. Clinical observations indicate that there is no risk of infection through contact of intact mucous membranes and skin with infected blood.

The concentration of the virus in biological fluids (saliva, semen and vaginal discharge) is in most cases insufficient for infection, however, if these fluids enter the blood of a healthy person, for example, through damaged skin or mucous membranes, the possibility of infection cannot be ruled out. According to some studies, the hepatitis C virus can retain its properties at room temperature on the surface of the environment, according to at least, 16 hours, but not more than 4 days. The infectious dose is quite large - 10 -2 - 10 -4 ml of virus-containing blood (depending on the concentration of viral RNA).

How do you get hepatitis C?

Under what circumstances can infection occur? Let's consider these circumstances in order from the most to the least probable.

Syringe injections. This is how most people get hepatitis C. Most of these cases are associated with intravenous drug use. According to statistics, more than 75% of people who use drugs, or have done so in the past, are infected with hepatitis C. The risk of infection increases with repeated use of intravenous drugs. Another cause of "syringe hepatitis" are cases of infection during medical manipulations: intravenous, intramuscular, subcutaneous injections with non-sterile syringes. This is due to negligence and violation of sanitary and epidemiological standards by medical workers. The amount of infected blood remaining in the needle and the concentration of viral RNA influence the likelihood of infection during injections. In this case, the size of the lumen of the needle or cannula plays an important role. A narrow lumen needle, used for example for intramuscular injections, carries a significantly lower risk of infection compared to wide lumen cannulas (eg infusion cannulas). As shown in one study, the risk of transmission of HCV infection from a single accidental injection by a physician or nurse is negligible. It was also shown that none of the recipients who received anti-HCV-positive but HCV-RNA-negative blood by accidental injection developed viral hepatitis C.
Transfusion of blood and its components. There is a high percentage of patients with hepatitis C among patients who have received blood products in the past (for example, patients with hemophilia, people with kidney failure receiving hemodialysis). Until 1986, there were no tests for the detection of hepatitis C virus in the world. Then this infection was called "neither A nor B." This emphasized the fundamentally different nature of the viral disease affecting the liver from hepatitis A and B, but donor studies were not developed. This has been possible since the early 1990s. Therefore, before this period, among those who received blood transfusions, the percentage of infected people was quite large. Subsequently, and up to the present, the risk of contracting hepatitis C in such cases has become minimal, since the examination of donors is mandatory. However, to say that the risk is reduced to zero, unfortunately, is still impossible. This is to some extent associated with situations where the donor has recently been infected and no markers of infection have yet been detected. This time period is called the "serological window period".
Surgical interventions. Gynecology. Improperly treated medical instruments may contain particles of the blood of a person with hepatitis C. When using these instruments, infection of a healthy person can occur.
Tattoos and piercings. These manipulations are associated with damage to the skin, often with little bleeding. The main danger is that the instruments can be poorly sterilized. Infection in this way often occurs in places of deprivation of liberty or in non-specialized institutions. Piercing and tattooing instruments should ideally be disposable or properly sterilized (including not only needles, but also accessories such as paint containers or piercing machines). The tattoo or piercing artist must wear disposable gloves and wear them throughout the entire procedure. Infection is also possible when using some methods of alternative medicine (acupuncture, ritual incisions), shaving in barbershops.

Transmission of the virus to the child during childbirth according to WHO, it occurs in 4-8% of women with hepatitis C and in 11-25% of women with HIV co-infection. This is the so-called "vertical path". Transmission of the virus from mother to child can occur during childbirth, childcare, and breastfeeding.

Of primary importance is infection during childbirth, when contact between the blood of mother and child can occur. In mothers with a viral load of less than 106 copies/ml, vertical transmission of the virus is extremely rare. The role of infection in the postpartum period is extremely small. The hepatitis C virus can be in the milk of a nursing mother, but the digestive juices and enzymes of the baby prevent infection, so it is not recommended to stop breastfeeding.

However, in breastfeeding women co-infected with HIV, the incidence of HCV infection in newborns is significantly higher than in formula-fed women, so breastfeeding is not recommended for HIV-infected mothers.

Sexual way. The risk of contracting hepatitis C through sexual contact is small, unlike the risk of contracting hepatitis B virus (HBV) or human immunodeficiency virus (HIV), but it exists. Studies on the content of HCV in male semen, vaginal secretions, and saliva indicate that the virus is rarely found in them and is contained in a low titer, which is likely to underlie the low incidence of HCV infection through sexual contact.

Infection can occur when there is a violation of the mucous membranes of sexual partners (with inflammatory diseases of the genital organs, the mucous membrane is damaged, bleeding increases, which increases the risk of transmission of hepatitis C). Studies have shown that the incidence of sexual transmission of hepatitis C does not exceed 5%.

It is believed that the risk of sexual transmission of the virus among spouses is no more than 1% per year. People who have multiple sexual partners, have underlying sexually transmitted diseases, practice anal sex, or are infected with HIV are at greater risk. In such cases, the use of barrier methods of contraception (condoms) is mandatory. The use of condoms in regular sexual partners reduces the already very low risk of HCV infection to zero. It is advisable to periodically (once a year) examine HCV markers. It is not recommended to practice unprotected sex during menstruation, regardless of who is infected with hepatitis C - a man or a woman.

Dentistry and cosmetology. Infection during dental procedures occurs when sanitary and epidemiological rules are not observed. Infected blood particles may be present on instruments that have not been properly treated. Try not to use the services of non-specialized and dubious establishments.

Inhaling cocaine. Cases of infection with hepatitis C by inhalation of cocaine through the nose are described. The vessels of the nasal mucosa are damaged when the drug is inhaled, this is especially true for chronic use, so this route of transmission of the virus is possible.

Infection with injuries, in fights, accidents. If the skin is broken, a healthy person can become infected after blood containing hepatitis C RNA enters the wound. Such cases occur in fights, car and other accidents, injuries received at work with a high level of injuries (firefighters, police, rescue services, etc.). .d.)

household contacts. There is no danger of infection for family members and friends of patients with hepatitis C. The hepatitis C virus is not transmitted through hands and kitchen utensils. However, it is important to remember that you should not allow the use of common sharp and injuring objects: nail scissors, razors, toothbrushes.

blood-sucking insects. In hot countries where the prevalence of HCV is high, studies have been conducted on the transmission of HCV through insect bites. More than 50 different mosquito species carrying yellow fever, dengue fever or malaria have been infected through a special membrane with blood containing HCV-RNA. The results obtained were compared with those of control mosquitoes injected with HCV-RNA-negative blood. During the subsequent preparation of mosquitoes, HCV-RNA was determined in the contents of the head, abdomen, and chest of insects. It turned out that 24 hours after infection, HCV remained in the contents of the abdomen. However, none of the insects had HCV-RNA found in the thorax. The authors concluded that mosquitoes cannot be considered as potential carriers of HCV.

Transmission through pets. At present, there are no known facts of hepatitis C infection through bites or cuts with the claws of domestic animals (cats, dogs, etc.)

How is hepatitis B transmitted?

Given the fact that the hepatitis B virus has an infective capacity several orders of magnitude higher than the hepatitis C virus, the ways of its transmission are similar to those described above. In this case, the likelihood of infection is much higher. In addition, hepatitis B is transmitted sexually and vertically (from mother to child) much more often than with HCV infection.

Frequently Asked Questions about Infection Routes

Can I hug and kiss my children?

Yes, you can do it and not be afraid that you will infect them.

Should my family members be tested for hepatitis C?

