How often is hepatitis C transmitted sexually. Sexual and contact-household ways of infection

Hepatitis C is a disease caused by an RNA virus. It has one distinctive feature - genetically quickly mutate. To date, 6 genotypes of the hepatitis C virus are known, but all of them are constantly changing, forming subspecies. This leads to the fact that the human immune system is simply unable to produce the necessary antibodies that can fight the rapidly mutating hepatitis C virus. Due to this, the virus itself is constantly in the human body in an active state, which leads to the development of chronic forms of hepatitis with a high frequency of complications. .

In this state of affairs, the treatment of viral hepatitis is a complex, time-consuming and lengthy process. It is the prerogative of infectious disease specialists. I want to dwell on issues related to everyone and everyone who cares about their health, does not want to “catch” viral hepatitis C. Within this article, I will talk about hepatitis C, how it is transmitted, whether hepatitis is sexually transmitted, whether it is possible to get infected as otherwise, what tests need to be done to identify it.

How is hepatitis C transmitted?

The source of infection is a sick active form of viral hepatitis C or its latent (hidden) carriers. The transmission of the virus itself occurs in several ways: parenterally (through infected blood), sexually, from a sick mother to a child.

1. Parenteral route of transmission. The most up-to-date. It occurs when a healthy person comes into contact with objects infected with the hepatitis C virus. The fact is that the virus itself is stable in the external environment, it is not so easy to inactivate it. It dies at a temperature of +60 for half an hour, and when boiled for 2 minutes. A person can “catch” it when using infected items that have microparticles of infected blood: syringes, manicure accessories, personal hygiene items (toothbrush, razor) together with a patient with viral hepatitis. Acupuncture, prising, tattooing procedures increase the risk of hepatitis C infection. This also includes infection through poorly processed medical instruments and medical manipulations (this is unlikely, but possible) during surgical interventions, dental treatment, transfusion of infected blood or its components.

2. sexual transmission. It ranks second in frequency of transmission of the virus itself. During normal unprotected sexual contact with a patient with hepatitis C or a virus carrier, the risk of infection is about 3-5%. With anal sex, this percentage doubles. This is especially true for individuals. In addition, there is no data on the possibility of transmission of the virus during oral sex.

3. Vertical transmission path. A mother can pass on the hepatitis C virus to her baby only at the moment of the birth itself, when the baby passes through the birth canal. The risk is 5%, and according to some sources 1.7%. Whether or not to breastfeed a baby after birth is still a matter of debate. Most scientists in the world have come to the conclusion that this is not a contraindication to breastfeeding. If the mother's process aggravates after childbirth, then only then it is advisable to temporarily wean the child! from the chest. In addition, the mother must ensure that there are no cracks in the nipples, in which case the risk of infection increases several times!
The household route of transmission and airborne droplets (talking, sneezing, coughing) are excluded.

Who is at risk of contracting hepatitis C virus?

I. High risk of infection. Injection drug addicts. Persons who have received a transfusion of blood or blood components. HIV infected.

II. Medium risk. Patients on hemodialysis. Patients with organ transplants or liver disease of unknown cause. Children born to mothers infected with the hepatitis C virus.

III. Low risk. Medical workers, persons having more than one sexual partner. People who have sex with people who are known to be infected.

What tests should be taken to detect viral hepatitis C?

To identify the presence of the hepatitis C virus in the body today is not difficult. There are several types of immunological reactions. The most common of them can be carried out in many medical institutions:

Method for determining Iq A and G. If Iq A is found in the blood, then an acute process is going on in the body. Iq G testify to the transferred disease, they are read in two ways. Each laboratory has its own standards, I will not give them, I will only say that if Iq G is 4 times higher than normal, the process is considered active, but if they are lower, then you should not worry, the virus itself is not in the body.

The PCR method determines the presence or absence of the virus in the body.

The hepatitis C virus is very insidious, it may not manifest itself for many years, undermining the body from the nutria. A person lives his ordinary life without knowing that he has this dangerous disease. He can do tattoos, piercings, manicures, while particles of his infected blood fall on objects and are transmitted to other people.

Remember, in order to protect yourself from infection, do not share personal hygiene items with other people! Be monogamous, do not forget that there is also a sexual way of transmission!! And if you engage in promiscuity, then let the sexual contact be protected.

