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Acute hepatitises

Table of contents
Acute hepatitises
Etiology and pathogeny
Diagnosis
Treatment and prevention

Acute hepatitises of a virus, alcoholic and medicinal etiology

Acute hepatitises — the acute inflammatory diseases of a liver of various etiology (virus, alcoholic, medicinal, etc.) proceeding with expressed cytolytic and it is frequent with a mesenchymal and inflammatory syndrome; at some patients jaundice develops. Usually acute hepatitises come to an end favorably, the small part passes in chronic and very small (fulminant forms) can come to an end letalno.

Epidemiology
About 90% of all acute hepatitises are the share of viral, alcoholic and medicinal hepatitis. The share of patients with sepsis, persons after extensive operations and depressed cases at which hepatitises of a multifactorial origin, and also the persons suffering from acute hepatitises as a result of professional develop (tetrachlorides, beryllium, vinyl chloride, etc.) and household intoxications, makes 10%.

Acute viral hepatitis does not tend to reduction, moreover, in a number of areas they become frequent. According to the USA on 57 557 cases (0,025% of population) of diseases of an acute viral hepatitis: 38% are carried to an acute viral hepatitis And, 45% to an acute viral hepatitis In and 7% to an acute viral hepatitis And In, 10% — to not specified forms. However further it is possible, and amendments as complex immuno-virologic research is executed at 64% of patients will be introduced in these data, at 19% only HBsAg is investigated.

Materials about the frequency of acute alcoholic and medicinal hepatitises in population are absent, however in the majority of the developed countries of the world growth of number of acute alcoholic and medicinal hepatitises is observed.

The ratio of patients with acute viral, acute alcoholic and acute medicinal hepatitis equals for the senior and average age, as a rule, 4:1:1. It is natural to assume that the contingent of patients is younger, the more there will be a share of an acute viral hepatitis. The lethality among hospitalized is equal to 0,3 — 1%. And at before healthy people of young age it is close to 0,1%. The indicator of a lethality grows at patients of advanced age and at persons with various somatopathies, first of all at patients with a circulatory unefficiency, malignant tumors, heavy anemia, a diabetes mellitus, etc.

In general among hospitalized with an acute viral hepatitis And the lethality is close to 0,2%, an acute hepatitis In — to 1 — 1,2%. At a sporadic form of hepatitis And In a lethality it is definitely not defined. Assume that it is 2 — 2,5 times less, than at hepatitis B. Also there are no exact data on a lethality at an epidemic form of hepatitis And V. Odnako at separate flashes (in particular, in India) a lethality reached 10%, especially at the expense of pregnant women. At persons with accession of hepatitis D (delta virus) to hepatitis In a lethality increases.

The lethality at the expressed forms of acute alcoholic hepatitis is equal to 3 — 10%.
The lethality at acute medicinal hepatitis is close to 0,2 — 0,4%. At separate types of acute medicinal hepatitises (paracetamol, Ftorotanum, etc.) it many times over exceeds this average value.



 
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