The risk of infection of family members through household contact is extremely small. The risk of infection through sexual contact among spouses is also small, however, it exists. Therefore, it is also desirable for the spouse of the patient to pass a simple test for the presence of anti-HCV antibodies. It is necessary to examine children born from infected mothers. Also, the analysis is necessary if there was contact with the blood of a patient with hepatitis C.

Can I cook food for my family? What if I cut myself while cooking?

You can cook for the family. Even if you cut yourself during this, and a drop of blood gets into your food, it is unlikely that your family members will be able to become infected, since the enzymes of their digestive system will destroy the virus.

What if my child or friend eats from my plate and uses my fork?

You will not transmit the virus to them by using these items together. However, the use of shared toothbrushes, towels is not recommended, as there is a certain risk.

My daughter uses my nail scissors. This is dangerous?

Shared sharp objects should be avoided, particles of your blood can remain on the surface of the scissors if you injure yourself, and mix with the blood of your daughter, who can also damage her skin with the scissors. It is necessary to have personal hygiene items such as a razor, scissors, toothbrushes, etc., and dispose of used tampons and pads in a timely manner.

We have been married for many years. Is it safe for us to have sex?

Under the condition of stable monogamous heterosexual relationships in the family, the risk of infection is very small.

What about French kissing? Oral sex?

The greatest danger can arise when the integrity of the mucous membranes is broken, and there is contact with the biological fluids of an infected partner.

Should you always use condoms?

The use of a condom is especially important if the patient has several sexual partners.

Can I have a child? Take care of him?

Yes. In only 6% of cases, the hepatitis virus is transmitted from mother to child during childbirth.

Do I need to tell doctors, such as a dentist, that I have hepatitis C?

Yes. It is necessary to inform all doctors about this, especially those who are going to carry out manipulations such as dental treatment or surgery.

How should blood stains be treated to make sure they are free of hepatitis C virus?

Any blood stains, including dry blood that may contain virus, should be treated with a solution of one part bleach to 10 parts water. Disposable rubber gloves must be used.

How long does a virus live outside the body?

The hepatitis C virus can retain its properties at room temperature on the surface of the environment for at least 16 hours, but not more than 4 days. In a frozen state, the virus retains its properties for years.

Is it possible to get infected with another genotype of the hepatitis C virus?

Infection with one type of virus does not protect against infection with another genotype.

Are there vaccines that can prevent hepatitis C?

So far, there are vaccines only for hepatitis A and hepatitis B. Although research in this area is underway.

Hepatitis C is an inflammation of the liver of a viral origin, clinical manifestations of which in most cases are significantly delayed in time or so little expressed that the patient himself may not notice that a “gentle” killer virus has settled in his body, as the hepatitis C virus (HCV) is commonly called.

Once upon a time, and this continued until the end of the 80s of the last century, doctors knew about the existence of a special form of hepatitis that did not fit into the concept of "Botkin's disease" or jaundice, but it was obvious that it was hepatitis that affects the liver in no way less than their own " brethren" (A and B). An unfamiliar species was called hepatitis neither A nor B, since its own markers were still unknown, and the proximity of pathogenesis factors was obvious. It was similar to hepatitis A in that it was transmitted not only parenterally, but suggested other routes of transmission. The similarity with hepatitis B, called serum hepatitis, was that it could also be infected by receiving someone else's blood.

At present, everyone knows that, called neither A nor B hepatitis, is open and well studied. This is hepatitis C, which in its prevalence is not only not inferior to the infamous, but also far exceeds it.

Similarities and differences

Botkin's disease was previously called any inflammatory liver disease associated with a certain pathogen. The understanding that Botkin's disease can represent an independent group of polyetiological pathological conditions, each of which has its own pathogen and the main route of transmission, came later.

Now these diseases are called hepatitis, but a capital letter of the Latin alphabet is added to the name according to the sequence of discovery of the pathogen (A, B, C, D, E, G). Patients often translate everything into Russian and indicate hepatitis C or hepatitis D. However, the diseases assigned to this group are very similar in the sense that the viruses they cause have hepatotropic properties and, when ingested, affect the hepatobiliary system , each in its own way violating its functional abilities.

Different types of hepatitis are unequally prone to chronization of the process, which indicates the different behavior of viruses in the body.

Hepatitis C is considered the most interesting in this regard., which for a long time remained a mystery, but even now, being widely known, it leaves secrets and intrigues, since it does not make it possible to give an accurate forecast (it can only be assumed).

Inflammatory processes of the liver caused by various pathogens do not differ in relation to sex, therefore men are equally affected, and women. There was no difference in the course of the disease, however, it should be noted that in women during pregnancy, hepatitis can be more severe. In addition, the penetration of the virus in recent months or the active course of the process can adversely affect the health of the newborn.

If liver diseases of viral origin still have a clear similarity, then considering hepatitis C, it is advisable to touch on other types of hepatitis, otherwise the reader will think that only the “hero” of our article should be afraid. But through sexual contact, you can become infected with almost every species, although this ability is attributed more to hepatitis B and C, and therefore they are often referred to as sexually transmitted diseases. In this regard, other pathological conditions of the liver of viral origin are usually kept silent, since their consequences are not as significant as the consequences of hepatitis B and C, which are recognized as the most dangerous.

In addition, there are hepatitis of non-viral origin (autoimmune, alcoholic, toxic), which should also be mentioned, because one way or another, they are all interconnected and significantly aggravate each other.

How is the virus transmitted?

Depending on which way the virus could "run across" to a person and what things it will start to "do" in the body of a new "host", different types of hepatitis are distinguished. Some are transmitted in everyday life (through dirty hands, food, toys, etc.), appear quickly and pass, basically, without any consequences. Others, called parenteral, having the potential of chronicity, often remain in the body for life, destroying the liver to cirrhosis, and in some cases to primary liver cancer (hepatocarcinoma).

In this way, hepatitis according to the mechanism and routes of infection are divided into two groups:

Having an oral-fecal transmission mechanism (A and E);
Hepatitis, for which the blood-contact (hemopercutaneous), or, more simply, the path through the blood, is the main one (B, C, D, G - a group of parenteral hepatitis).

In addition to the transfusion of infected blood or flagrant non-compliance with the rules for medical manipulations associated with damage to the skin (the use of insufficiently processed instruments, for example, for acupuncture), often there is the spread of hepatitis C, B, D, G and in other cases:

Various fashionable procedures (tattoos, piercings, ear piercings) performed by a non-professional at home or in any other conditions that do not meet the requirements of the sanitary and epidemiological regime;
By using one needle for several people, this method is practiced by syringe addicts;
Transmission of the virus through sexual intercourse, which is most likely for hepatitis B, hepatitis C in such situations is transmitted much less frequently;
Cases of infection by the "vertical" route (from mother to fetus) are known. Active disease, acute infection in the last trimester, or HIV carriers greatly increase the risk of hepatitis.
Unfortunately, up to 40% of patients cannot remember the source that “gifted” the hepatitis B, C, D, G virus.

The hepatitis virus is not transmitted through breast milk, so women with hepatitis B and C can safely feed their baby without fear of infecting him.

We can agree that the fecal-oral mechanism, water, contact-household, being so interconnected, cannot exclude the possibility of transmitting the virus and sexually just as well as other types of hepatitis transmitted through the blood, have the ability to penetrate into another organism during sex.

Signs of an unhealthy liver

After infection, the first clinical signs of different forms of the disease appear at different times. For example, the hepatitis A virus declares itself in two weeks (up to 4), the causative agent of hepatitis B (HBV) is somewhat delayed and manifests itself in the interval from two months to six months. As for hepatitis C, it the pathogen (HCV) can detect itself after 2 weeks, after 6 months, or it can “hide” for years, turning a healthy person into a carrier and source of infection for a rather serious disease.