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 remained a mystery for a long time, 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 touched upon, 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:

1. 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;
2. By using one needle for several people, this method is practiced by syringe addicts;
3. Transmission of the virus through sexual intercourse, which is most likely for hepatitis B, hepatitis C in such situations is transmitted much less frequently;
4. 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.
5. 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 transmission of 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:

1. Easy, more characteristic of hepatitis C: jaundice is often absent, subfebrile or normal temperature, heaviness in the right hypochondrium, loss of appetite;
2. Medium: the above symptoms are more pronounced, there is pain in the joints, nausea and vomiting, there is practically no appetite;
3. heavy. All symptoms are present in a pronounced form;
4. 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:

1. Fever, headache;
2. Decreased efficiency, general weakness, malaise;
3. Pain in the joints;
4. Disorder of the function of the digestive system (nausea, vomiting);
5. Sometimes rashes and itching;
6. Heaviness in the right hypochondrium;
7. Enlarged liver, sometimes - spleen;
8. Jaundice;
9. 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 "move". 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 noticed, 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 a 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 complex, 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:

1. Autoimmune hepatitis, characterized by extensive damage to the liver, and, therefore, an abundance of symptoms;
2. 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;
3. Chronic hepatitis B, C, D;
4. Hepatitis caused by the toxic effects of drugs;
5. 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:

1. 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;
2. 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;
3. Chronic lobular hepatitis, due to the predominance of the inflammatory process in the lobules. The defeat of several lobules with multibular necrosis indicates a high degree of 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:

1. Viral hepatitis, caused by certain microorganisms (B, C, D, G) and indefinite - little studied, unconfirmed by clinical data, new forms - F, TiTi;
2. autoimmune hepatitis(types 1, 2, 3);
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;
4. Toxic hepatitis due to the influence of hepatotropic toxic substances, ionizing radiation, alcohol surrogates and other factors;
5. 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;
6. 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;
7. 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);
8. 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 drugs.

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:

1. Severe malaise, loss of working capacity;
2. Heaviness and pain on the side of the liver;
3. Nausea;
4. Skin reactions (capillaritis, telangiectasia, purpura, etc.)
5. Itching of the skin;
6. Lymphadenopathy;
7. Jaundice (intermittent);
8. Hepatomegaly (enlargement of the liver);
9. Splenomegaly (enlargement of the spleen);
10. In women, the absence of menstruation (amenorrhea);
11. In men - an increase in the mammary glands (gynecomastia);
12. 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:

1. Feverish state;
2. progressive jaundice;
3. Vomiting with an admixture of blood;
4. Nose and gingival bleeding, hemorrhages on the skin due to damage to the vascular walls by toxins;
5. 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 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:

1. Prevent "syringe hepatitis" common among people who use drugs. To this end, organize points for the free distribution of syringes;
2. 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);
3. 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 supervision authorities;
4. 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 people 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:

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

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

According to statistics, about twenty percent of people suffer from this disease, having no idea where it comes from. To understand this, you need to answer a few questions. What are the symptoms of the disease? What are the routes of transmission of the virus? Is hepatitis C sexually transmitted?

Ways of disease transmission

In Greek, the word "hepatitis" means inflammation of the liver. Viral hepatitis has several routes of transmission. But many are interested in the question of whether hepatitis C is sexually transmitted.

Modern medicine distinguishes several forms of hepatitis:

• Hepatitis A is a viral infection that enters the human body through the mouth. Sources of infection are dirty hands, poor-quality food and water. The infection can get to the person at violation of hygienic rules. As a result, a disease develops with jaundice and other symptoms.
• Hepatitis B, C and D enter the human body by blood contact: through the blood.
• Hepatitis E is transmitted by water and household contact. Especially dangerous for pregnant women.

Hepatitis F and G are currently not studied enough and are not of particular interest.

Causes of infection

Hepatitis C is a viral disease. The incubation period of the disease ranges from 14 days to 6 months. In most cases, the disease is asymptomatic and is detected when the liver is damaged and becomes chronic.

