Definition and causes
Viral hepatitis is an infection of the liver that can be caused by different viruses. The major causes of children in Denmark are Hepatitis A virus (HAV), Hepatitis B virus (HBV) and less Hepatitis C virus (HCV). There are other hepatitis viruses, D and E.
Hepatitis can also be part of other viral diseases, for example. mononukleose That is caused by Epstein-Barr virus.
Hepatitis A virus is present in all countries outside of Western Europe, North America, Japan, Australia and New Zealand. In particular, immigrants and adopted children from these countries are at risk of hepatitis A virus infection.
Infections are often just before the child comes to Denmark, or when the child is at home on visits or holidays. Infections can be done for all under the holiday in the above countries. Often the infection is discovered, when others in the family or børneinstitutionen infected. Hepatitis A virus spreads through contact with faeces from an infected.
Virus transferred typically due to poor hygiene of foodstuffs, articles or fingers, then put in the mouth. This pathway is called fæko-oral, which is to say from the stool to mouth. There are 15-45 days from infection to disease breaks out. Hepatitis A virus infection becomes chronic and never leaves lifelong immunity, which means that it can not be infected again.
Hepatitis B virus is a global problem. Infection with Hepatitis B virus can become chronic. The risk of chronic infection is greater, the younger one is by infection. Some 400 million people are chronic carriers of Hepatitis B virus worldwide.
Hepatitis B virus spreads through body fluids. Smittevejene is through blood and through intimate contact, for example. unprotected sexual intercourse and from mother to child. Mother to child infection is the most important in Denmark. The mother is often chronically infected with Hepatitis B virus and subsequently becomes pregnant. Infections of the child can be done while the child is in the womb, but is made under the birth of the child often come into direct contact with the mother's blood.
Infections through blood could previously be done by blood. This is not topical today because of the screening of all blood. Infections through blood can also happen when drug users share needles. The incidence of chronic hepatitis B among internationally adopted children are 2-5%.
Hepatitis C virus spreads through blood, like hepatitis B virus. The most common pathway is via contaminated needles. Infections can also be made through non-screening blood donations. Hepatitis C virus infection is often chronic. In young children can only find out whether the infection has become chronic after 1 year of age. This is because the antibodies to HCV detected in the child's blood before that age, do not have to be formed by the child's own immune system in response to the disease, but can be transmitted from the mother.
Symptoms of infectious hepatitis
Most symptoms of acute viral hepatitis are weak and non-specific. The most common are:
- Abdominal pain
Rare but serious symptoms include:
- Ascites, there is an accumulation of fluid in the abdominal cavity.
- Encephalopathy, is a term that covers the influence of the brain and hepatitis only in the context of liver failure. Symptoms include behavioural changes, confusion, drowsiness, impaired memory, restlessness, irritability and others. In severe cases developed unconsciousness and convulsions.
- Leversvigt: The term covers a reduced function of the liver. The symptoms are poor general condition, low blood pressure, low blood sugar, renal impairment and tendency to bleeding, particularly in the skin and stomach. Encephalopathy is not always present and can be particularly difficult to detect in young children.
Hepatitis B and C viruses may after the acute infection go down and become chronic. By a chronic infection, there is no or only very light symptoms. Virus is in hibernation, but causes a constant betændelsesreaktion in the liver, which is why the complications could arise (see complications). Viruses can also flare up again and give the symptoms as the first time Monday were infected.
Precautions and diagnosis
The diagnosis can be difficult to make. Especially because the symptoms are often mild and non-specific in children. However, a doctor immediately if your child develops jaundice, ascites or signs of liver failure. This is especially true if the child has been exposed to risk of contamination. udenlandsrejse to countries with the Hepatitis A virus presence. If the child is stuck in an abandoned used needle, seek medical advice immediately, although not yet developed symptoms. It should also consult a doctor if the non-specific
The study of the child, the doctor may. For jaundice, enlarged liver and accumulation of fluid in the abdominal cavity. The final diagnosis made on samples of blood, which shows the influence of the liver cells and reduced function of the liver. One can detect the type of virus by examining for specific antibodies in the blood.
Treatment of infectious hepatitis
There is no treatment of viral hepatitis caused by the Hepatitis A virus. Since the infection is often mild process and never become chronic, this is not necessary.
Chronic infection with the Hepatitis B virus can be treated with two different medicines. The guidelines for start-up of the treatment follows international guidelines. Often you will start treatment if the liver has been affected in over 1-2 years (detected by blood tests), or if the chronic infection flare up repeatedly.
There are currently two different treatments. Lamivudine is taken as tablets, and interferon alfa for injection. Both substances have drawbacks. Hepatitis B virus may develop resistance to lamivudine, so it does not work anymore.
Another problem is that the disease often flare up again, when you try to stop the treatment. The disadvantage of interferon alpha is that it be given by injection, and there are frequent side effects. The treatment reduces the virus's ability to reproduce and hence betændelsesreaktionen in the liver. This reduces the risk of complications from chronic Hepatitis B infection.
Select and complications
All the hepatitis virus infections in rare cases, regardless of viruses, have a serious process with the development of jaundice, ascites and liver.
Infection with Hepatitis B virus can become chronic. The younger one is by infection, the greater the risk. By infection during childbirth, nearly all chronic carriers. This can be prevented by vaccination of the child and the injection of antibodies immediately after birth.
Complications of chronic hepatitis occurs only after many years and includes liver cirrhosis and liver . The risk of complications is reduced with treatment.
Prevention of viral hepatitis
Hepatitis A is preventable with vaccines or injection of antibodies. The antibodies cover only a short period, for example. during travel or stay in an area where Hepatitis A virus appears.
The vaccine protects against Hepatitis A virus throughout their lives. It is recommended that children of different ethnic origins vaccinated if they visit the home during holidays. The aim is to protect children against Hepatitis A infection and to prevent the Hepatitis A virus is becoming more frequent in Denmark.
There is a vaccine against Hepatitis B virus. WHO recommends that all children in the world be vaccinated against H