The fact that something is wrong with the liver can be guessed from the clinical manifestations of hepatitis:

Temperature. With it and the phenomena of influenza infection, hepatitis A usually begins (headache, pain in the bones and muscles). The onset of HBV activation in the body is accompanied by subfebrile temperature, and with C-hepatitis it may not rise at all;
Jaundice varying degrees of expression. This symptom appears a few days after the onset of the disease, and if its intensity does not increase, then the patient's condition usually improves. A similar phenomenon is most characteristic of hepatitis A, which cannot be said about hepatitis C, as well as toxic and alcoholic hepatitis. Here, a more saturated color is not attributed to signs of an impending recovery, rather, on the contrary: with a mild form of inflammation of the liver, jaundice may be absent altogether;
Rashes and itching more characteristic of cholestatic forms of inflammatory processes in the liver, they are caused by the accumulation of bile acids in tissues due to obstructive lesions of the hepatic parenchyma and injury to the bile ducts;
Decreased appetite;
Heaviness in the right hypochondrium, possible enlargement of the liver and spleen;
Nausea and vomiting. These symptoms are more characteristic of severe forms;
Weakness, malaise;
Joint pain;
dark urine, dark beer-like , discolored feces - typical signs of any viral hepatitis;
Laboratory indicators: liver function tests (AlT, AST, bilirubin), depending on the severity of the course, can increase several times, the number of platelets decreases.

During viral hepatitis, 4 forms are distinguished:

Easy, often characteristic of hepatitis C: jaundice is often absent, subfebrile or normal temperature, heaviness in the right hypochondrium, loss of appetite;
Medium: the above symptoms are more pronounced, there is pain in the joints, nausea and vomiting, there is practically no appetite;
heavy. All symptoms are present in a pronounced form;
Lightning (fulminant), which is not found in hepatitis C, but is very characteristic of hepatitis B, especially in the case of coinfection (HDV / HBV), that is, a combination of two viruses B and D that cause superinfection. The fulminant form is the most dangerous, because as a result of the rapid development of massive necrosis of the hepatic parenchyma, the death of the patient occurs.

Hepatitis, dangerous in everyday life (A, E)

In everyday life, first of all, liver diseases that have a predominantly fecal-oral route of transmission can lie in wait, and these are, as you know, hepatitis A and E, so you should dwell a little on their characteristic features:

Hepatitis A

Hepatitis A is a highly contagious infection. Previously, it was simply called infectious hepatitis (when B was serum, and others were not yet known). The causative agent of the disease is a small but incredibly resistant virus containing RNA. Although epidemiologists note susceptibility to the pathogen as universal, it is predominantly children who have stepped over the age of one who are ill. Infectious hepatitis, triggering inflammatory and necrobiotic processes in the hepatic parenchyma, giving symptoms of intoxication (weakness, fever, jaundice, etc.), as a rule, ends with recovery with the development of active immunity. The transition of infectious hepatitis to a chronic form practically does not occur.

Video: hepatitis A in the program "Live healthy!"

Hepatitis E

Its virus also belongs to RNA-containing ones, it “feels good” in the aquatic environment. It is transmitted from a sick person or carrier (in the latent period), there is a high probability of infection through food that has not undergone heat treatment. Mostly young people (15-30 years old) living in the countries of Central Asia and the Middle East get sick. In Russia, the disease is extremely rare. The contact-household route of transmission is not excluded. Cases of chronicity or chronic carriage have not yet been established or described.

Hepatitis B and dependent hepatitis D virus

hepatitis virusB(HBV), or serum hepatitis, is a DNA-containing pathogen with a complex structure that prefers liver tissue for its replication. A tiny dose of infected biological material is enough to transmit the virus, why this form passes so easily not only during medical manipulations, but also during sexual intercourse or in a vertical way.

The course of this viral infection is multivariate. It may be limited to:

Carrying;
Give acute liver failure with the development of a fulminant (fulminant) form, often taking the life of the patient;
When the process is chronic, it can lead to the development of cirrhosis or hepatocarcinoma.

The incubation period of this form of the disease lasts from 2 months to six months, and the acute period in most cases has symptoms characteristic of hepatitis:

Fever, headache;
Decreased efficiency, general weakness, malaise;
Pain in the joints;
Disorder of the function of the digestive system (nausea, vomiting);
Sometimes rashes and itching;
Heaviness in the right hypochondrium;
Enlarged liver, sometimes - spleen;
Jaundice;
A typical sign of liver inflammation is dark urine and discolored feces.

Very dangerous and unpredictable combinations of HBV with the causative agent of hepatitis D (HDD), which was previously called delta infection - a unique virus that is invariably dependent on HBV.

The transmission of two viruses can be simultaneous, which leads to the development co-infections. If the D-causative agent later joined the HBV-infected liver cells (hepatocytes), then we will talk about superinfection. A serious condition, which was the result of such a combination of viruses and the clinical manifestation of the most dangerous type of hepatitis (fulminant form), often threatens to be fatal in a short time.

Video: hepatitis B

The most significant parenteral hepatitis (C)

viruses of various hepatitis

The “famous” C-hepatitis virus (HCV, HCV) is a microorganism with unprecedented heterogeneity. The causative agent contains a single-stranded positively charged RNA encoding 8 proteins (3 structural + 5 non-structural), to each of which corresponding antibodies are produced during the course of the disease.

The hepatitis C virus is quite stable in the external environment, it tolerates freezing and drying well, but it is not transmitted in negligible doses, which explains the low risk of infection by the vertical route and during sexual intercourse. A low concentration of an infectious agent in the secrets released during sex does not provide the conditions for the transmission of the disease, unless other factors are present that "help" the virus "relocate". These factors include concomitant bacterial or viral infections (HIV in the first place), which reduce immunity, and a violation of the integrity of the skin.

The behavior of HCV in the body is difficult to predict. Having penetrated into the blood, it can circulate for a long time at a minimum concentration, forming in 80% of cases a chronic process that can eventually lead to severe liver damage: cirrhosis and primary hepatocellular carcinoma (cancer).

The absence of symptoms or a slight manifestation of signs of hepatitis is the main feature of this form of inflammatory liver disease, which remains unrecognized for a long time.

However, if the pathogen nevertheless “decided” to immediately start damaging the liver tissue, then the first symptoms may already appear after 2-24 weeks and last 14-20 days.

The acute period often proceeds in a mild anicteric form, accompanied by:

weakness;
Joint pains;
indigestion;
Slight fluctuations in laboratory parameters (liver enzymes, bilirubin).

The patient feels some heaviness on the side of the liver, sees a change in the color of urine and feces, however, pronounced signs of hepatitis, even in the acute phase, are generally not typical for this species and are rare. It becomes possible to diagnose C-hepatitis when the corresponding antibodies are detected by the method (ELISA) and the RNA of the pathogen by conducting (polymerase chain reaction).

Video: film about hepatitis C

What is Hepatitis G

Hepatitis G is considered the most mysterious today. It is caused by a virus containing single-stranded RNA. The microorganism (HGV) has 5 varieties of genotypes and is structurally very similar to the causative agent of C-hepatitis. One (first) of the genotypes chose the west of the African continent for its habitat and is not found anywhere else, the second has spread throughout the globe, the third and fourth “liked” Southeast Asia, and the fifth settled in southern Africa. Therefore, the inhabitants of the Russian Federation and the entire post-Soviet space have "chance" to meet with a representative of type 2.