The main cause of infection is direct contact with the blood of a sick person. A high risk of infection is noted in such situations:

• in beauty salons that do tattoos and piercings;
• in the joint use of narcotic substances using the same syringe;
• in places of detention;
• during a blood transfusion;
• during unprotected intercourse.

Infection through kisses and household contacts is almost impossible. The hepatitis C virus is practically not transmitted through bloodless safe contact through saliva and skin. The risk of infection occurs when cracks appear on the skin and mucous membranes. In this situation, there is contact with blood, and there is a possibility of transmission of the virus.

The hepatitis C virus is not transmitted by household means (through household items, bedding, clothing). You can eat from the same dish with a patient with viral hepatitis without fear of infection.

Hepatitis C cannot be transmitted by airborne droplets. This disease is transmitted sexually or through the blood of an infected person. The use of a condom during intercourse can protect against infection by ninety-five percent. But at the same time, the conditions must be met that it will not tear or be damaged by another method. Much also depends on how many viruses are contained in the blood of a carrier of hepatitis.

If there is an increased viral load, then the probability of infecting a partner even with protected sex is no more than four percent. If the partner has damage to the mucous membrane and skin, or sexual intercourse is unprotected, then infection with hepatitis will be inevitable.

Is hepatitis C transmitted through saliva? Is it possible to get hepatitis if you kiss a carrier of the virus? Much research has been done in medicine. And experts came to the conclusion that hepatitis is not transmitted through saliva and kisses. Although the presence of the virus is possible, but only in a minimal amount. Another question is whether hepatitis C can be transmitted through oral sex. These data have not yet been studied. But it is believed that infection occurs through the sperm and blood of the patient. There is a high chance of infection during intimacy during menstruation due to contact with blood.

Vertical transmission of the hepatitis C virus is virtually non-existent. The virus does not pass through breast milk. In most cases, a woman in labor can safely feed her baby. When in doubt, it is not superfluous to consult a doctor.

A few facts

If infection with hepatitis C sexually or through the blood did occur, then:

1. With a strong immune function, the disease can be relieved. With timely treatment, the patient can fully recover. In practice, such situations occur in about twenty percent.
2. Carrying the virus is not a sentence. With this disease, you can live a long and normal life. The main thing is that it is necessary to undergo an examination every year and follow all the recommendations of the doctor.
3. The patient becomes a carrier of the virus. It is worth noting that hepatitis C spreads through the body quite slowly, without any symptoms. With the help of liver tests or a biopsy, it is quite difficult to recognize the disease, since no significant changes occur at the initial stage.
4. Viral hepatitis C often goes along with hepatitis B and D, as well as HIV infection. If any of these diseases is detected, it is necessary to undergo a full examination for the presence of other dangerous diseases.
5. Sex life in viral hepatitis is possible with the use of barrier protective equipment. It is not recommended to have sex during menstruation.

At-risk groups

After we figured out how hepatitis is transmitted, it is worthwhile to find out who is at risk. The list with an increased likelihood of infection includes:

• people who received blood transfusions;
• patients who underwent surgery;
• medical workers of a surgical profile;
• people who inject drugs;
• patients who suffer from HIV.
• patients who are on hemodialysis.
• people who have an active sex life and change partners every time;
• people who have one infected partner (transmission of the virus from husband to wife and vice versa is possible during unprotected intercourse).

Patient in the family: measures

Hepatitis C cannot be transmitted through saliva, conversation, touch, or household items. It is contagious only during unprotected intercourse and is transmitted through the blood. If the virus got into the external environment, then it lives there for no more than three days. If the blood of a sick family member has dripped somewhere in the room or on clothes, then it is urgent to treat the surface with any chlorine-containing agent in the form of Domestos or Whiteness. When washing things, the virus can die at a temperature of sixty degrees in thirty minutes. During boiling, the virus will not live for more than two minutes.

The carrier of the virus himself needs to follow some rules to prevent the transmission of hepatitis C to his loved ones:

1. For any type of injury to the skin, it is necessary to bandage the affected area with a bandage or seal it with adhesive tape. If one of the family members wants to provide first aid, rubber gloves must be worn.
2. A patient with hepatitis C should have personal items in the form of a manicure set, a razor, an epilator, a toothbrush. Under no circumstances should the infected person use other household items.
3. During intercourse, it is recommended to use barrier methods of contraception in the form of condoms.
4. An examination is required every six months.

