Viral hepatitis D

Viral hepatitis D (delta-hepatitis) is an infectious liver disease, co-infection or superinfection of viral hepatitis B, which significantly worsens its course and prognosis. Viral hepatitis D belongs to the group of transfusion hepatitis, the mandatory condition for infection with hepatitis D is the presence of an active form of hepatitis B. The detection of the hepatitis D virus is carried out by PCR. A liver examination is mandatory: biochemical tests, ultrasound, MRI, and rheopathography. Treatment of viral hepatitis D is similar to that of hepatitis B, but it requires a high dosage of drugs and a longer period of their intake. In most cases, the disease is chronic with subsequent outcome in cirrhosis of the liver.

  1. Characteristics of the pathogen
  2. Symptoms of viral hepatitis D
  3. Diagnosis of viral hepatitis D
  4. Treatment of viral hepatitis D
  5. Prognosis and prophylaxis of viral hepatitis D
  6. Treatment prices
  7. Viral hepatitis D
  8. Viral hepatitis D (delta-hepatitis) is an infectious liver disease, co-infection or superinfection of viral hepatitis
  9. B, which significantly worsens its course and prognosis. Viral hepatitis D belongs to the group of transfusion hepatitis.

Characteristics of the pathogen
Hepatitis D is caused by an RNA-containing virus, which is the only known representative of the “wandering” genus Deltavirus, which is characterized by the inability to self-form the protein for replication and uses for this protein produced by the hepatitis B virus. Thus, the causative agent of hepatitis D is a satelitis virus and occurs only in combination with the hepatitis B virus.

The hepatitis D virus is extremely stable in the external environment. Heating, freezing and thawing, exposure to acids, nuclease and glycosidases do not significantly affect its activity. The reservoir and the source of infection are patients with a combined form of hepatitis B and D. Contagiosity is particularly pronounced in the acute phase of the disease, but patients present an epidemic danger throughout the whole circulatory period of the virus in the blood.

The mechanism of transmission of viral hepatitis D is parenteral, an essential condition for the transmission of the virus is the presence of active hepatitis B virus. The hepatitis D virus is integrated into its genome and enhances the replication ability. The disease can be a co-infection when the hepatitis D virus is transmitted simultaneously with B, or superinfection, when the pathogen enters the body already infected with the hepatitis B virus. The most significant risk of infection when blood is transfused from infected donors is notable epidemiological significance are surgical interventions, traumatic medical manipulation (for example, in dentistry).

Hepatitis D virus is able to overcome the placental barrier, can be transmitted sexually (the spread of this infection among people prone to promiscuous sexual relations, homosexuals), which in some cases has a family spread of the virus suggests the possibility of its transmission through a contact-household way. Patients with viral hepatitis B, as well as carriers of the virus, are susceptible to viral hepatitis D. In particular, the susceptibility of individuals in whom the chronic carrier of HBsAg is detected is high.

Symptoms of viral hepatitis D
Viral hepatitis D supplements and heaves the course of hepatitis B. The incubation period of co-infection is significantly reduced, is 4-5 days. Incubation of superinfection lasts 3-7 weeks. The pre-hepatic period of hepatitis B proceeds similarly to that of hepatitis B, but has a shorter duration and more turbulent flow. Superinfection can be characterized by early development of edematous-ascitic syndrome. The icteric period proceeds as well as with hepatitis B, but bilirubinemia is more pronounced, more often signs of hemorrhage are manifested. Intoxication in the icteric period of hepatitis D is significant, prone to progression.

Coinfection takes place in two phases, the interval between peaks of clinical symptoms is 15-32 days. Superinfection is often difficult to diagnose differential diagnosis, since its course is similar to that of hepatitis B. The characteristic difference is the speed of the clinical picture deployment, fast process chronicization, hepatosplenomegaly, the breakdown of protein synthesis in the liver. Recovery takes a much longer time than in the case of hepatitis B, residual asthenia can persist for several months.