For comparison: a map of the spread of hepatitis C

In epidemiological terms (sources of infection and transmission routes), G-hepatitis resembles other parenteral hepatitis. As for the role of HGV in the development of inflammatory liver diseases of infectious genesis, it is not defined, the opinions of scientists differ, and the medical literature data remain contradictory. Many researchers associate the presence of the pathogen with the fulminant form of the disease, and also tend to think that the virus plays a role in the development of autoimmune hepatitis. In addition, a frequent combination of HGV with hepatitis C (HCV) and B (HBV) viruses was noted, that is, the presence of coinfection, which, however, does not aggravate the course of monoinfection and does not affect the immune response during treatment with interferon.

HGV monoinfection usually proceeds in subclinical, anicteric forms, however, as the researchers note, in some cases it does not pass without a trace, that is, even in a latent state it can lead to morphological and functional changes in the hepatic parenchyma. There is an opinion that the virus, like HCV, can hide, and then strike no less, that is, transform into cancer or hepatocellular carcinoma.

When does hepatitis become chronic?

Chronic hepatitis is understood as a diffuse-dystrophic process of an inflammatory nature, localized in the hepatobiliary system and caused by various etiological factors (viral or other origin).

The classification of inflammatory processes is complicated, however, like other diseases, besides, there is still no universal methodology, therefore, in order not to load the reader with incomprehensible words, we will try to say the main thing.

Given that in the liver, for certain reasons, a mechanism is triggered that causes degeneration of hepatocytes (liver cells), fibrosis, necrosis of the hepatic parenchyma and other morphological changes that lead to a violation of the functional abilities of the organ, they began to distinguish:

Autoimmune hepatitis, characterized by extensive damage to the liver, and, therefore, an abundance of symptoms;
Cholestatic hepatitis, caused by a violation of the outflow of bile and its stagnation as a result of an inflammatory process affecting the bile ducts;
Chronic hepatitis B, C, D;
Hepatitis caused by the toxic effects of drugs;
Chronic hepatitis of unknown origin.

It is obvious that the classified etiological factors, associations of infections (coinfection, superinfection), phases of the chronic course, do not fully provide a complete picture of inflammatory diseases of the main organ of detoxification. There is no information about the reaction of the liver to the damaging effects of adverse factors, toxic substances and new viruses, that is, nothing is said about very significant forms:

Chronic alcoholic hepatitis, which is the source of alcoholic cirrhosis;
Nonspecific reactive form of chronic hepatitis;
Toxic hepatitis;
Chronic hepatitis G, discovered later than others.

For this reason, it was determined 3 forms of chronic hepatitis based on morphological features:

Chronic persistent hepatitis (CPH), which is usually inactive, manifests itself clinically for a long time, infiltration is observed only in the portal tracts, and only the penetration of inflammation into the lobule will indicate its transition to the active phase;
Chronic active hepatitis (CAH) is characterized by the transition of the inflammatory infiltrate from the portal tracts into the lobule, which is clinically manifested by varying degrees of activity: slight, moderate, pronounced, pronounced;
Chronic lobular hepatitis, due to the predominance of the inflammatory process in the lobules. The defeat of several lobules with multibular necrosis indicates high degree activity of the pathological process (necrotizing form).

Given the etiological factor

Inflammatory process in the liver refers to polyetiological diseases, as it is caused by a number of reasons:

The classification of hepatitis has been revised many times, but experts have not come to a consensus. Currently, only 5 types of liver damage associated with alcohol have been identified, so it hardly makes sense to list all the options, because not all viruses have been discovered and studied yet, and not all forms of hepatitis have been described. Nevertheless, it may be worthwhile to acquaint the reader with the most understandable and accessible division of chronic inflammatory liver diseases according to etiological grounds:

Viral hepatitis, caused by certain microorganisms (B, C, D, G) and indefinite - little studied, unconfirmed by clinical data, new forms - F, TiTi;
autoimmune hepatitis(types 1, 2, 3);
Inflammation of the liver (drug-induced), often detected in "chronics", associated with the long-term use of a large number of drugs or the use of drugs that show severe aggression to hepatocytes for a short time;
Toxic hepatitis due to the influence of hepatotropic toxic substances, ionizing radiation, alcohol surrogates and other factors;
Alcoholic hepatitis, which, together with the drug-induced one, is classified as a toxic form, but in other cases is considered separately as a social problem;
Metabolic that occurs in congenital pathology - disease Konovalov-Wilson. The reason for it lies in the hereditary (autosomal recessive type) violation of copper metabolism. The disease is extremely aggressive, quickly ends with cirrhosis and death of the patient in childhood or young age;
Cryptogenic hepatitis, the cause of which, even after a thorough examination, remains unknown. The disease is characterized by progression, requires monitoring and control, as it often leads to severe liver damage (cirrhosis, cancer);
Nonspecific reactive hepatitis (secondary). It is often a companion of various pathological conditions: tuberculosis, renal pathology, pancreatitis, Crohn's disease, ulcerative processes in the gastrointestinal tract and other diseases.

Considering that some types of hepatitis are very related, widespread and quite aggressive, it makes sense to give a few examples that are likely to be of interest to readers.

Chronic form of hepatitis C

An important question regarding hepatitis C is how to live with it and how many years they live with this disease. After learning about their diagnosis, people often panic, especially if they receive information from unverified sources. However, this is not necessary. With C-hepatitis they live a normal life, but they have it in mind in terms of some diet (you should not load the liver with alcohol, fatty foods and substances toxic to the organ), increasing the body's defenses, that is, immunity, being careful at home and when sexual contacts. You just need to remember that human blood is contagious.

As for life expectancy, there are many cases when hepatitis, even among lovers of good food and drink, has not shown itself in anything for 20 years, so you should not bury yourself prematurely. The literature describes both cases of recovery and the reactivation phase, which occurs after 25 years, and, of course, a sad outcome - cirrhosis and cancer. Which of the three groups you get into sometimes depends on the patient, given that there is currently a drug - synthetic interferon.

Hepatitis associated with genetics and immune response

Autoimmune hepatitis, which occurs in women 8 times more often than in men, is characterized by rapid progression with a transition to portal hypertension, renal failure, cirrhosis, and ends with the death of the patient. In accordance with the international classification, autoimmune hepatitis can occur in the absence of blood transfusions, liver damage from alcohol, toxic poisons, and medicinal substances.

The cause of autoimmune liver damage is believed to be a genetic factor. Positive associations of the disease with antigens of the major histocompatibility complex (HLA leukocyte system), in particular, HLA-B 8 , which is recognized as an antigen of hyperimmunoreactivity, were revealed. However, many may have a predisposition, but not all get sick. Some drugs (for example, interferon), as well as viruses can provoke an autoimmune lesion of the hepatic parenchyma:

Epstein-Barra;
Corey;
Herpes 1 and 6 types;
Hepatitis A, B, C.

It should be noted that about 35% of patients who were overtaken by AIH already had other autoimmune diseases.

The vast majority of cases of autoimmune hepatitis begin as an acute inflammatory process (weakness, loss of appetite, severe jaundice, dark urine). After a few months, signs of an autoimmune nature begin to form.

Sometimes AIT develops gradually with a predominance of symptoms of asthenovegetative disorders, malaise, heaviness in the liver, slight jaundice, rarely the onset is manifested by a significant increase in temperature and signs of another (extrahepatic) pathology.

The following manifestations may indicate a detailed clinical picture of AIH:

Severe malaise, loss of working capacity;
Heaviness and pain on the side of the liver;
Nausea;
Skin reactions (capillaritis, telangiectasia, purpura, etc.)
Itching of the skin;
Lymphadenopathy;
Jaundice (intermittent);
Hepatomegaly (enlargement of the liver);
Splenomegaly (enlargement of the spleen);
In women, the absence of menstruation (amenorrhea);
In men - an increase in the mammary glands (gynecomastia);
Systemic manifestations (polyarthritis),

Often AIH is a companion of other diseases: diabetes mellitus, diseases of the blood, heart and kidneys, pathological processes localized in the organs of the digestive system. In a word, autoimmune - it is autoimmune and can manifest itself in any, far from hepatic pathology.