Diagnosis and treatment

The most common way to diagnose a disease is to look for antibodies to the virus.

With a positive result, a PCR analysis is performed, which makes it possible to determine the RNA of the virus with the greatest accuracy.

A negative result does not always indicate that a person is completely healthy. For accuracy it is necessary to carry out several such analyzes. Within six months, the virus may not be detected in the body.

The patient is also given a liver biopsy. The method allows assessing the degree of damage to liver cells by the virus. This method is especially important when the disease proceeds without symptoms.

As additional diagnostic methods used:

1. Fibrotest. The method can obtain information about the presence of biomarkers of fibrosis in the patient's blood.
2. Fibroscan. Allows you to determine the degree of plasticity of the liver tissues.
3. Blood biochemistry for ALT and AST.
4. Biochemical blood test for the amount of bilirubin.
5. Ultrasound examination of the abdominal organs.
6. General blood analysis.

Fibroscan and Fibrotest are types of diagnostics that are convenient for those people who suffer from poor blood clotting. Also, such methods make it possible to accurately determine the disease in the absence of changes in the organ.

Hepatitis C treatment is complex. The main task of the treatment process is to reduce the number of viruses in the human body or completely eliminate them.

Often used Interferon-alpha. This medication is designed to prevent infection in newborns. Its use does not guarantee full recovery. Ribavirin and other agents may be prescribed as additional treatment.

The duration of the treatment course is from three months to one and a half years.

Also, experts use a new combination of drugs in the form of Sofosbuvir and Ledipasvir. This combination of drugs made it possible to cure patients in ninety-seven cases.

The main danger of hepatitis C is that doctors have not yet come up with a vaccine against the disease. Therefore, people should think about their own protection.

If a patient has chronic hepatitis C along with other diseases, then often this process leads to death. Therefore, do not delay treatment. It is necessary to consult a specialist at the first signs of the disease.

The site is a medical portal for online consultations of pediatric and adult doctors of all specialties. You can ask a question about Is Hepatitis Sexually Transmitted? and get a free online consultation with a doctor.

Questions and answers on: is hepatitis sexually transmitted?

2015-06-10 09:27:21

Arina asks:

Good afternoon. My husband was diagnosed with hepatitis C. I worry about myself, I read that it is sexually transmitted. What tests do I need to pass to accurately determine if I have a virus? We are planning a child. Can the virus be passed on to a child?

2013-10-09 17:06:07

Vlad asks:

Hello! Please help me understand the results of the analysis. Tested on May 31, 2013 for hepatitis C virus (HCV) Cor, NS3, NS4, NS5 antigens, IgG antibodies

Anti-HCV IgG cor 0.1 R
Anti-HCV IgG NS3 0.19 R
Anti-HCV IgG NS4 0.07 R
Anti-HCV IgG NS5 1.99 R

R ≥ 1.0 - positive result
R The positivity coefficient R is the optical density of the sample / critical optical density.
_______________________________________________

PCR. Hepatitis C virus (qualitative definition, Real-time)
PCR HCV qualitative was not detected. The analytical sensitivity of the test system for the determination of HCV in blood plasma is 200 copies/ml.

What does it mean? Am I a carrier of the virus? Can I infect someone? Is it sexually transmitted?

Responsible Rudneva Oksana Yurievna:

Hello Vlad!
The absence of a live virus in the blood (negative PCR for HCV RNA) and the presence of positive class G antibodies indicate that there was a meeting with the hepatitis C virus, two outcomes of such a meeting are possible: spontaneous recovery (then the antibodies remain with you for life, as a result of the transferred infections) and the transition to a chronic form (in the absence of RNA - the remission phase, the process is inactive).
Activation of viral hepatitis can occur at any time under the influence of external and internal factors (violation of the diet, colds, stress). Since the disease is transmitted through the blood, for this, the blood must contain a live virus (PCR RNA +). Your PCR is negative. The risk of sexual transmission is very low, but possible nonetheless. I recommend that you periodically be examined for the presence of HCV RNA (every six months / year). If the result is negative within 5 years, the observation is stopped.
Be healthy!

