Modern diagnosis of hepatitis C and interpretation of the results of identifying markers of infection

Side effects from vaccination

The highest level of adverse reactions after hepatitis vaccination occurs within 2 days. Visually, such a reaction is observed at the injection site.

A hepatitis vaccine is an active immunobiological preparation that contains substances that provoke the development of desirable and undesirable changes in the body. The formation of immunity to infection is the desired goal of vaccination, and side effects are an undesirable reaction. They are not the purpose of vaccination, but arise as a response to the introduction of a foreign substance and the production of immunoglobulins.

There may be a slight increase in body temperature.

Unpleasant reactions can be divided into two groups: local and general. The first includes redness on the skin, hardening of soft tissues and pain when touched. General manifestations affect the entire body. These include fever, general malaise and others. If the nature of post-vaccination manifestations is not severe, this effect is considered a successful confirmation of the development of immunity of the body to infection.

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Hepatitis C

Hepatitis

Jaundice

21913 January 12

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Hepatitis C: causes, classification, symptoms, diagnosis and treatment methods.

Definition

Hepatitis C is a viral infection that causes inflammation of the liver, often leading to serious damage. The hepatitis C virus is spread through contaminated blood.

Until recently, treatment for hepatitis C required weekly injections and oral medications, which many people infected with the virus were unable to use because of other health problems or serious side effects.

Today the situation has changed - a new generation of drugs have been developed, and with their help chronic hepatitis C can be treated.

However, about half of people with hepatitis C are unaware they are infected because the disease is often asymptomatic.

Therefore, hepatitis C screening should be performed regularly, especially if there are risk factors for infection.
Causes of Hepatitis C
The disease usually spreads when the blood of a person infected with the hepatitis C virus enters the body of an uninfected person. This happens especially often among drug addicts.

At risk are people who frequently receive blood transfusions and those on hemodialysis for a long time.

Newborn children are susceptible to infection if their mother has hepatitis C.

In addition, there are rare, but still possible situations of infection with the virus:

1. Sharing personal hygiene items that may have come into contact with the blood of a sick person (razors, scissors or toothbrushes).
2. Sexual contact with a person infected with the hepatitis C virus.
3. Tattoos or piercings performed under unsanitary conditions.

The hepatitis C virus is not transmitted by sharing cutlery, breastfeeding, hugging, kissing, holding hands, coughing or sneezing, or insect bites.
It also does not spread through food or water. Classification of the disease Depending on the duration of the disease:

1. Acute hepatitis C is an early stage when hepatitis lasts less than six months.
2. Chronic hepatitis C is a long-term type where the disease lasts more than six months.

Up to 85% of cases of acute hepatitis eventually become chronic.
Hepatitis is distinguished by the activity of the pathological process:

1. Minimal activity (liver transaminases (ALT and AST) in the biochemical blood test are increased by no more than 3 norms)).
2. Moderate activity (3–10 norms of liver transaminases).
3. High activity (> 10 norms).

According to the degree of fibrosis, that is, replacement of normal liver tissue with connective tissue during the inflammatory process:

1. F0 – no fibrosis.
2. F1 – portal fibrosis without septa (connective tissue septa).
3. F2 – portal fibrosis with single septa.
4. F3 – numerous septa without cirrhosis.
5. F4 – cirrhosis (complete replacement of normal liver tissue with fibrous tissue. Leads to severe dysfunction of liver cells, and also significantly slows down the movement of blood and bile through the liver).

Symptoms of Hepatitis C
Chronic hepatitis C virus is usually a silent infection for many years until it damages the liver enough to cause signs and symptoms of severe disease.

During the first 6 months from the onset of the disease, a person may not even suspect that he is sick, feeling only unexplained fatigue, poor appetite, heaviness in the right hypochondrium, regular headaches and dizziness.

During the same period, the color of feces (from light to white) and urine (from dark yellow to brown) may change. Some patients say their joints hurt.

As the disease progresses, spontaneous bleeding (nose, uterine, bleeding from the gums), yellowness of the skin, a tendency to form hematomas, itching, accumulation of free fluid in the abdominal cavity (ascites), and swelling of the legs join the initial symptoms. In addition, patients begin to lose weight, memory decreases, vision problems appear, and spider veins form on the skin.

Men may experience gynecomastia (enlarged mammary glands), decreased libido, and decreased testicular size.

Symptoms of acute hepatitis C include jaundice, fatigue, nausea, fever and muscle pain. They appear 1-3 months after infection with the virus and last from two weeks to three months.

Acute hepatitis C infection does not always progress to a chronic phase. In some people, the virus goes away after the acute phase in a process known as spontaneous viral clearance (cure). In studies of patients diagnosed with acute hepatitis C, the rate of spontaneous viral clearance varied from 15 to 25%.

Diagnosis of hepatitis C

The diagnosis is made based on the patient's complaints and medical history. If viral hepatitis C is suspected, the doctor must find out whether there have been blood transfusions, surgical procedures during his life, whether the patient has injected drugs, had tattoos and piercings, or whether unprotected sexual intercourse has taken place.