Any liver "does not like" alcohol ...

Alcoholic hepatitis (AH) can be considered as one of the forms of toxic hepatitis, because they have one reason - a negative effect on the liver of irritating substances that have a detrimental effect on hepatocytes. Hepatitis of alcoholic origin is characterized by all the typical signs of inflammation of the liver, which, however, can take place in a sharply progressive acute form or have a persistent chronic course.

Most often, the onset of an acute process is accompanied by signs:

Intoxication: nausea, vomiting, diarrhea, aversion to food;
weight loss;
Jaundice without itching or with itching due to the accumulation of bile acids in the cholestatic form;
A significant increase in the liver with its compaction and soreness in the right hypochondrium;
Tremor;
Hemorrhagic syndrome, renal failure, hepatic encephalopathy with fulminant form. Hepatorenal syndrome and hepatic coma can cause the death of the patient.

Sometimes in the acute course of alcoholic hepatitis, a significant increase in body temperature is observed, bleeding and the addition of bacterial infections are possible, causing inflammation of the respiratory and urinary tract, gastrointestinal tract, etc.

Chronic persistence of hypertension is oligosymptomatic and often reversible if a person manages to stop in time. Otherwise the chronic form becomes progressive with transformation into cirrhosis.

… And other toxic substances

For the development of acute toxic hepatitis a single dose of a small dose of a toxic substrate is sufficient, which has hepatotropic properties, or a large number of substances that are less aggressive towards the liver, for example, alcohol. Acute toxic inflammation of the liver manifests itself by its significant increase and pain in the right hypochondrium. Many people mistakenly believe that the organ itself hurts, but this is not so. Pain is caused by stretching of the liver capsule due to an increase in its size.

With toxic liver damage, the symptoms of alcoholic hepatitis are characteristic, however, depending on the type of poisonous substance, they can be more pronounced, for example:

Feverish state;
progressive jaundice;
Vomiting with an admixture of blood;
Nose and gingival bleeding, hemorrhages on the skin due to damage to the vascular walls by toxins;
Mental disorders (excitation, lethargy, disorientation in space and time).

Chronic toxic hepatitis develops over a long period of time when small but constant doses of toxic substances are ingested. If the cause of the toxic effect is not eliminated, then after years (or only months) complications can be obtained in the form cirrhosis of the liver and liver failure.

Markers for early diagnosis. How to deal with them?

Viral hepatitis markers

Many have heard that the first step in the diagnosis of inflammatory liver diseases is a study on markers. Having received a piece of paper with the answer to the analysis for hepatitis, the patient is unable to understand the abbreviation if he does not have a special education.

Viral hepatitis markers determined with the help of and, inflammatory processes of non-viral origin are diagnosed by other methods, not excluding ELISA. In addition to these methods, biochemical tests, histological analysis (based on liver biopsy material) and instrumental studies are carried out.

However, we should return to the markers:

Infectious hepatitis A antigen can be determined only in the incubation period and only in the feces. In the phase of clinical manifestations, class M immunoglobulins (IgM) begin to be produced and appear in the blood. HAV-IgG synthesized somewhat later indicate recovery and the formation of lifelong immunity, which these immunoglobulins will provide;
The presence or absence of the causative agent of viral hepatitis B they are determined by the “Australian antigen” - HBsAg (surface antigen) detected from time immemorial (though not by modern methods) and the inner shell antigens - HBcAg and HBeAg, which became possible to identify only with the advent of laboratory diagnostics by ELISA and PCR. HBcAg is not detected in the blood serum, it is determined using antibodies (anti-HBc). To confirm the diagnosis of HBV and monitor the course of the chronic process and the effectiveness of treatment, it is advisable to use PCR diagnostics (detection of HBV DNA). The patient's recovery is evidenced by the circulation of specific antibodies (anti-HBs, total anti-HBC, anti-HBe) in the serum of his blood in the absence of the antigen itselfHBsAg;
Diagnosis of C-hepatitis without detection of virus RNA (PCR) is difficult. IgG antibodies, having appeared at the initial stage, continue to circulate throughout life. The acute period and the reactivation phase are indicated by class M immunoglobulins (IgM), the titer of which increases. The most reliable criterion for diagnosing, monitoring and controlling the treatment of hepatitis C is the determination of virus RNA by PCR.
The main marker for the diagnosis of hepatitis D(delta infection) class G immunoglobulins (anti-HDD-IgG) are considered to persist throughout life. In addition, to clarify monoinfection, super (association with HBV) or coinfection, an analysis is carried out that detects class M immunoglobulins, which remain forever with superinfection, and disappear with coinfection in about six months;
The main laboratory study of hepatitis G is the determination of viral RNA using PCR. In Russia, antibodies to HGV are detected using specially designed ELISA kits that can detect immunoglobulins to the E2 envelope protein, which is a component of the pathogen (anti-HGV E2).

Hepatitis markers of non-viral etiology

Diagnosis of AIH is based on the detection of serological markers (antibodies):

In addition, the diagnosis uses the determination of biochemical parameters: protein fractions (hypergammaglobulinemia), liver enzymes (significant activity of transaminases), as well as the study of the histological material of the liver (biopsy).

Depending on the type and ratio of markers, types of AIH are distinguished:

The first is more often manifested in adolescents or in adolescence, or “waits” up to 50;
The second most often affects childhood, has high activity and resistance to immunosuppressors, quickly transforms into cirrhosis;
The third type used to stand out as a separate form, but now it is no longer considered in this perspective;
Atypical AIH representing cross-hepatic syndromes (primary biliary cirrhosis, primary sclerosing cholangitis, chronic viral hepatitis).

Direct evidence of the alcoholic origin of liver damage does not exist, therefore there is no specific analysis for hepatitis associated with the use of ethanol, however, some factors that are very characteristic of this pathology have been noticed. For example, ethyl alcohol, which acts on the hepatic parenchyma, promotes the release of alcoholic hyaline called Mallory bodies, which leads to the appearance of ultrastructural changes in hepatocytes and stellate reticuloepithelial cells, indicating the degree of negative impact of alcohol on the "long-suffering" organ.

In addition, some biochemical indicators (bilirubin, liver enzymes, gamma fraction) indicate alcoholic hepatitis, but their significant increase is characteristic of many pathological conditions of the liver when exposed to other toxic poisons.

Clarification of anamnesis, identification of a toxic substance that affected the liver, biochemical tests and instrumental examination are the main criteria for the diagnosis of toxic hepatitis.

Can hepatitis be cured?

Treatment of hepatitis depends on the etiological factor that caused the inflammatory process in the liver. Of course , hepatitis of alcoholic or autoimmune origin usually requires only symptomatic, detoxification and hepatoprotective treatment .

Viral hepatitis A and E, although of infectious origin, are acute and, as a rule, do not give chronicity. The human body in most cases is able to resist them, therefore it is not customary to treat them, except that sometimes symptomatic therapy is used to eliminate headaches, nausea, vomiting, and diarrhea.

The situation is more complicated with inflammation of the liver caused by viruses B, C, D. However, given that delta infection practically does not occur on its own, but obligately follows HBV, B-hepatitis has to be treated first of all, but with increased doses and lengthened course.

It is not always possible to cure hepatitis C, although the chances of a cure nevertheless appeared with the use of interferons-alpha (a component of the immune defense against viruses). In addition, at present, to enhance the effect of the main drug, combined regimens are used that involve combinations of prolonged interferons with antiviral drugs, for example, ribavirin or lamivudine.