2013-04-24 14:19:04

Larissa asks:

Hello! I have such a situation, there was pain in the knee joint and the therapist advised me to take tests. And I got the following results: IgA + 1: 80, IgG + 1: 160, IgM-negative. Well, she sent me to a venereologist with a diagnosis of chlamydia .I was prescribed tests for syphilis, gonorrhea, AIDS, hepatitis B: PCR for almost all sexually transmitted infections, except for chlamydia. Of course, I am far from medicine, but I think PCR should be done directly for chlamydia or is a blood test sufficient? to undergo treatment in a hospital, on a day department and completely free of charge. Somehow I have doubts about free of charge and is a hospital really necessary for chlamydia?

Answers:

Good afternoon Larisa.
The very presence of IgG antibodies does not require treatment, but only indicates that you have met with chlamydia. However, in order to know whether there are chlamydia, whether they cause inflammation (chlamydia), and accordingly, whether treatment is required, a comprehensive conclusion of a specialist for an internal appointment is necessary based on complaints, examination, data on the presence / absence / dynamics of their IgG, IgM, IgA titers to chlamydia and their detection by PCR or in culture in a clinically significant amount.
Because you have class A antibodies detected, but class M antibodies are not detected, then I would, of course, clarify the data by doing PCR for chlamydia and re-testing for IgG class antibodies with an interval of 2-4 weeks from the previous one in the same laboratory to track the dynamics their titles.
Chlamydia, of course, is treated on an outpatient basis, but perhaps, given that you have problems with your knee joints, we are talking about some specific manipulations, in view of which your doctor recommended a hospital.
In any case, it is more visible at an in-person appointment, if in doubt, go to another specialist for an appointment.
Be healthy!

2012-10-12 07:52:03

Julia asks:

My husband has Hepatitis B. He feels well. We want a child. The doctor said that it is not necessary for me to be vaccinated, i.e. at your own discretion, because this disease is rarely transmitted sexually. Tell me, is it really as she says, or is it still necessary to be vaccinated? I know the vaccination is done in three stages. Is it possible to get pregnant after the first injection or is it necessary to wait for the 3rd vaccination?

Responsible Tsarenko Yury Vsevolodovich:

2011-08-13 01:23:56

Julia asks:

Hello, I have one question from my friend Hepatitis B, as he says in a closed form and it is not transmitted, but for some reason I'm still afraid if Hepatitis B is transmitted in a closed form sexually. Thanks in advance.

Responsible Agababov Ernest Danielovich:

Hello Julia, there is no closed form of hepatitis, there is the concept of a carrier, in any case, there is a risk, albeit a small one, I recommend that you get vaccinated against hepatitis B, which will reliably protect you.

2011-03-11 06:24:38

Ilya asks:

Good afternoon! Please tell me, I was recently diagnosed with chronic hepatitis B, HBv DNA (+), at the stage of virus replication, without enzymatic activity. If I understand correctly, this disease is also transmitted sexually. If a friend has been vaccinated against hepatitis, is there a chance of infecting her?
Treatment prescribed:
1. Cycloferon 12.5% ​​4.0 according to the scheme-1,2,4,6,8,11,13,17 and then 1 time in three days for 2.5 months.
2. Normaze 10 ml * 3 rubles = 6 days
3. Homizim 0.5*3r.=10 days
4. Riboxin 0.2*3r=10 days
5. Diet
Can you tell me if the prescribed treatment is effective? Is such a large amount of Cycloferon harmful to the body? And in general, is it possible to mix drug treatment with herbal treatment?

Responsible Medical consultant of the portal "site":

Good afternoon, Ilya! If your girlfriend was fully vaccinated, that is, she was given a three-fold introduction of the vaccine according to a special scheme, and this happened before the start of your sexual relationship, then you can not worry, she cannot get infected. After all, such vaccination leads to the formation of specific antibodies that prevent the development of hepatitis B in 98% of those vaccinated. Remember that after vaccination, immunity lasts at least 8-10 years, but often remains for life. This was the answer to your first question. As for the treatment prescribed for you, I will not comment on it, you have an attending doctor whom you either trust or are looking for another attending doctor. And finally, yes, hepatitis treatment can be combined with phytotherapy (herbal treatment), but you must inform your doctor about all undertakings. Discuss with him the need for taking herbal hepatoprotective drugs. Be healthy!

