Hepatitas B yra vienas iš penkių virusų, galinčių užkrėsti kepenis, sukeliant uždegimą. Jis plinta per kūno skysčius. Dauguma žmonių patiria tik trumpalaikę, ūminę infekciją, tačiau kai kuriems žmonėms jis tampa lėtinis. Lėtinė infekcija gali stipriai pakenkti kepenims ilgalaikėje perspektyvoje. Hepatitas B yra išvengiamas vakcina, tačiau jis neturi išgydymo.
Kas yra hepatitas B?
Hepatitas B yra virusinė infekcija, paveikianti kepenis. Ji sukelia kepenų audinių uždegimą, o tai ir reiškia „hepatitas“. Ši infekcija prasideda kaip ūminė ir paprastai trunka trumpai. Tačiau kai kuriems žmonėms ji tampa lėtinė ir niekada nepraeina.
Ilgalaikis uždegimas laikui bėgant gali stipriai pažeisti kepenis, sukeldamas cirozę ir kepenų nepakankamumą. Kaip ir kitos lėtinės kepenų ligos, hepatitas B gali daryti žalą be jokių simptomų. Daugelis žmonių nežino, kad yra užsikrėtę, nes nejaučia ligos požymių.
Kodėl hepatitas B vadinamas „hepatitu B“?
Yra keletas skirtingų virusų, galinčių užkrėsti kepenis ir sukelti uždegimą (hepatitą). Tai yra hepatitas A, B, C, D ir E. Kiekvienas iš šių virusų skiriasi savo plitimo būdu, poveikiu organizmui bei gydymo ar prevencijos metodais.
Kuo hepatitas B skiriasi nuo kitų hepatitų?
Kai kurie specifiniai hepatito B bruožai yra šie:
- Hepatitas B turi saugią ir veiksmingą vakciną, kuri gali užkirsti kelią infekcijai. Pasaulio sveikatos organizacija (PSO) rekomenduoja skiepyti visus kūdikius kuo greičiau po gimimo.
- Hepatitas B labiau paveikia vaikus. Tik 5% suaugusiųjų, užsikrėtusių šiuo virusu, vystosi lėtinė infekcija, tačiau net 30% vaikų iki 6 metų amžiaus.
- Hepatitas B plinta per kūno skysčius, todėl gimdyvės gali perduoti virusą savo kūdikiams gimdymo metu. Iki 90% kūdikių, užsikrėtusių hepatitu B, vystosi lėtinė infekcija.
- Lėtinis hepatitas B yra gydomas, tačiau neišgydomas. Antivirusiniai vaistai gali padėti kontroliuoti infekciją, tačiau visą gyvenimą reikės rūpintis savo kepenimis.
Kiek paplitęs hepatitas B?
Hepatitas B yra dažniausia kepenų infekcija pasaulyje. Apie 2 milijardai žmonių (arba kas trečias) buvo užsikrėtę šiuo virusu visame pasaulyje. Maždaug 250 milijonų žmonių gyvena su lėtine hepatito B infekcija, dauguma jų to nežino.
JAV hepatitas B yra mažiau paplitęs dėl vakcinos. Ligų kontrolės ir prevencijos centrai (CDC) apskaičiavo, kad kasmet JAV pasitaiko apie 20 000 naujų ūminių infekcijų. Apytiksliai 862 000 žmonių JAV gyvena su lėtine hepatito B infekcija.
Simptomai ir priežastys
Simptomai gali būti šie: karščiavimas, pykinimas ir pilvo skausmas. Ne visi užsikrėtusieji turi simptomų, tačiau jie gali būti lengvi arba sunkūs.
Kokie yra hepatito B infekcijos simptomai?
Ne visi turi simptomų, tačiau jei jie yra, simptomai gali svyruoti nuo lengvų iki sunkių. Simptomai gali pasireikšti ūminės infekcijos metu arba ilgainiui su lėtine infekcija. Jūs galite būti užkrečiamas, nepaisant to, ar turite simptomų.
Tipiniai infekcijos simptomai yra šie:
- Karščiavimas.
- Apetito praradimas.
- Pykinimas ir vėmimas.
- Pilvo skausmas.
- Silpnumas ir nuovargis.
- Sąnarių skausmas.
Taip pat galite pastebėti kepenų ligos simptomus, tokius kaip:
- Gelta (odos ir akių baltymų pageltimas).
- Tamsiai nuspalvintas šlapimas.
- Šviesios arba molio spalvos išmatos.
- Pilvo arba galūnių patinimas skysčiu.
Ūminės infekcijos atveju kepenų ligos simptomai gali rodyti rimtesnę reakciją. Nors dauguma žmonių gali išvalyti HBV virusą be gydymo, jei pastebite kepenų ligos simptomus, turėtumėte kreiptis į sveikatos priežiūros specialistą.
Lėtinės infekcijos atveju simptomai gali būti lengvi ar neapibrėžti, arba jų gali nebūti ištisus dešimtmečius. Kai simptomai pasireiškia vėliau, ypač kepenų ligos požymiai, tai gali reikšti, kad jūsų kepenys pradeda nebeveikti.
Kaip užsikrečiama hepatitu B?
Hepatitas B plinta per kūno skysčius, kai infekuoto žmogaus skysčiai patenka į sveiko žmogaus kūną. Tai gali nutikti:
- Gimdymo metu.
- Seksualinio kontakto metu.
- Per atvirą žaizdą.
- Dalijantis adatomis arba švirkštais.
- Naudojant tą patį dantų šepetėlį ar skustuvą.
- Atsitiktinai įsidūrus užkrėstu aštriu daiktu.