Chronic viral hepatitis D does not differ in specific symptoms, it is similar to chronic hepatitis of another etiology. Patients are disturbed by general weakness and fatigue, from time to time there may be “causeless” episodes of fever with a fever without catarrhal symptoms, accompanied by a sub jaundice and jaundice. On the skin formed secondary hepatic signs (palmar erythema, vascular sprockets), the liver and spleen are enlarged, often develop hepatic edema, ascites.

Treatment of hepatitis D in Israel

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Hepatitis D virus often accompanies the disease with hepatitis B. In case of damage to the body by both viruses, the risk of developing liver cirrhosis increases significantly. Healing of hepatitis D in Israel helps effectively to get rid of the disease.

Treatment of hepatitis D in Israel The hepatitis D virus can not independently reproduce itself in the body and therefore uses the envelope of the hepatitis C virus, which greatly exacerbates the clinical picture. Competently diagnosed with hepatitis D can only be a qualified specialist with the help of modern methods.

Such methods are used in most Israeli medical centers. Innovative equipment allows you to obtain complete information about the spread of viruses and internal organs. And the treatment of hepatitis D in the centers of Israel is rightfully considered to be one of the most effective in the world. The main thing is not to delay the treatment to the doctor and pay attention to the specific symptoms of hepatitis D. Learn more …

Innovations in treatment
Hepatology in Israel: the cost of individual procedures Unqualified treatment can aggravate the condition of the patient, so you need to entrust your health exclusively to professionals. ServiceMed organizes consultations for you with the best Israeli infectious disease specialists, hepatologists or gastroenterologists.

You can go through a course of treatment in the leading Israeli clinics, equipped with the latest technology and the latest medical products. It is noteworthy that the cost of treating hepatitis D in Israel is quite acceptable in comparison with European and American medical institutions. To learn more…

Before treatment of hepatitis D in hospitals in Israel, a detailed diagnosis of the disease, aimed at detecting delta-virus hepatitis in the body. For this, the patient is assigned:

  1. numerous blood tests, functional and hormonal tests, checking oncomarkers, etc .;
  2. analysis of polymerase chain reaction and viral load to determine the virus and its prevalence in the body;
  3. Ultrasound, CT, MRI of the liver, helping to visually determine the extent of internal organs virus damage;
  4. fibroscanning and fibro-testing – non-invasive methods, which allow obtaining maximum information about liver damage;
  5. Dopplerography of the blood vessels of the liver and esophagogastroscopy are performed for the diagnosis of cirrhosis;
  6. To study affected tissue of the liver, a biopsy of this organ is performed.
  7. A full-fledged diagnosis of hepatitis D in Israel allows to qualitatively reveal the prevalence of the virus in the body and make up an individual treatment program.

The methods used for the treatment of hepatitis D in clinics depend on the results of the tests, the degree of involvement of internal organs and complications. The patient is placed in the hospital, he is assigned bed rest and a special diet.

Treatment is carried out in a complex way and can include several of the methods listed below.

Antiviral therapy with interferons and other drugs of the latest generation is prescribed to all patients and is the basis of treatment.
Therapy, aimed at supporting the liver, includes the appointment of special hepatoprotectors.
To remove toxins, extracorporeal detoxification is used in the form of plasmapheresis, plasmosorption, and ultrafiltration. 
The disturbed metabolism is restored with the help of metabolic therapy.
Disintoxication therapy is performed in severe cases – the patient is assigned colloidal, crystalloid solutions.
With a significant destruction of hepatitis with cirrhosis caused by hepatitis D, this organ is transplanted.
Using the latest drugs and perfect equipment for removing toxins, Israeli doctors manage to cope with the most difficult cases. And the methods of transplantology used in Israeli clinics are among the most advanced in the world. Usually, after treatment of hepatitis D, the patient quickly returns to normal life and does not experience relapses. This is evidenced by positive reviews about the treatment of hepatitis D in Israeli clinics.