2010-03-10 13:09:28

Lena asks:

Hello, many articles indicate that chronic hepatitis is an STD, that is, it is sexually transmitted. How do I know if I have hepatitis or not?

Responsible Kushch Evgenia Gennadievna:

Hello, Elena! Sexual way - refers to the natural ways of spreading viral hepatitis B, C and D. Infection STD can occur if one of the sexual partners is sick or is a carrier of a viral infection. The implementation of this route of infection transmission becomes possible in the presence of the causative agent of viral hepatitis in the seminal fluid or in the secret of the vagina. The risk of contracting STDs increases with an increase in the number of sexual partners and an increase in the frequency of sexual intercourse, during sexual intercourse during menstruation, in the presence of other STDs (venereal diseases), especially diseases accompanied by a violation of the integrity of the skin and mucous membranes of the genital organs and anus, with immunodeficiencies. With hepatitis B, when one of the partners is a carrier of the virus, the risk of contracting STDs in men is higher than in women. Condom use prevents sexual transmission of hepatitis viruses and the development of STDs. For the primary diagnosis of viral hepatitis, a blood test is performed for the presence of serological markers of viral hepatitis B and C: HBsAg, a-HВcor IgM and a-HCV IgM, a-HCV IgG. All the best!

2008-04-12 20:31:22

Arina asks:

Responsible Medical laboratory consultant "Synevo Ukraine":