HBV gali išlikti ant paviršių ne mažiau kaip septynias dienas. Todėl ne sterilizuoti instrumentai gali toliau perduoti virusą, įskaitant medicinos instrumentus ir įprastus daiktus, kaip dantų šepetėlis ar skustuvas.
Kam didesnė rizika užsikrėsti hepatitu B?
Jūs labiau rizikuojate užsikrėsti hepatitu B, jei priklausote bendruomenei, kurioje ši infekcija yra labiau paplitusi. Rizikos grupės apima:
- Žmones su ŽIV.
- Intraveninių narkotikų vartotojus.
- Afrikos, Azijos ar Ramiojo vandenyno salų kilmės žmones.
Kaip vystosi lėtinis hepatitas B?
Lėtinis hepatitas B vystosi, kai imuninė sistema nepavyksta sunaikinti viruso ūminės infekcijos metu. Tai gali atsitikti, jei:
- Jūs esate mažas vaikas, kurio imuninė sistema dar vystosi.
- Turite kitą infekciją tuo pačiu metu.
- Turite lėtinę ligą, kuri silpnina imuninę sistemą.
- Gaunate imunosupresinius vaistus ar chemoterapiją.
Kas yra reaktyvuotas hepatitas B?
Kartais, po to, kai organizmas sėkmingai įveikia ūminę hepatito B infekciją, kažkas gali susilpninti jūsų imuninę sistemą vėliau gyvenime. Galbūt jūsų imuninė sistema buvo stipri infekcijos metu, tačiau dabar turite būklę, kuri ją silpnina.
Kai tai atsitinka, anksčiau nugalėtas virusas gali vėl tapti aktyvus jūsų kūne. Reaktyvuotas hepatitas B gali būti laikinas arba ilgalaikis. Tačiau dėl to, kad dažniausiai pasireiškia žmonėms su susilpnėjusia imunine sistema, jis gali būti ypač sunkus ir net sukelti ūminį kepenų nepakankamumą.
Kaip ilgai hepatitas B yra užkrečiamas?
Jūs esate užkrečiamas tol, kol virusas yra aktyvus jūsų kūne. Jei turite ūminę infekciją, ji gali trukti nuo kelių savaičių iki šešių mėnesių, ir visą šį laikotarpį jūs būsite užkrečiamas. Jei turite lėtinę infekciją, jūs būsite užkrečiamas visą gyvenimą, kol ji truks.
Kokios yra hepatito B komplikacijos?
Dauguma komplikacijų atsiranda dėl lėtinės infekcijos, tačiau kai kurie žmonės gali patirti komplikacijas ir su ūmine infekcija. Nors tai nėra dažna, kai kurie žmonės patiria ūminį kepenų nepakankamumą su ūmine hepatito B infekcija, o tai yra gyvybei pavojinga situacija.
Lėtinio hepatito B komplikacijos gali apimti:
- Hepatitas D. Hepatitas D, arba delta virusas, yra dar viena hepatito infekcija, kuri paveikia tik hepatitu B užsikrėtusius žmones. Tai vadinama superinfekcija, kuri padvigubina kepenų krūvį ir gali sukelti ūminį kepenų nepakankamumą.
- Cirozė. Lėtinis kepenų uždegimas kai kuriems žmonėms sukelia cirozę. Tai trunka ilgą laiką ir priklauso nuo daugelio veiksnių, tokių kaip bendra kepenų sveikata bei kitos sąlygos, galinčios jas paveikti. Cirozė atsiranda, kai pažeistas kepenų audinys palaipsniui pakeičiamas randiniu audiniu. Randinis audinys stabdo kepenų funkcionavimą, o tai veda prie lėtinio kepenų nepakankamumo.
- Lėtinis kepenų nepakankamumas. Tai yra laipsniškas procesas, kai kepenys per tam tikrą laiką praranda savo gebėjimą veikti. Nors procesas vyksta lėtai, jis yra pavojingas gyvybei. Be tinkamai veikiančių kepenų negalima išgyventi.
- Kepenų vėžys. Žmonės, sergantys lėtiniu hepatitu B, turi didesnę tikimybę susirgti kepenų vėžiu. Kepenų vėžys yra viena iš pagrindinių mirčių priežasčių tarp sergančiųjų lėtiniu hepatitu B.
Kaip diagnozuojamas hepatitas B?
Gydytojas gali paklausti apie jūsų simptomus ir atlikti fizinę apžiūrą. Jie taip pat gali paklausti apie jūsų sveikatos istoriją, kepenų ligos istoriją jūsų šeimoje arba kitus veiksnius, galinčius padaryti jus labiau pažeidžiamu virusiniam hepatitui.
Kadangi simptomų gali nebūti, vienintelis būdas sužinoti, ar turite hepatitą B, yra kraujo tyrimas. Specialūs kraujo tyrimai gali pasakyti gydytojui viską, ko reikia žinoti apie jūsų būklę, pvz.:
- Ar turite ūminę ar lėtinę infekciją.
- Ar buvote užsikrėtę praeityje.
- Ar jūsų imuninė sistema kovojo su virusu.
- Ar infekcija veikia jūsų kepenų funkciją.
Po diagnozės gydytojas gali skirti papildomus tyrimus, norėdamas patikrinti kepenų būklę. Tai gali apimti radiografinius kepenų audinių vaizdus arba, kai kuriais atvejais, audinio mėginį laboratoriniam tyrimui (kepenų biopsija).
Koks gydymas galimas sergant hepatitu B?
Gydytojas gali pasiūlyti įvairius gydymo variantus, atsižvelgiant į infekcijos stadiją.
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