Treatment program

  • Diagnosis of hepatitis D with the latest equipment.
  • Consultations with doctors and preparation of an individual treatment program.
  • The course of treatment of hepatitis D in a clinic chosen by the patient.
  • Additional therapy in case of internal involvement.
  • If necessary, a course of rehabilitation.
  • Questions from our patients
  • What methods of excretion of toxins, except for extracorporeal detoxification are used in Israel?

The medicamentous method is widely used. Modern drugs are able to effectively absorb toxins and metabolic products. They reliably protect the liver, allowing it to restore its functions and structure. Usually a course of treatment with adsorbents takes 2 weeks, and then through the same interval is repeated.

Hepatitis D

Delta-hepatitis – an infection caused by the hepatitis D virus, characterized by symptoms of acute liver damage and intoxication, in most cases proceeding heavier than other viral hepatitis. An essential condition for the manifestation of the negative effect of the hepatitis D virus is the presence of the hepatitis B virus multiplying. The delta infection exists in two forms: acute infection with simultaneous infection with hepatitis B virus and delta virus-coinfection and acute infection with infection of BDD carriers of the hepatitis B surface antigen – superinfection.

Delta-hepatitis, as well as hepatitis B, has almost universal, but uneven distribution. The frequency of coinfection cases varies in different countries from rare registration to 25-30% of the number of cases of acute HBsAg-positive hepatitis.

The frequency of detection of antibodies to delta antigen among carriers of hepatitis B virus and patients with chronic hepatitis serves as an indicator of the latitude of the spread of delta infection. It is estimated that about 5% of HBsAg carriers (approximately 15 million people) are infected with the delta virus. Regarding the level of spread of delta infection, regions, territories and countries can be conditionally assigned to one of four zones:

– a zone of high endemicity, with an incidence of anti-BHD over 20% in HBsAg carriers and more than 60% among patients with chronic hepatitis B (some countries in Africa:

Kenya, Central African Republic, Niger; Taiwan, as well as Venezuela; South Italy, Romania, Southern districts of Moldova);

– the zone of medium endemicity of anti-BHD – 10-19% in HBsAg carriers and from 30 to 60% among patients with chronic hepatitis B (some countries in Africa: Nigeria, Somalia, Uganda, Burundi, some areas of the USA – California, Russia – Yakutia, Tuva );

– low endemicity of 3 to 9% among carriers of HBsAg and from 10 to 30% among patients with chronic hepatitis B (Liberia, Ethiopia, South Africa, Lithuania, Estonia, Latvia, European Russia, USA);

– very low endemicity of up to 2% among HBsAg carriers and less than 10% among patients with chronic hepatitis B (Northern and Central European countries, China, Japan, Uruguay, Chile, Argentina, Southern Brazil, Australia).

The level of endemicity of delta infection is associated with the prevalence of hepatitis B in this area, however, this relationship is not absolute. So, despite the high intensity of the circulation of the hepatitis B virus among the Alaskan Eskimos, the delta infection there is recorded at a low level.

Infection with hepatitis D occurs only when the virus enters the blood directly, which then enters the liver with the bloodstream. It is suggested that the liver is the only organ where the hepatitis D virus multiplies. The mechanism of hepatocyte damage in hepatitis D is not fully understood. At the same time, it is considered that the direct destroying effect of the virus on the cell occupies a leading role in this process.

Hepatitis D has no specific signs and is characterized by common manifestations of inflammation. In this case, changes in hepatocytes are more pronounced in the absence of a clearly expressed inflammatory reaction. In coinfection, changes are observed that are characteristic of acute hepatitis B. In cases of acute superinfection, there are signs of acute inflammation and a chronic process caused by a previous infection of hepatitis B.

Infection with delta virus (both with coinfection and superinfection) leads to the development of an acute disease. At the initial stage of the study of delta-hepatitis, the relationship between the presence of delta-infection and the severity of the disease was emphasized. However, studies conducted in delta-hepatitis-endemic regions have demonstrated that delta-hepatitis can be associated with a wide range of clinical manifestations of the disease from asymptomatic carriage to extremely severe hepatitis and cirrhosis of the liver. Analysis of histological data of liver biopsy of patients with chronic delta-hepatitis in Italy revealed two types of course of the disease. At the first, approximately 10% of patients registered non-progressive hepatitis. In the second case, chronic hepatitis of high activity or active cirrhosis of the liver was noted in 90% of cases.