Good afternoon, Arina! If you do not mind, I will answer without adhering to the numbers of questions you have indicated, it will be easier to figure it out! So, let's begin! What we have? Erosion, cervicitis, elevated white blood cells and HPV 16.
1) Erosion is a collective concept that simply describes some changes in the cervical mucosa, but is not a diagnosis as such. Accordingly, not all erosion requires treatment. In order to determine what exactly led to the formation of a mucosal defect, it is necessary at least to do a cytological examination of a scraping from the cervix and colposcopy, as a maximum, an additionally extended colposcopy. If you have only ectropia (false erosion associated with the peculiarities of the hormonal background in the period up to 23-25 ​​years, in women who have not given birth), besides, it is small in size, then this does not require any further examination and treatment. If, however, you are diagnosed not with ectopia, but with any transformation of the mucosa, an examination for infectious factors is recommended - to identify the causative agent of the inflammatory process, which is a frequent companion of cervical erosion, followed by anti-inflammatory treatment. An increase in leukocytes in a smear often occurs with STDs (chlamydia, gonococci, Trichomonas, HSV, less often - others), or with urogenital dysbacteriosis (causes opportunistic flora: cocci, bacilli, etc.). I note that an experienced gynecologist can distinguish the inflammatory process from dysbacteriosis only by the results of a smear, other studies are only auxiliary (confirming). Unfortunately, knowledgeable specialists are rare specimens. Thus, it is necessary to determine what is hidden under the guise of "erosion", whether there is inflammation and, if so, what caused it. The inflammatory process and dysbacteriosis must be treated, I want to draw your attention to the fact that antibiotics are contraindicated in dysbacteriosis! After pre-anti-inflammatory treatment, if the mucosa still remains changed, the next step in the diagnosis is a biopsy of the cervix (taking a piece of tissue for histological examination). A histological examination allows you to make a final diagnosis (by the way, only after this study can a diagnosis of cervicitis be established) and it is the results of the histological examination that help the doctor choose a method for treating diseases of the cervix. I hope you understand that at this stage there is no need to use the first two drugs, since you first need to determine what to treat, and only then prescribe drugs.
2) is very widespread. According to medical statistics, about 90% of people in the world are carriers of one type or another of the human papillomavirus. Modern medicine describes more than 70 varieties of papillomavirus that cause various diseases of the skin or mucous membranes. A good doctor can often determine the HPV genotype by external manifestations. HPV transmission only possible from person to person. Viruses can remain in exfoliating cells for a certain time - therefore, for some diseases caused by a virus, a contact-household route of infection (warts) is likely, especially if there are microdamages to the skin. The main route of infection with the human papillomavirus of any oncogenic type is the sexual route of infection (it is necessary to take into account oral-genital contact and anal sex). It is possible to infect newborns with HPV during childbirth, as a rule, this is observed in the presence of activation of the infection in the mother (papillomatosis of the vagina and perineum), although even in this case, infection does not always occur. For human papillomavirus infection, a latent (latent) course is characteristic. A person can become infected with several types of HPV at the same time. Once in the body, HPVs penetrate into the basal layer of the epithelium, especially in the transition zone of the stratified squamous epithelium into the columnar epithelium. In a cell, a virus can exist in two forms - outside the cell's chromosomes or by integrating into the cell's genome. At any location in the cell, the virus will be detected by PCR. Being in a cell outside the chromosomes, the virus may either not cause clinical changes (latent course), or lead to increased reproduction of unchanged (!) Cells and clinically manifest itself in the form of warts or papillomas. Integration into the genome is more difficult. In this case, it either leads to the development of neoplasia (dysplasia), or becomes the cause of the development of carcinoma (malignant process - invasive cancer). In most cases (up to 90%), within up to 24 months, self-healing occurs - the repayment of activity (transfer to a latent phase, in which the virus is no longer detected by currently available diagnostic methods), in other cases, there is a long chronic relapsing course with possible malignancy of the process. However, even with high oncogenic risk HPV infection, the likelihood of developing cancer is not as great as it might seem. On the one hand, oncogenic HPV increases the risk of developing precancerous diseases by 60 times. However, according to statistics, less than 1% of women with HPV subsequently develop uterine cancer. Thus, the risk of tumor formation is not higher than when infected with the flu, for example. In addition, I hope you paid attention to the list of clinical manifestations of HPV in the female genital area, and made sure that there was no “erosion” in this list. The PCR method, of course, is of great diagnostic value and allows you to identify individual types of HPV, however, using it as a diagnostic criterion for neoplastic processes of the cervix (dysplasia) often leads to overdiagnosis (see. above about latent persistence), especially if the doctor is not very competent in this matter. In addition, detection of HPV DNA does not predict the development of cervical cancer in most cases, especially if there is no dysplasia. Although, even in the presence of dysplasia, it is necessary to conduct a PCR test for other STDs and dysbacteriosis, since this condition is in most cases associated with other urogenital infections.
3) Now about treatment and pregnancy. For a long time, scientists and doctors around the world have come to the conclusion that there are currently no HPV treatments with reliably proven effectiveness. Systemic therapy for HPV infection has not been developed. Including the effectiveness of antiviral drugs prescribed to you has not been proven. In light of the presence of HPV in you, you are personally shown dynamic monitoring - a regular PAP test and colposcopy, consider the possibility of vaccination against HPV. The vaccine will certainly not protect you from the HPV 16 you already have, but it will help prevent other types of HPV. The husband is shown the removal of HPV manifestations by physical-chemical-mechanical methods (warts on the neck, if they bother him). As for the use of immunomodulators (including dietary supplements), antiviral drugs, their use should be balanced, reasoned, and only after determining the indications using an immunogram.
4) You can get pregnant, since HPV does not threaten the baby, and if the virus is activated before childbirth, delivery can be performed by caesarean section. Be sure to correctly diagnose TORCH infections before pregnancy and interpret the results with an adequate infectious disease specialist.
5) As for the situation with your doctor, try to find a common language with him, and if it doesn’t work out, look for another doctor! If there is no way to find another, put up with what you have.
6) To all kinds of "cleansing the body" with dietary supplements, currents, etc. I am ambivalent, the benefits of them are doubtful, but how the placebo effect can work, the main thing is that they do not bring harm, because there are no studies on them.
Good luck to you and be healthy!

Responsible Markov Igor Semenovich:

Hello! Human papillomavirus (HPV) do not cause cervicitis and "elevated" leukocytes. Therefore, it does not need treatment, and you do not need to take antiviral drugs, no. The treatment of a healthy husband is generally a complete absurdity. The attitude towards the polarizer is negative: shamanism of pure water. I cannot help your gynecologist, respected by all: this is not amenable to any correction.

2007-10-05 20:06:49

Galina asks:

My boyfriend is now being treated in Germany for hepatitis C (for half a year already), he was prescribed interferon therapy for 2 years. Please tell me how hepatitis C manifests itself, is it sexually transmitted and where can I get tested? Thank you!

