Life Without Hepatitis

Hepatitis A. This type of viral liver inflammation is often referred to as “household hepatitis” because it is transmitted through contaminated hands, unwashed fruits and vegetables, and contaminated water. By the age of 30, about 95% of the population has been exposed to this virus, and roughly half of them are unaware that they have already had the infection. The incubation period ranges from 7 to 50 days. The disease always presents acutely, accompanied by pronounced flu-like symptoms.

Hepatitis B. This virus enters the body only through blood and rarely penetrates mucous membranes. Infection can occur during surgeries, blood transfusions, at dental offices, and during tattooing, piercing, and manicures. In addition, hepatitis B is sexually transmitted. A distinctive feature of this type is that in 5% of patients, the virus progresses to a chronic stage, remaining in liver cells for life. Nevertheless, in 95% of cases, hepatitis B is completely curable.

Hepatitis C. Similar to hepatitis B, the infection is transmitted through blood, but the likelihood of sexual transmission is significantly lower. Couples in which one partner has hepatitis C can live together for many years without transmitting the virus to the other. There are several types of hepatitis C, differing in the degree of liver damage and the rate of disease progression. The chronic form develops in 85% of cases.

The Role of Chance

According to statistics from Rospotrebnadzor, cases of hepatitis infection in medical facilities are being reported with increasing frequency—accounting for about 10% of all patients with this infection. More than half of these cases are linked to dental offices. Hepatologists attribute these figures to violations in instrument sterilization and the fact that some medical equipment cannot technically be made disposable. However, not all specialists agree with these findings. According to Professor Emilia Yakovenko, head of the Department of Gastroenterology, Academician of the Russian Academy of Natural Sciences, and Doctor of Medical Sciences, Emilia Yakovenko, the increase in the number of detected cases is due to improved diagnostics. Any surgical procedures, from gastroscopy to dental treatment, require mandatory testing for hepatitis. These tests are important for both the patient and the clinic. At the same time, a person visiting a dental office may already be infected, since in 40% of cases, hepatitis is asymptomatic. Although infections do occur in medical facilities, they are the exception rather than the rule when sterilization protocols are followed and disposable materials are used.

Who is at risk

• Blood transfusions, especially before 1992;
• Multiple surgical procedures;
• Regular visits to the dentist;
• Frequent visits to a gynecologist;
• Piercings or tattoos;
• Multiple sexual partners and anal sex.

Viruses in the liver

The severity of hepatitis lies in the diversity of viral strains. Currently, several dozen types of this disease are known, but hepatitis types A, B, and C are the most widespread. Hepatitis A usually masquerades as the flu and does not lead to a chronic form or serious complications. However, hepatitis B and C viruses differ in that they can remain in liver tissue, causing cell death and replacement by connective tissue—a process known as fibrosis. Fortunately, the liver is capable of self-repair, and this process is reversible. If fibrosis progresses faster than the organ can repair itself, cirrhosis develops—the terminal stage of the disease. With chronic hepatitis B and C viruses, irreversible cirrhosis can develop after about 15 years.

Recognizing the enemy

A distinctive feature of this disease is that it can easily be mistaken for other conditions. The initial symptoms are very nonspecific: weakness, general fatigue, reduced work capacity, and sleep disturbances. The symptoms are also similar to those of the flu, including joint aches. Patients often discover they have hepatitis by chance—during an examination for another condition. As the disease progresses, symptoms such as loss of appetite, pain in the right upper quadrant, nausea, and vomiting appear; urine darkens, and stools lighten in color. In the acute form, the skin often turns yellow. A blood test is required to confirm hepatitis—preferably using the PCR method.

How to check your condition

Once the virus is detected, it is important to assess the extent of liver damage. Previously, a biopsy—a painful and unpleasant procedure—was used for this purpose. Now there is a gentler and faster method—elastometry using the FibroScan device, which resembles an ultrasound exam and takes about 10 minutes—explains Bella Lurie, MD, head of the Hepatology Center at the Research Institute of Physical and Chemical Medicine.

Preventive injection

It is much more effective to prevent the disease than to treat it later. The best prevention is vaccination against hepatitis A and B. Vaccination against hepatitis A is recommended for anyone traveling to countries with poor hygiene standards, such as India, certain countries in Central Asia, and Africa. The hepatitis B vaccine is administered to newborns and provides protection in 99% of cases. However, immunity lasts for 5–8 years, after which a booster shot is required; this is administered only after testing for the virus to avoid vaccinating someone who is already infected. A few weeks after the booster shot, tests should be taken to assess antibody production.

What is prohibited?

Diet for hepatitis B and C should provide the body with the necessary vitamins , minerals, and nutrients. It is important to maintain gut health, as bloating, flatulence, diarrhea, and constipation indicate disturbances in the gut microbiota and fermentation processes.

Alcohol. For all forms of hepatitis, a maximum dose of 80 ml of pure ethanol per week is permitted, which is roughly equivalent to one glass of beer or wine. It is best to avoid hard liquor, as alcohol weakens the immune system and contributes to the accumulation of fats in the liver.

• Fried foods. Foods cooked at temperatures above 160 °C are harmful to the liver.
• Sugar. Excess glucose is stored in the liver as fat, which damages its cells.

Sun exposure. It is recommended to limit time spent outdoors, as ultraviolet rays promote the replication of the virus.

Life goes on

Hepatitis A usually does not require specific antiviral treatment. Treatment consists of basic supportive care—bed rest and diet , similar to treatment for the flu and acute respiratory viral infections. If necessary, detoxification therapy is prescribed, and liver function is monitored for three months after recovery.

“Chronic hepatitis B and C are lifelong diseases, but this is not a death sentence,” notes Bella Lurie. “The main concern is the development of cirrhosis. Modern treatment allows for remission, when the virus stops replicating and the person can live a full life without serious complications. “In the chronic form, the patient must undergo an examination every six months and take maintenance medications for life.” Treatment for such patients is supervised by a hepatologist, who determines dosages and treatment regimens. The outcome depends largely on the patient themselves: age, immune system status, Lifestyle and adherence to medical recommendations play a key role.

Hepatitis: Myths and Reality

Myth 1. Hepatitis B and C viruses are incurable. In fact, treatment is not aimed at completely eradicating the virus, but at the patient’s recovery—stopping and reversing liver fibrosis. Complete elimination of the virus does not always occur, but it is possible to suppress its replication after just one month of therapy, which leads to the disappearance of symptoms.

Myth 2. Viral hepatitis C is more dangerous than hepatitis B. In reality, hepatitis B is considered a more aggressive disease—it leads to cirrhosis more quickly. Additionally, the hepatitis B virus can be accompanied by the delta virus, which severely damages the liver and cannot enter the body on its own.

Myth 3. Treatment for hepatitis should begin when antibodies are detected in the blood. In reality, the indication for therapy is the presence of the virus itself in the blood—its DNA or RNA. Only a hepatologist can assess the situation and select the appropriate treatment.

Myth 4. If your condition worsens during treatment, it means the therapy isn’t working. Unfortunately, a temporary decline in well-being is possible at the start of treatment. However, after completing the course, quality of life quickly returns to normal, and the symptoms of the disease disappear.

Myth 5. There are alternative treatments for hepatitis. Do not trust dubious “nanotechnology-based” methods or herbal remedies. Effective treatment is only possible with medications that have been proven effective through scientific research.