The duration of the incubation period varies from 3 to 7 weeks. The pre-egg phase of the disease has clinical symptoms similar to hepatitis B: increased fatigue, lethargy, loss of appetite, nausea, in some patients, fever, joint pain. With superinfection, the pre-jaundice period is shorter than with coinfection and hepatitis B and is usually only 4-5 days.

The beginning of the icteric period coincides with the appearance of yellowing of the skin and sclera, dark urine and light stools, an increase in the symptoms of intoxication, pain in the right hypochondrium. When superinfection for 3-5 days, a fever is recorded. The liver and spleen are enlarged.

Treatment of hepatitis A

Hepatitis A is prevalent everywhere, but it prevails in the least developed countries. This disease can also be called Botkin’s disease or jaundice. It is transmitted by eating contaminated water and food. Children are most often affected, although infection is becoming more prevalent in the adult population due to the lack of natural immunity, usually acquired in childhood. Implementation of a program of total vaccination of children in the early life can completely prevent the incidence of this pathology in adults.

Hepatitis A is the most common preventable infectious disease of travelers. Among the “non-vaccinated” tourists – visitors to developing countries (even for guests of five-star hotels!), The incidence of hepatitis A reaches three cases per 1000 travelers for each month of residence. “Only 0.3%!”, – you will say. Yes, only three out of a thousand. But how painful it will be if they are you, your spouse (or spouse) and your beloved child! Moreover, with a decrease in the “star” of the hotel or a decrease in hygiene standards, the incidence increases to 2% for each month of residence. And this is a serious risk – 20 sick from a thousand. In addition, we must not forget about the risk of infection with hepatitis A when visiting a restaurant (even expensive!) In his native Moscow or any other Russian city – our country belongs to the territories with an average (not low !!!) prevalence of this infection.

In our clinic for treatment of hepatitis, with the help of the best doctors – gastroenterologists, hepatologists in Moscow, you will be able to assess the risk of infection with hepatitis A, by the presence of antibodies to the virus in the blood.

Who needs protection from hepatitis A?

All previously unvaccinated persons traveling to countries with an average or high prevalence of hepatitis A virus infection or living and working in such countries should be vaccinated against hepatitis A. Vaccination is also necessary for people suffering from various chronic liver diseases, especially chronic hepatitis C. Infection with hepatitis A against a background of chronic hepatic pathology can lead to serious and sometimes fatal complications.

According to recommendations of the World Health Organization, children living in countries where the incidence of hepatitis A is higher than 20 cases per 100 thousand population, total vaccination is indicated. Russia, unfortunately, is on the list of such countries.

Vaccination against hepatitis A virus. Quality and safe vaccinations

For vaccination against hepatitis A we use a well-established vaccine worldwide, a solution that contains inactivated highly purified hepatitis A antigen (strain HM 175) adsorbed on aluminum hydroxide. The introduction of the vaccine promotes the formation of immunity against hepatitis A virus (HAV), causing the production of specific antibodies and the formation of memory lymphocytes. In clinical studies, which included individuals aged 18 to 50 years, the formation of antibodies to the hepatitis A virus antigen was detected in more than 88% of those vaccinated on day 15 and 99% at 1 month after the administration of a single dose of the vaccine.

Immunization with this vaccine on a properly selected schedule provides protection against hepatitis A for a period of not less than 20 years.

Chronic hepatitis C: symptoms and treatment

Over the past few years, central television channels have often shown social advertising that warns against what can lead to hepatitis C, for example, from promiscuity. And at the same time they call for tests for hepatitis. This is due to the constant increase in cases of chronic hepatitis C, with the study of its symptoms and methods of treatment.