Responsible Markov Igor Semenovich:

For a long time, hepatitis C does not manifest itself in any way, it is transmitted sexually, analyzes (2-3 tests) can be done in any laboratory that conducts ELISA and PCR studies.

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Is hepatitis C sexually transmitted, can it be contracted through household contacts, and how does this disease occur? Consider what kind of disease it is, what types of hepatitis are, how you can reduce the risk of infection, and whether hepatitis is transmitted through a kiss.

Hepatitis is the collective name for various liver diseases.

Varieties of the disease

All of them are divided into two types:

• infectious;
• toxic.

The second type is cirrhosis of the liver. True, not only chronic alcoholics suffer from it. It can also be caused by the use of drugs, and by poisoning with chemicals. Infectious occurs due to damage to the body by various viruses. Today, medicine has identified and studied 7 varieties of viruses, named in Latin letters A, B, C, D, E, F, G. And this is by no means the final list. Viruses constantly mutate, each of them has its own genotype.

The first three are the most common. Hepatitis A is known as jaundice, or Botkin's disease. Surely almost everyone remembers the introduction of quarantine in schools and kindergartens when jaundice is detected in a group or in a class. You can become infected with Botkin's disease if basic hygiene rules are not followed. It is treated today quite easily, although rather serious consequences are not excluded. In advanced cases, death is possible.

But there is also a positive side. Those who have been ill with jaundice develop lifelong immunity to this disease, although it does not apply to viruses of groups B and C. Sexual transmission of the virus has not been fixed by medicine.

Virus B is more difficult to treat, but it can only be transmitted through blood. Transmission of hepatitis can occur through the use of insufficiently sterile medical instruments, sexual contact, and blood transfusion; mothers can pass the virus to their children during pregnancy or childbirth. There is a fairly persistent myth that hepatitis B infection is lifelong. In fact, modern medicines allow you to fully recover. There are cases when the body independently defeated hepatitis A and B.

Hepatitis C is also transmitted sexually or through blood. This virus is especially dangerous because the first symptoms of the disease are difficult to catch, they are practically absent. And a person, unaware of his illness, translates hepatitis C into a chronic condition. There are cases when a person suffering from chronic hepatitis C calmly lived to old age, but this is more an exception than a rule.

Ways of infection and prevention

Of course, it is better not to get sick than to be treated later, even if very successfully. Difficult, but you can try to minimize the risk of infection.

The ways of transmission of hepatitis are varied: using someone else's toothbrush, visiting piercing or tattoo parlors, sexually, through blood transfusion, etc.

It would seem, where does the toothbrush and sex? But these routes of infection are very similar, despite the difference in processes. The fact is that when brushing your teeth, microscopic damage to the gums by the bristles occurs and the virus penetrates into the wounds.

The same thing happens with sexual intercourse. Even with non-aggressive sex, microtrauma of the genital organs is not excluded, which opens the way for infection and the virus is transmitted sexually. But the percentage of sexual transmission of hepatitis C is quite small. According to various sources, it is in the range from 2 to 6%. Anal sex increases the risk of infection, as does multiple sexual intercourse without the use of condoms.

Subject to marital fidelity in marriage, sexual transmission of hepatitis C does not exceed 1%. And the use of a condom in sex reduces the risk of infection to zero.

Naturally, drug addicts belong to the high-risk group. With the joint use of drugs injected into the bloodstream, the probability of transmission of hepatitis C, the AIDS virus, and other diseases is almost 100%.

Blood transfusion is less dangerous, but only if it is carried out in developed countries, where testing of donor blood for hepatitis is mandatory. In our country, such a check has become an indispensable condition for donating blood after 1992. Individual cases of infection occur due to the negligence of medical workers, but the infection rate has dropped to 5%.

There is no single answer to the question of whether hepatitis is transmitted through a kiss. The fact is that the hepatitis virus is necessarily present in all biological fluids produced by humans: saliva, tears, urine, semen and sweat. So theoretically, you can get infected through a kiss if there are microcracks or sores on the oral mucosa. But the concentration of the virus in saliva is extremely low, so the risk is minimal.