Prevention of hepatitis

Doctors all over the world, at the request of Ivan Bezugly, have compiled for you a program of defense against hepatitis viruses, which have incredibly proliferated recently. The enemy will not pass!

I do not know how children replenish their stock of such knowledge, but I distinctly remember my fascinating conversations on a medical topic with friends in kindergarten. If you don’t have an older brother with fists and a real motorcycle, then the only way to gain respect among your peers is to have a mark on your left forearm (smallpox vaccination mark). The acquired immunity after chickenpox or mumps could also strengthen the VIP position. Of all childhood diseases, respect did not extend only to jaundice. In addition, from our numerous company, only the girl Elea was “lucky”, who once suddenly stopped going to kindergarten. Many years later, after studying at the medical university, I realized that Elya then fell ill with hepatitis A. By that time, scientists had discovered five more types of hepatitis, and in total there were six of them – A, B, C, D, E and G, and each is much more disgusting than kindergarten chickenpox. The most dangerous doctors recognized hepatitis B and C – with inadequate treatment, they develop into a chronic form, fraught with cirrhosis and liver cancer.

Get vaccinated against hepatitis!

Until scientists in the 90s came up with a vaccine against hepatitis A (“jaundice”) – “Hep-a-in-vac”, “Avaxim”, “Vakta”, “Havrix” – normal human immunoglobulin was used for these purposes. Children are vaccinated in the first years of life with the consent of the parents. Three-stage vaccination against hepatitis B (vaccines “Engerix B”, “Euwax”, etc.) in Russia has become mandatory since 2001. Immunity develops in 99% of cases. Previously unvaccinated children are vaccinated at age 13. Adults (especially those at risk: doctors, drug addicts, people who may need a blood transfusion) can be vaccinated at any age and at any time.

The earlier a person becomes infected with the hepatitis B virus in a person’s life, the higher the likelihood of developing a chronic infection. In most cases, the illness is accompanied by flu-like symptoms, yellowing of the whites of the eyes and skin, increased fatigue, abdominal pain, loss of appetite, nausea, vomiting, and joint pain. Acute infection (the time between exposure to the virus and the appearance of the first symptoms) is 45 to 180 days. In 40% of patients, symptoms may not be present at all – until the moment the infection becomes chronic. “A virus entering the nucleus of a cell can go unnoticed for a long time,” says Helena Brett-Smith, MD, clinical research director for Bristol-Myers Squibb in the United States. – Anyone can get hepatitis B (in the absence of vaccination, the risk of the disease is much higher). In some regions (Africa, Asia, as well as some southern and eastern regions of Europe), the incidence of hepatitis B exceeds the global average. “

Algebra and the beginnings of analysis

We recommend adding tests for hepatitis B to the list of medical tests that you, as a civilized person, pass every year.

  1. ELISA (determination of virus antigens, that is, virus particles, and human antibodies produced in response to infection). It is better to take this blood test from a vein every six months. If at least one of the antigens is detected, methods of higher accuracy will be needed.
  2. PCR (polymerase chain reaction) detects the DNA of the virus in the blood at a minimum concentration. Detection of DNA indicates active multiplication of the virus.
  3. Determination of transaminases – a biochemical blood test for enzymes released into the blood when infected liver cells die.
  4. Liver biopsy – is performed only in a patient with hepatitis B and allows you to most accurately determine the severity of inflammation and thickening of the liver.

Attack of the Clones

Antiviral therapy is used for treatment: the earlier the drug is prescribed, the more likely it is to slow down the progress of the chronic process. The final assessment of the effectiveness of the treatment (“sustained response”) is carried out six months after its completion. By the way, contrary to rumors with chronic hepatitis, it is not necessary to follow a strict diet: you need to feed yourself regularly and fully, with all the necessary vitamins, trace elements and two liters of water a day. Only fatty, spicy and fried foods that cause discomfort even in a healthy person are not recommended. And doctors advise not to strain physically and emotionally, not to freeze, not to sunbathe and not to change the climate drastically.

