GENERAL
For the first time the virus of hepatitis A was diagnosed in the late XX century, Italian experts. They conducted histological examination of liver tissue in patients with viral hepatitis B (HBV) and found an unknown antigen, which is assigned the index "delta". Further study of its genetic structure allowed us to conclude that this is a completely new virus, referred to subsequently Deltavirus old. Of the features indicative of a kind of inferiority of the genome that does not allow yourself to play envelope proteins.
For reproduction Deltavirus representatives must have in the patient's genetic material of hepatitis B virus From this we can conclude that hepatitis D is a disease that can not develop on their own. It is always difficult for HBV. According to statistics, 5% of patients with viral hepatitis B have a combined liver injury.
CAUSES
According to the recommendations of the World Health Organization, the causative agent of the disease was named Hepatitis Deltavirus or HDV. Its characteristics are:
- particle size of 36 nm can be attributed to its smallest viruses of animals;
- 2 has a structure envelope, one of which is represented by the Australian antigen and another - their own genetic material;
- virus genome consists of a single strand RNA;
- resistance to thermal stresses, acids and ultraviolet radiation;
- sensitivity to alkaline substances.
The infection often can be transmitted by the parenteral route.
See also: What is Hepatitis - Causes, Treatment and Prevention
Infection can occur when:
- Transfusion of infected blood;
- surgical interventions;
- Use one needle for injecting drug users;
- during pregnancy from a sick mother to the fetus through the placenta;
- unprotected sex, especially among those leading promiscuous.
CLASSIFICATION
Hepatitis D is divided depending on the time of infection into 2 types:
- Co-infection - hepatitis co-infection with the two.
- Superinfection - state, when the background of an existing Hepatitis B is an infection of hepatitis D.
The forms of the disease:
- easy;
- mid-weight;
- heavy;
- lightning.
SYMPTOMS
The clinical picture of hepatitis D occurs cyclical symptoms.
incubation period
Hepatitis D starts with the incubation period, which can range from months to superinfection with 3-4 months with coinfection. At this time there is an active viral replication, its accumulation in the liver cells and the debut of the inflammatory process.
preicteric period
Duration period predzheltushnogo hepatitis D amounts to several days. It is characterized by acute onset and the following clinical manifestations:
- deterioration of the general condition;
- loss of appetite and weight loss;
- nausea, vomiting;
- headaches and other neurological symptoms;
- migratory arthralgia of large joints;
- rise in body temperature to subfebrile indicators;
- discomfort in liver area projection.
Some patients develop a rash on the skin, which is difficult to diagnose.
icteric period
With the change in color of the skin in the patient begins to increase toxicity. This is due to a toxic effect of bilirubin accumulating due to liver cells. This period can last up to 2 months. In addition to jaundice staining of the skin and mucous membranes, patients with hepatitis D are concerned:
- itching;
- pain in the right upper quadrant;
- low-grade fever;
- weakness and fatigue;
- sleep disturbance;
- pain in the head and joints;
- rapid loss of body weight.
two waves there are often acute clinical picture due to concomitant viral infection of liver cells. The first wave associated with hepatitis B, the second occurs when sufficient replication Hepatitis Deltavirus.
Intensity of symptoms may vary depending on the form of hepatitis D. When lightning form duration of all the periods is reduced, occurs almost immediately multiorgan failure, which leads to death.
See also: How is Hepatitis C?
DIAGNOSTICS
Determine what is hepatitis D, allows a comprehensive approach to diagnosis. Used for this purpose:
- data history of the disease;
- inspection;
- Laboratory techniques;
- instrumental diagnostics.
disease anamnesis
A careful history allows you to set best time of infection, the manipulation that led to the development of infection, the factors that can aggravate the course of hepatitis D.
inspection
During the inspection of the pay attention:
- ikterichnost skin and visible mucous membranes;
- skin rash;
- enlarged liver, the change in its consistency, tenderness, determined by palpation.
laboratory diagnosis
The blood analysis in patients with hepatitis D revealed the following changes:
- increase in bilirubin;
- increase activity liver function testsThat constitutes a violation of the integrity of the hepatocytes;
- positive thymol testWhich is characteristic of functional liver failure;
- significant reduction of protein concentration in plasma blood and changes in their qualitative composition.
Characteristic for hepatitis D is the identification of pathogen-specific antigens or antibodies, produced in response to infection by polymerase chain reaction or other precision techniques.
diagnostics
To confirm the destruction of liver tissue perform ultrasound. This manipulation allows you to set:
- the exact dimensions of the body;
- changing its echogenicity;
- prevalence of pathologic process;
- vascular lesions.
TREATMENT
Treatment of hepatitis D is carried out exclusively in terms of infectious hospital. The basis of treatment - etiotropic application of antiviral drugs. In addition, use:
- disintoxication therapy;
- symptomatic drugs;
- gepatoprotektory;
- immunostimulants.
Once inpatient treatment in patients with hepatitis D takes a long clinical observation.
COMPLICATIONS
The most severe complications of hepatitis A are:
- chronization process;
- cirrhosis of the liver;
- multiple organ failure.
See also: What is infectious disease (hepatitis A) - treatment and prevention
PREVENTION
Knowing what is hepatitis A have been developed measures to prevent this disease:
- using disposable surgical instruments;
- thorough virological control blood;
- propaganda protected sex;
- Safety compliance medical staff.
Specific immune defense is not yet developed.
FORECAST FOR RECOVERY
Unfavorable prognosis for patients, especially when superinfection. There is a rapid transition of the disease into a chronic form with the development of cirrhosis of the liver or other terminal conditions, are fatal, even with adequate treatment of hepatitis D.
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