Symptoms of hepatitis C
Hepatitis C is very dangerous in that it often happens asymptomatically, and is detected – by accident, when a person is checked for other diseases. Many of the symptoms of chronic hepatitis, characteristic of the initial stage of hepatitis C, are also in other diseases:

  1. fast fatiguability;
  2. weakness;
  3. indigestion disorder;
  4. pain in the joints
  5. Since effective vaccines against the hepatitis C virus have not yet been invented, recovery comes with proper treatment in only 20-30% of cases. Most often the disease becomes chronic. Acute hepatitis C can go on into a chronic form for quite some time. Gradually, for sometimes several years, the disease increasingly damages the liver cells, with the development of fibrosis they are replaced by cells of connective tissue.

Chronic viral hepatitis C leads to complications, against its background, cirrhosis of the liver, as well as in some cases, cancer. In this case, the symptoms of the disease often manifest only at the stage of cirrhosis. The main symptoms of chronic hepatitis C are:

  • jaundice;
  • gradual increase in weakness;
  • an increase in the volume of the abdomen;
  • pain in the right hypochondrium;
  • the appearance of vascular asterisks in the upper half of the trunk.

Treatment of chronic hepatitis C In the past two decades, the treatment of a serious illness has become much more successful than before. In each case, an individual course of therapy is selected, while much depends not only on the doctor, but also on the patient. It is necessary to constantly follow the diet, follow all the recommendations of the doctor in charge. The use of fatty foods and alcohol, exercise can lead to an exacerbation and development of complications of chronic hepatitis C.

Treatment of chronic hepatitis C requires a detailed study of the history of the disease, as it depends on the form in which the disease occurs, how hard the patient is suffering and whether there are complications and side-effects requiring a separate course of therapy. Modern methods of treating a disease that occurs in a chronic form are based on interferon therapy, using complex therapy.

It should be remembered that the timely detection of the disease can achieve much greater results in treatment, avoid the development of cirrhosis and the appearance of malignant tumors.

Hepatitis B: general information about the infection

Hepatitis B virus
Hepatitis B virus (HBVrefers to hepadnavirusSimilar viruses cause hepatitis in marmotsground squirrels and

Chinese duckswhich makes it possible to use these animals as experimental models in the development of medicines and vaccines.

The hepatitis B virus is very stable in the external environmenthas a high infectivityIf the immune response is kepta person with persistent hepatitis B develops a permanent lifelong immunity.

In the environmentthe hepatitis B virus can persist for about a week – even in a dry and inconspicuous bloodstainon the razor’s edgethe end of the needle.

How common is hepatitis B?
Hepatitis B affects more than 2 million people worldwidethe number of infected carriers of the virus is 350 millionThree quarters of the Earth’s inhabitants live in regions with a high incidence.

Annuallyabout 4 million cases of acute hepatitis B occurand 1 million people die from the effects of chronic hepatitis B (25of HBV carriers).

But in recent yearsthanks to the widespread ubiquity of hepatitis B vaccinationthere has been an encouraging trend towards a decrease in the incidence of this infection.

The mechanism of development of infection due to the hepatitis B virus
The mechanism of transmission of the hepatitis B virus is hematogenousi.ethrough the bloodInfection occurs from a patient with acute or chronic hepatitis B when infected blood enters the body of a healthy person.

The blood of a hepatitis B virus infected becomes viral long before the onset of the first symptoms of the diseaseand retains these properties to varying degrees throughout the duration of a chronic infection.

It is possible to transmit the infection sexually and from mother to child in childbirthThe HBV virus itself is large and does not pass through the placenta.
Through damage to the skin and mucous membranesthe HBV virus enters with a blood flow into the liverThe hepatitis B virus penetrates into liver cellshepatocytes and begins to multiply.

Genetic material of the virus – viral DNA is collected in the nucleus of the hepatocyte celland the enveloped proteins are synthesized in the cytoplasmThen viral chamstice – virions undergo complete assembly and leave the cellhitting neighboring ones.