To clarify the diagnosis, the following examinations may be necessary:

1. Clinical blood test with a detailed leukocyte formula.

Is there any danger?

Minor redness and swelling is considered normal.

If there is a small bump and swelling of soft tissues within 7-8 cm, there is no need to worry. There is no need to make compresses or apply ointment. After the drug enters the bloodstream, these external signs will disappear on their own. But it is important to monitor and not miss the appearance of the following symptoms that should alert you:

• allergic reaction;
• heat;
• pain;
• wounds at the injection site;
• convulsions;
• signs of poisoning;
• fainting state.

The presence of at least one of the side symptoms indicates deviations from the body’s normal reaction.

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Having had hepatitis A or E once, patients acquire immunity to it.

A person who has hepatitis A is contagious to others, and therefore it is worth limiting contact with him. In addition, the patient’s relatives are under medical supervision for 35 days from the onset of the disease. If hepatitis A is detected in a school or preschool, quarantine measures are introduced there.

Development of complications of the disease and its symptoms

When the immune system begins to destroy cells infected with the virus, the patient experiences the following symptoms:

• Loss of appetite;
• Noticeable weakness;
• Excessive fatigue;
• Increase in body temperature.

The patient's mucous membranes and skin also turn yellow, the color of feces and urine changes - this is explained by a violation of the metabolism of one of the bile pigments (bilirubin). Free or indirect bilirubin is a toxic substance that is released during the breakdown of red blood cells and is processed in the liver. Free bilirubin is taken up by liver cells from the blood and, after a series of chemical reactions, is converted into direct or bound bilirubin. Liver cells secrete direct bilirubin along with bile; it is excreted in the feces after a series of chemical reactions.

When liver cells die, excess bound bilirubin is released from them, and the mechanisms for transporting the resulting bilirubin into the biliary tract from the liver cells are disrupted. In this case, direct bilirubin begins to enter the blood; there, its increased content leads to the fact that the mucous membranes and skin become yellow. The kidneys partially take over the removal of bilirubin from the body, which is why the urine darkens. Due to the fact that the amount of bilirubin secreted with bile in the gastrointestinal tract decreases, the color of the stool also changes.

Symptoms

Hepatitis A and E occur in three periods:

• Incubation;
• Prodromal or preicteric;
• Icteric.

The incubation period is the period from the moment the above-mentioned viruses enter the body directly until the first symptoms of the disease appear. As a rule, the first symptoms of hepatitis A appear approximately 28 days after infection, hepatitis E - between 14 and 60 days from infection.

The pre-icteric period in patients lasts 4-7 days. It is characterized by the following symptoms:

• Loss of appetite;
• Pronounced weakness;
• Severe fatigue;
• A feeling of heaviness that occurs in the liver area;
• Increased body temperature.

But these symptoms are not specific to these diseases.

The icteric period lasts approximately 2-3 weeks on average. During it, the temperature decreases and becomes normal, but the following symptoms appear:

• Urine darkens;
• The whites of the eyes, mucous membranes and skin turn yellow;
• The feces become light;
• Itchy skin;
• Nausea and vomiting rarely occur.

There is also an anicteric form of these hepatitises. In addition, these diseases can occur without symptoms.

Hepatitis E is especially severe in pregnant women in the third trimester.

Who is at risk?

• People who visit or work in regions with high incidence of these viruses (Africa and Southeast Asia);
• People who eat contaminated water, unwashed fruits and vegetables, fish and meat that have not been pre-cooked;
• People suffering from HIV infection;
• People who have had household contacts with those infected with hepatitis A or E;
• People who use drugs.

Diagnostics

To diagnose hepatitis A or E in a patient, specialists conduct the following tests:

For hepatitis A:

• Bilirubin (direct, indirect, total - code 23);
• Alkaline phosphatase;
• AST (code 81);
• ALT (code 78);
• anti-HAV, IgG;
• anti-HAV, IgM.

For hepatitis E:

• Alkaline phosphatase;
• LDH;
• AST;
• ALT;
• Bilirubin (direct, indirect and total);
• anti-HEV, IgM.

Need treatment?

In case of adverse reactions of the body, it is dangerous to postpone a visit to the doctor.

Without consulting a doctor and determining the severity of post-vaccination signs, you should not try to remove them yourself. In some cases, iodine mesh, lotions or ointments can only complicate the situation, while in others you cannot do without them. The most effective methods include the following:

• Vodka compress. Throughout the day, gauze soaked in an alcoholic drink is applied to the area of ​​inflammation. You need to keep it for 2-3 hours, the break between compresses is also about 3 hours.
• Ointments. For bumps, doctors recommend treating the surface with Traumeel or Troxevasin.
• Lotions. A cotton swab soaked in Novocaine or Chlorhexidine is applied to the inflammation to reduce the appearance of external signs.

The following actions are strictly prohibited:

• Warming up. Warming compresses should not be applied to the area of ​​inflammation.
• Carding. The action will only increase skin irritation.

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