Chronic hepatitis occurs when an inflammatory disease of the liver continues for more than 6 months. Manifested chronic hepatitis asthenovegetative disorders, dyspeptic disorders, enlarged liver and spleen, abnormal liver function, increase in blood liver enzymes, a violation of protein metabolism.
The prevalence of chronic hepatitis B is high. She is about 5% of the adult population. Disease, the outcome of which may be chronic hepatitis B:
Hepatitis caused by drugs.
Hepatitis caused by exposure to toxic substances.
Hepatitis of unknown origin.
The most common cause of chronic hepatitis - is transferred viral hepatitis. For chronic viral hepatitis leads acute hepatitis caused by hepatitis viruses B, C, D and G. Acute viral hepatitis leads to chronicity in 10% of cases, this percentage increases with concomitant liver disease hepatitis C, and D, in the severe and protracted course of hepatitis, disorders of the immune system, with concomitant alcoholic liver disease, if not properly treated.
Acute viral hepatitis C leads to chronic hepatitis in more than 80% of cases. The clinical picture of chronic viral hepatitis can be varied and depends on the activity of inflammation in the liver and the duration of the disease. At the beginning of the disease most often there are complaints that are referred to as astenovegetativnogo syndrome: weakness, fatigue, aggravated by physical exertion, irritability, sleep disturbances and mood. There is headache, dizziness, sweating, low long-term increase in body temperature. In children, these manifestations can be expressed only slightly.
Dyspeptic syndrome is characterized by complaints of a feeling of heaviness and discomfort in the liver, nausea, belching, abdominal pain, bloating and flatulence. Some patients complain of poor appetite, and intolerance to fatty foods. Jaundice occurs even with a smaller number of patients and there is no intense, the most frequent light yellowness of the eyes of the protein. Roughly half of the patients there is a hemorrhagic syndrome. It is manifested by skin dot hemorrhages on the face, trunk, ease of bruising, frequent nosebleeds. The blood found in violation of coagulation.
Two thirds of patients exhibit the so-called "signs of liver." It telangiectasia, which have the form spider veins ranging in size from one to 10 mm. This kapillyarity - extended small vessels - capillaries. Most often they appear on the cheeks and back. It may be varicose veins in the chest. And that palmar erythema - redness of the inner surfaces of the hands - "liver palms". Palmar surface of the patient's hands and feet are covered with small pink spots. Liver enlarged and indurated, and sometimes painful. In some patients, liver enlargement may be the only sign of disease. Frequently found, and enlarged spleen.
Chronic hepatitis usually occurs with a small number of complaints and, sometimes, is found only on changes in the biochemical analysis of blood. Chronic hepatitis C progresses very slowly. Often remains undetected for many years, the patient and doctor, and then may occur rapidly developing cirrhosis or liver cancer development. Continued existence of chronic hepatitis C leads to changes in the endocrine system, manifested by hypo-or gipertirozom, Hashimoto's goitre, diabetes. There are disturbances in the hematopoietic system, the coagulation of blood, changes in the skin, joints and muscles, kidneys.
Chronic hepatitis B occurs in a mild, but sometimes progresses rapidly. With the current release chronic viral hepatitis with minimal activity when expressed in manifestations of the disease is negligible. In this case, beyond the acute stage the patient's complaints do not arise, and if there are worsening weakness, fatigue, loss of appetite, nausea and sometimes vomiting. Rarely epistaxis, or yellowing of the sclera, skin manifestations and hepatic signs. In the biochemical analysis of blood detected a slight increase in liver enzymes, proteins. Bilirubin remained normal.
Chronic viral hepatitis with a low level of activity is different from chronic hepatitis with minimal activity to higher changes in the biochemical analysis of blood. Moderate level of activity of chronic viral hepatitis occurs most often. The patient is constantly having complaints of weakness, fatigue, sweating, fatigue, sleep deprivation, headaches and dizziness, nausea, pain in the liver after exercise. Found on the skin bruises, liver stars, liver palms. Occasionally there is yellowing of the sclera and skin. The liver is enlarged. In the blood, elevated bilirubin, liver enzymes (AST, ALT).
Chronic viral hepatitis with a high degree of activity seen the emergence of a large number of complaints, yellowing of sclera and skin, liver marks. The liver increased significantly, the structure of it is sealed. There are often a rash, pain in the joints. Changes in the biochemical analysis of blood expressed significantly.
There is still a fairly rare form of chronic viral hepatitis with cholestasis. In this case the patient has expressed jaundice and itchy skin. In the blood, there is a large amount of bilirubin, which is rapidly growing. Soon, cirrhosis of the liver. Exacerbation of chronic viral hepatitis can be triggered by acute respiratory viral diseases, other infectious processes, use of alcohol, increased physical activity.
Diagnosis of chronic viral hepatitis on the basis of producing a typical picture and long-term course of the disease, identification of blood markers of hepatitis B, C, D, blood test, ultrasound of the liver and abdominal organs, the study of blood circulation in the liver (reogepatografiya), biopsy of the liver scan liver (гепатохолецистосцинтиграфия).
Treatment of chronic hepatitis.
In the remission of medication the patient is not prescribed. Recommended diet, mode. Sometimes appointed hepatoprotectors. In the acute stage is assigned a strict diet, the means for normalizing the process of digestion in the intestine, hepatoprotectors (legalon, Kars, silibor, SAMe, Essenciale, hepatitis). Appointed by the collection of medicinal herbs and treatment of opportunistic diseases. For a long time used interferon (Roferon A, Intron A, viferon, etc.) or a combination of interferon with the antiviral drugs.