It should be noted that not every immune system adequately responds to interference with its work by immunomodulators introduced from the outside, so interferon, for all its advantages, can produce undesirable effects. In this regard, interferon therapy is carried out under the close supervision of a doctor with regular laboratory monitoring of the behavior of the virus in the body. If it is possible to completely eliminate the virus, then this can be considered a victory over it. Incomplete elimination, but the cessation of replication of the pathogen is also a good result, allowing you to "lull the enemy's vigilance" and delay the likelihood of hepatitis turning into cirrhosis or hepatocellular carcinoma for many years.

How to prevent hepatitis?

The expression “It is easier to prevent a disease than to cure” has long been hackneyed, but not forgotten, since many troubles can really be avoided if preventive measures are not neglected. As for viral hepatitis, special care will not be superfluous here either. Compliance with the rules of personal hygiene, the use of specific protective equipment when in contact with blood (gloves, fingertips, condoms) in other cases can become an obstacle to the transmission of infection.

Medical workers in the fight against hepatitis specifically develop action plans and follow them every point. Thus, in order to prevent the incidence of hepatitis and the transmission of HIV infection, as well as reduce the risk of occupational infection, the Sanitary and Epidemiological Service recommends adhering to certain prevention rules:

Prevent "syringe hepatitis" common among people who use drugs. To this end, organize points for the free distribution of syringes;
Prevent any possibility of transmission of viruses during blood transfusions (organization of PCR laboratories at stations for transfusion and quarantine storage of drugs and components obtained from donor blood at ultra-low temperatures);
Minimize the likelihood of occupational infection to the maximum, using all available personal protective equipment and complying with the requirements of the sanitary and epidemiological surveillance authorities;
Pay special attention to departments with an increased risk of infection (hemodialysis, for example).

We should not forget about the precautions for sexual intercourse with an infected person. The chance of sexually transmitting hepatitis C virus is negligible, but for HBV it increases significantly, especially in cases associated with the presence of blood, such as menstruation in women or genital trauma in one of the partners. If you can’t do without sex, then at least you shouldn’t forget about a condom.

There is a higher chance of becoming infected in the acute phase of the disease, when the concentration of the virus is especially high, so for such a period it would be better to abstain from sexual relations altogether. Otherwise, carrier people live a normal life, give birth to children, remembering their peculiarities, and be sure to warn doctors (ambulance, dentist, when registering at a antenatal clinic and in other situations that require increased attention) about what is included in risk group for hepatitis.

Increasing resistance to hepatitis

Hepatitis prevention also includes vaccination against a viral infection. Unfortunately, a vaccine against hepatitis C has not yet been developed, but available vaccines against hepatitis A and B have significantly reduced the incidence of these types.

The hepatitis A vaccine is given to children 6-7 years of age (usually before school entry). A single use provides immunity for a year and a half, revaccination (re-vaccination) extends the protection period to 20 years or more.

The HBV vaccine is administered to newborn babies still in the maternity hospital without fail, for children who for some reason have not been vaccinated, or for adults there are no age restrictions. To ensure a full-fledged immune response, the vaccine is administered three times over several months. The vaccine was developed on the basis of the surface ("Australian") HBs antigen.

The liver is a delicate organ

Treating hepatitis on your own means taking full responsibility for the outcome of the inflammatory process in such an important organ, therefore, in the acute period or in the chronic course, it is better to coordinate any of your actions with the doctor. After all, anyone understands: if the residual effects of alcoholic or toxic hepatitis can neutralize folk remedies, then they are unlikely to cope with the rampant virus in the acute phase (meaning HBV and HCV). The liver is a delicate organ, albeit a patient one, so home treatment should be thoughtful and reasonable.

Hepatitis A, for example, does not require anything other than diet, which is necessary, in general, in the acute phase of any inflammatory process. Nutrition should be as sparing as possible, since the liver passes everything through itself. In the hospital, the diet is called the fifth table (No. 5), which is also observed at home for up to six months after the acute period.

In chronic hepatitis, of course, it is not advisable to offer strict adherence to a diet for years, but it would be right to remind the patient that one should not irritate the organ once again. It is advisable to try to eat boiled foods, exclude fried, fatty, pickled, limit salty and sweet. Strong broths, strong and weak alcoholic and carbonated drinks, the liver also does not accept.

Can folk remedies save?

Folk remedies in other cases help the liver cope with the load that has fallen on it, raise natural immunity, and strengthen the body. However they cannot cure hepatitis, therefore, to engage in amateur activities, to treat liver inflammation without a doctor is unlikely to be correct, because each of the types has its own characteristics that must be taken into account in the fight against it.

"Blind" sounding

Often the attending physician himself, when discharging a convalescent from the hospital, recommends simple home procedures for him. For example - "blind" probing, which is done on an empty stomach in the morning. The patient drinks 2 chicken yolks, throwing away the proteins or using them for other purposes, after 5 minutes he drinks it all with a glass of still mineral water (or clean from the tap) and puts it on the right barrel, putting a warm heating pad under it. The procedure takes an hour. You should not be surprised if after it a person runs to the toilet to give away everything unnecessary. Some use magnesium sulphate instead of yolks, however, this is a saline laxative that does not always provide such comfort to the intestines as, say, eggs.

Horseradish?

Yes, some people use finely grated horseradish (4 tablespoons) as a treatment, diluting it with a glass of milk. Drinking the mixture immediately is not recommended, so it is first heated (almost to a boil, but not boiled), left for 15 minutes so that a reaction occurs in the solution. Use the medicine several times a day. It is clear that such a remedy will have to be prepared every day if a person tolerates a product such as horseradish well.

Soda with lemon

They say that in the same way some people lose weight . But still we have another goal - to treat the disease. Squeeze the juice of one lemon and pour a teaspoon of baking soda into it. After five minutes, the soda will be extinguished and the medicine is ready. Drink for 3 days three times a day, then rest for 3 days and repeat the treatment again. We do not undertake to judge the mechanism of action of the drug, but people do it.

Herbs: sage, mint, milk thistle

Some say that milk thistle, known in such cases, which helps not only with hepatitis, but also with cirrhosis, is absolutely ineffective against hepatitis C, but in return, people offer other recipes:

1 tablespoon peppermint;
Half a liter of boiling water;
Infused for a day;
Strained;
Used throughout the day.

Or another recipe:

Sage - a tablespoon;
200 - 250 grams of boiling water;
A tablespoon of natural honey;
Honey is dissolved in sage with water and infused for an hour;
Drink the mixture on an empty stomach.

However, not everyone adheres to a similar point of view regarding milk thistle and offers a recipe that helps with all inflammatory liver diseases, including C-hepatitis:

A fresh plant (root, stem, leaves, flowers) is crushed;
Put in the oven for a quarter of an hour to dry;
Remove from the oven, lay out on paper and place in a dark place to complete the drying process;
Select 2 tablespoons of dry product;
Add half a liter of boiling water;
Insist 8-12 hours (preferably at night);
Drink 3 times a day, 50 ml for 40 days;
Arrange a break for two weeks and repeat the treatment.

Video: viral hepatitis in the "School of Dr. Komarovsky"

Sexually, and how dangerous unprotected intercourse is in this regard, few people know. In recent years, the prevalence of this viral disease has been rapidly increasing. And if a few years ago hepatitis C was the prerogative of drug addicts, today there are more and more ways of transmitting this disease, which indicates people's ignorance of the problem, the extent of its spread.

How can you get hepatitis C? This information is important for everyone.

No one has a guarantee of safety from possible infection, almost every one of us is at risk. The number of infected people is constantly increasing every year. And the statistics on this disease looks like this: 170 million people on the planet are carriers or are sick with chronic hepatitis C.