A serious problem for many antiviral drugs is the development of resistance – addiction. Hepatitis B takes years to cure, and every day billions of new copies of the virus are formed in the sick person’s body, with numerous mutations that allow them to dodge the drug. “The variety of new viruses and the development of persistent resistance leads to ineffective therapy, so the patient urgently needs a drug that he has not previously used,” warns S. L. Lai, professor of hepatology at the University of Hong Kong. More than 60% of patients develop resistance (addiction and reduced effectiveness) to some of the existing antiviral drugs. To determine if a medicine is working, you need to visit your doctor regularly and get tested.

Figures and Facts

  1. Chronic hepatitis B affects 400 million people worldwide. Of these, 75% are in the Asia-Pacific region.
  2. The hepatitis B virus infects 10-30 million people every year. In Europe alone, about one million new infections are recorded annually.
  3. One million people die from complications of hepatitis B every year.
  4. Two people die from hepatitis B and its complications every minute.
  5. China ranks first in the world in the number of patients with hepatitis B and liver cancer. Every year 360 thousand people die from hepatitis B in Western Asia (China, Hong Kong, Korea, Japan).

Great expectations

This year, the newest antiviral drug for the treatment of hepatitis B, Baraklud ™ (entecavir), was put into operation. It was presented by the pharmaceutical company Bristol-Myers Squibb on March 24 in Seoul as part of the 18th Asia-Pacific Association for the Study of the Liver International Conference. In comparison with “Lamivudine” (the most commonly used drug) “Baraklud” reduces the concentration of the virus in the blood of a sick person by 58–94% in just a few months. “Reducing the virus concentration sustainably is the goal of treating patients with chronic hepatitis B,” said Nancy Leung, MD, Alice Ho Miu Ling Nethersole Hospital in Hong Kong. “Resistance to the drug develops as a result of mutations in the virus that allow it to escape death. After a two-year course of treatment with Baraklud, no signs of resistance were found, which indicates a high barrier to addiction to the drug, ”says Masao Omata, a doctor at the Department of Gastroenterology at Tokyo University. The new drug is approved for use in more than 60 countries around the world, Russia is also on this list.

Enemy at the gate

  1. 60% of infection occurs through the use of non-sterile needles.
  2. In 25-30% of cases, hepatitis B is sexually transmitted. The chance of contracting hepatitis B is 100 times higher than that of HIV. If there are microcracks on the lips or in the mouth of a healthy partner, even a kiss may be dangerous, because the hepatitis virus is also present in the saliva of an infected person.
  3. 90% of babies born to infected mothers subsequently develop chronic hepatitis.
  4. The hepatitis virus enters the body of a healthy person during blood transfusion, hemodialysis and various medical and diagnostic procedures. The source of infection is tools for applying tattoos, manicure, other people’s toothbrushes and razors.

By the way, about childhood memories. Elya, who suffered from hepatitis as a child (even if A, not B, but also an unpleasant thing), now feels great and is the head of a successful recruiting agency. I found out.

PS Since 2008, May 19 has been declared International Hepatitis Day. The event is organized by the World Hepatitis Alliance, which includes more than 200 associations around the world. This is the beginning of a five-year plan, the main goal of which is to inform people that the problem is really serious, to implement effective diagnostic programs and to help those who get sick. More information is available on the website www.gepatitb.ru.

At the moment, there are six types of hepatitis – A, B, C, D, E, G, which are divided into two main groups according to the mode of infection.

  1. Hepatitis A and E are intestinal infections, they can be infected by contact – through the household (through hands, water and food). After suffering hepatitis A, a stable lifelong immunity is formed. Hepatitis E is very similar to hepatitis A, but it starts gradually and is very dangerous for pregnant women.
  2. Other types of viral disease (B, C, D, G) are blood-borne forms, that is, infection is somehow associated with blood (including sexual transmission and from the mother to the fetus). Hepatitis B and C are the most dangerous and severe forms. Hepatitis D is a “companion disease” that complicates the course of hepatitis B. Hepatitis G resembles hepatitis C in many ways, but is less dangerous.

Vaccination (or specific prophylaxis) is carried out only in the case of hepatitis A and B. Preventing this infection is easier than getting rid of it, so if vaccination has passed by you and your children, get vaccinated on your own initiative.

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