And these are just the recorded facts. Every year this figure increases by 3-4 million people. Therefore, it is important for each of us to know and understand information about how you can catch this disease, as well as the mechanisms of its transmission.

The main route of transmission of hepatitis C is infection through the blood. At the same time, this viral disease can be obtained not only from the patient, but also from an infected person. It has been proven that the blood and its components contain the maximum number of viral cells.
Blood is not the only fluid in which the presence of the virus is noted. Its presence is in the menstrual flow of a woman, in the sperm of a man, lymphatic fluid, saliva.

Despite the fact that there are more virus cells in the blood than in the semen or saliva of a person, you should not think that the disease is not transmitted through unprotected intercourse.

Sex without a condom today has become one of the main causes of the spread of viral hepatitis C. In saliva, the percentage of viral cells is quite low even in the later stages of the disease. The probability that infection through a kiss will take place is quite low and practically reduces to zero.

The insidiousness of the virus lies in the fact that it is quite active and is able to remain viable for a long time even in dried biological fluids. Here, its activity lasts up to 96 hours.

Doctors also identify certain risk groups. These are people who, due to their behavior or working conditions, are exposed to hepatitis C infection.

Conventionally, they are divided into three groups according to the likelihood of infection:

low risk - these are medical workers who come into contact with the blood of people who have unprotected sex with fickle and unverified partners;
medium risk - people who undergo hemodialysis, children from an infected mother, patients who have transplanted organs;
a high degree of risk is injection drug addicts, people diagnosed with HIV infection.

According to this gradation, people who have unprotected sex with unknown partners have a small risk of becoming infected. But do not think that such behavior is safe, and hepatitis is not terrible for you. This is far from true!

Unprotected sex and hepatitis C

Despite the fact that unprotected sex is considered an unlikely route of infection, the number of patients who got hepatitis C in this way is increasing significantly every year.

Thus, medical professionals claim that the probability of contracting this viral disease ranges from approximately 3 to 5% if sex was unprotected with an infected sexual partner. If a condom was used during intercourse, then the possibility of infection is reduced to zero.

These figures are not accurate enough, since determining the exact route of infection of a particular patient is almost impossible. From the time a virus is received to its detection, it can take months, and sometimes years.

The fact that it can not be determined by any external signs. Many people think that people with this diagnosis have some obvious external symptoms, for example, yellow sclera of the eyes or skin. But this is far from true. Many patients are carriers of the disease and may not even know they are sick. And characteristic superficial features can appear already at later stages, when chronic hepatitis C leads to a significant loss of liver function. Therefore, relying on the appearance of a person and trusting him blindly is not worth it.

We have already said that the approximate percentage of the probability of transmitting the virus through unprotected sexual contact with an infected partner is no more than 5%. But for a particular person, this percentage can increase significantly.

For example, for someone who practices unprotected sex with unverified and unfamiliar partners constantly, this figure increases to 25%.
An increased danger is anal sex without protective equipment, as it is often accompanied by cracks and bleeding.
The likelihood of contracting hepatitis C during sexual contact increases significantly if aggressive sex is practiced, in which traumatization and bleeding of the mucous membranes occur.
The risk also increases during menstruation in women.

Hepatitis C is a fairly common phenomenon among representatives of non-traditional sexual orientation. Here, the percentage of carriers of the viral component reaches 4. If we talk about women of "easy virtue", then here the number of patients with hepatitis C is 6%.

It should be noted that patients who are being treated in dermatovenerological dispensaries quite often face the fact of detecting hepatitis C. This detection is approximately 4% of all patients. Agree, the figure is not small and makes you think about safety during intercourse with an unknown partner.

When the virus is detected in the blood

Many are interested in the question of how the disease is diagnosed, and does it have characteristic external manifestations after infection? If you had unprotected sex, when should you come for an analysis so that its result gives a complete picture of the state of health? Let's figure it out.

It is not difficult to determine the presence of a virus in the blood today. Such an analysis is carried out in most medical institutions and laboratories.

An analysis for hepatitis C represents several methods of immunobiological reactions in the human body:

determination of immunoglobulin A and G;
PCR method.

The first type of research is considered to be more extensive and rather indicative.

So, if immunoglobulin A is found in the patient's blood, then this indicates an active process of development of viral hepatitis C in the body of this person.
Positive immunoglobulin G gives more ambiguous results, as it indicates the presence of viral hepatitis or its absence, but at the same time, it is quite difficult to determine the phase of its activity in the body based on the results. Therefore, most often, if its results are doubtful, additional tests are prescribed. Many doctors practice the simultaneous determination of immunoglobulin A and G.

The PCR method helps to identify the RNA of the virus in the patient's blood and talk about its presence or absence.

Translated from Greek, hepatitis means liver. This disease occurs in a chronic or acute form and affects a large part of the liver. Whether it is sexually transmitted is the main question asked by people who are carriers of this disease.

Forms of the disease

The acute form is of natural origin. Often, infected viruses can be found in water or food and infect the human body with strong poisons. Intoxication of the body leads to a violation of the liver, an increase in body temperature, in addition, a change in the composition of the blood. With timely treatment to medical institutions, the disease can be completely cured. With untimely or belated treatment, its form can develop into a chronic one.

The chronic form is the result of poisoning with strong poisons over a significant period of time. Most often, this poison is ethyl alcohol, and the source of vodka is the “green snake”. This can lead to cirrhosis of the liver, cancer and chronic viral hepatitis of groups B, C, D.

Ways of transmission of viruses of different types

Type A is a virus that enters the human body through the mouth. Sources of infection can be dirty food, water or hands. The infection can also accumulate on the fur of animals, and enter the human body if hygiene rules are violated. The consequence of this disease is jaundice, which affects the gastrointestinal tract and the intestinal mucosa.

Type B is a virus that enters the human body through drugs and medicines, in addition, through inhalation and injection.

Hepatitis C is a virus that is transmitted through blood or sexual contact. This risk group includes the category of people who have direct contact with blood. Infection occurs through blood transfusion, drug injection using shared syringes, in a nail salon and during hair removal.

90% of infections occur sexually as a result of sex with an unprotected partner who is infected. The disease usually has an incubation character and manifests itself on the 14th day. Symptoms of the disease can be severe burning in the genital area, redness, the appearance of ulcers and wounds, bleeding during urination.

When using condoms during sex, you can protect yourself from infection by 95%, provided that it does not break or be damaged in any other way. A lot depends on the viral load, i.e. the amount of virus in an infected person's blood. With a high viral load during protected sex, the probability of infection does not exceed 4%. With damage to the mucous membrane or unprotected sex, it is almost impossible to avoid infection with hepatitis C.

Type D. This type of virus can be transmitted directly through the blood, so it can also be transmitted sexually, especially if there was damage to the vaginal mucosa during contact. Only 3% of 100% hepatitis type D becomes chronic and can cause cirrhosis of the liver. The incubation period is very fast, and in just 4-7 days you can find the corresponding symptoms on your genitals. Currently, he is successfully treated with a 100% result.

Type E has similar symptoms to hepatitis A. It is also transmitted through contaminated water, food, and also directly through the blood. This virus is most commonly found in Asia and Africa. It is uncharacteristic for Russia and neighboring countries.

Type F - this virus is observed in people of a certain group. These include drug addicts and people with hemophilia. In this category of people, re-infection with jaundice is possible, provided that they have already been infected with one of these viruses before.

Hepatitis G is a mutated form of strain C. It usually occurs if a person has already been infected with it before. It is transmitted directly through the blood and through unprotected sexual contact. Treatment of the disease is longer and more serious. There are a number of complications that can lead to cancer and cirrhosis of the liver. Therefore, no matter what stage your disease is, you should immediately consult a doctor.

In addition, there are hepatitis: alcoholic, medicinal, and as a consequence of poisoning with industrial poisons. All of them have one characteristic feature: they come from an overdose of various harmful substances. Therefore, before self-medicating, be sure to seek the advice of a specialist. Do not forget to undergo an annual medical examination and donate blood to check for the presence / absence of hepatitis in the blood.

The area affected by the virus also covers male sperm.

Thus, hepatitis in the semen is clearly present, and the conception of a child becomes almost impossible.

If conception does occur, it is not possible to bear and give birth to a full-fledged child. Therefore, before having sex and having sexual intercourse, it is necessary to undergo a medical examination for both partners.

Strictly remember that unprotected sex and promiscuity can lead to hepatitis, which is then treated for a long time and leaves a mark on your liver and gastrointestinal tract for life.

Additional sources of information:

Serov V.V., Aprosina Z.G. "Chronic viral hepatitis".
Makarov V.K. "Infectious diseases (diagnosis, differential diagnosis, immunotherapy)".
Gavrisheva N.A. “Infectious process. Clinical and pathophysiological aspects - Textbook.

Hepatitis C is more common in young people. However, the "age" of infection is gradually increasing.

More than 170 million of the world's population is affected by chronic hepatitis C. Every year, 3-4 million people become infected. The disease is common in all countries, but unevenly.

Where can you get hepatitis C virus?

You can get infected when performing piercings, tattoos - in the respective salons. However, according to statistics, they are more likely to become infected in those places where there is a joint use of injecting drugs. High risk of infection in prisons.
Medical staff can become infected at work (in a hospital, clinic) when injured while working with infected blood.
Hemotransfusions (blood transfusion) are currently rarely the cause of infection in patients, their contribution is no more than 4%.
Previously, hepatitis C was characterized as "post-transfusion". The risk of infection during medical procedures may persist in developing countries. If sanitary standards are grossly violated, then any office where medical manipulations are performed can become the site of infection.

Often with hepatitis C, it is not possible to establish the exact source of infection.

How is infection transmitted?

The main mechanism of infection is hematogenous, parenteral (through the blood). Most often, infection with the hepatitis C virus occurs when a sufficient amount of infected blood is injected with a shared needle.

Infection is possible when performing piercings and tattoos with instruments contaminated with the blood of a patient or carrier of an infection, possibly when sharing razors, manicure accessories, and even toothbrushes (infected blood that gets on them can cause infection), with a bite.

Infection with hepatitis C through the introduction of blood products during operations and injuries, the introduction of medicines and mass vaccinations, in dental offices is less likely in developed countries.

sexually transmitted infection

Sexual transmission of hepatitis C is of little relevance. With unprotected sexual contact with a carrier of the virus, the probability of transmission is 3-5%.
In a monogamous marriage, the risk of infection transmission is minimal, but it increases with a large number of partners, casual relationships.
It is not known how much oral sex contributes to transmission.

Persons who have sexual contact with patients with hepatitis C or carriers of the virus are advised to use condoms.
At the same time, as a rule, you cannot tell by the appearance of a person whether he has hepatitis C, and even more so - whether he is a carrier of the virus.

Transmission of hepatitis C from mother to child

Hepatitis C virus is rarely transmitted from an infected mother to a fetus, in no more than 5% of cases. Infection is possible only in childbirth, during the passage of the birth canal. Preventing infection today is not possible.

In most cases, children are born healthy. Data on the course of infection in the long term is still insufficient, protocols for the treatment of newborns have also not been developed.

There are no data indicating the possible transmission of the virus with mother's milk. Breastfeeding in the presence of hepatitis C in the mother is recommended to be canceled if there are violations of the integrity of the skin of the mammary glands, bleeding.

Is hepatitis C transmitted through normal household contact?

Hepatitis C is not transmitted by airborne droplets (when talking, sneezing, with saliva, etc.), shaking hands, hugging, sharing utensils, food or drinks.
If an infection has been transmitted in everyday life, then a particle of blood from a patient or a carrier of the hepatitis C virus must enter the blood of an infected person (in case of injury, cut, through abrasions, etc.).

Patients and carriers of the hepatitis C virus should not be isolated from family members and society, they should not be limited or create special conditions in work, study, care for them (children, the elderly) only on the basis of the presence of infection.
However, persons infected with viral hepatitis C in Russia are exempt from military conscription.

How do I know if I'm at risk for hepatitis C?

There are groups of people who are at higher risk of contracting hepatitis C. CDC epidemiologists distinguish three degrees of increased risk.
The highest risk of infection are:

People who inject drugs
Persons transfused with clotting factors prior to 1987

Intermediate (medium-increased) risk of contracting hepatitis C have:

Patients on hemodialysis (artificial kidney machine)
People who received an organ transplant (transplant) or who received a blood transfusion prior to 1992, and anyone who received blood from a donor who subsequently tested positive for hepatitis C
Persons with unidentified liver diseases (problems)
Babies born to infected mothers

Medical workers and employees of the sanitary and epidemiological service
Persons who have sex with multiple partners
Persons who have sex with one infected partner

People in high- and intermediate-risk groups should be screened for hepatitis C.
At the same time, tests should be taken even if (for example) injecting drug use occurred only once or several times many years ago. All persons infected with HIV are also tested for hepatitis C.
In children born to infected mothers, the analysis is performed at the age of 12-18 months.
Health care workers should be screened in all cases of suspected contact with infected blood (for example, if they were pricked with a needle or blood got into the eye).

Individuals in certain risk groups for hepatitis C should be vaccinated against hepatitis B because they are at risk of contracting this infection as well.

What tests establish the fact of infection?

The first test that is usually recommended is antibodies to hepatitis C virus (anti-HCV). It is performed in most medical institutions. This analysis establishes only the fact of infection in the present or past.
In addition, this test can give false-positive (the test is positive, but there is actually no infection) and false-negative results (the test is negative, but there is actually an infection), for various reasons.
Therefore, a more complex examination is performed to accurately diagnose hepatitis C.

Is it possible to catch the hepatitis C virus and not get sick?

You can get infected and recover from hepatitis C, i.e. get well. The probability of this is about 10-20%.
You can become infected and become a carrier of the hepatitis C virus. Viruses multiply in the body of the carrier, but they do not cause much harm to him. These people do not show changes in liver tests and signs of hepatitis on liver biopsy. However, latent progression is also possible.

But still, once infected with the hepatitis C virus, the majority of those infected acquire chronic hepatitis C. The probability of this is about 70%. All infected people need constant medical supervision because they remain at risk of activating the disease.

Is it possible to get infected and get sick with hepatitis C again?

Yes, you can get infected and get sick again. Even if the treatment was successful, immunity to the hepatitis C virus is not developed, so re-infection (including another type of HCV) causes the disease.

What to do if there is a patient with hepatitis C in the family?

A sick or infected family member must take all measures to prevent transmission of the virus to other family members, including:

Do not donate blood or organs for transplant
Do not use common household items that can serve as transmission factors (razors and appliances, epilators, toothbrushes and floss, manicure sets)
For cuts and abrasions, cover them with a bandage or band-aid so that blood does not get out (if he needs to bandage or put a band-aid, you need to wear medical gloves)

It has been established that the hepatitis C virus survives in the external environment (for example, in dried blood drops) at room temperature for at least 16 hours, and even up to 4 days.

All places where drops of blood of an infected family member accidentally fall should be treated with a disinfectant solution - for example, chlorine-containing detergents, or a solution of bleach at a dilution of 1:100. Washing at 60 degrees inactivates the virus in 30 minutes, boiling in 2 minutes.