The focus: what you need to know about the silent illness
Hepatitis describes an inflammatory disease of the liver that affects millions of people worldwide. Annually On July 28th, the World Hotatiti Day committed to raise awareness of this often quiet, but potentially life -threatening illness. This day of action was launched by the World Health Organization 2010 (WHO). The date reminds of Dr.'s birthday Baruch Blumberg, who discovered the hepatitis B virus and received the Nobel Prize. This day aims to highlight the importance of early detection, prevention and treatment of hepatitis and to bundle the effort in order to reduce the number of hepatitis-related deaths worldwide.
What is hepatitis?
Hepatitis denotes inflammation of the liver, which can be triggered by various causes. However, the disease is most common to virus infections, with the five main types of hepatitis viruses A, B, C, D and E are the most important. These viruses differ in their transmission paths, their distribution and their health effects.
How many people have hepatitis ill?
Hepatitis in Germany
In Germany, prevalence rates for hepatitis B and C are relatively low compared to other parts of the world, but still significant. The prevalence of hepatitis B amounts to 0.3-0.7 % of the population. This corresponds to a population of around 83 million people that around 250,000 to 580,000 people in Germany are chronically infected with hepatitis B. About 0.2-0.3 %are affected by hepatitis C. This corresponds to around 160,000 to 250,000 people in Germany who are infected with hepatitis C. The hepatitis forms A and E are less common in Germany and often occur in the form of outbreaks, which are usually due to higher prevalence when traveling to countries. Exact numbers fluctuate depending on the year and outbreak.
Hepatitis in European and non -European countries
In Europe, the prevalence rates vary greatly between the countries. Countries such as Italy, Romania and Bulgaria have higher prevalence rates for hepatitis B and C compared to Germany. In southern Europe, the rates are generally higher, which is due to factors such as different health infrastructures, vaccination rates and health education. Viewed globally, the prevalence rates in Africa and Asia are significantly higher. In some African countries, hepatitis B-prevalence is over 8 %, while hepatitis C-prevalence can be over 3 % in Southeast Asia. These high rates are often due to a combination of limited access to health services, lower vaccination rates and higher transmission rates due to uncertain medical practices.
What tasks does the liver have?
Metabolism and energy reserve
| function | Description |
|---|---|
| Glucose metabolism | The liver regulates blood sugar levels by storing glucose (in the form of glycogen) and releasing it if necessary. |
| Lipid metabolism | The liver produces cholesterol and triglycerides that are necessary for the structure of cell membranes and energy generation. It also plays a role in processing fats from food. |
| Protein metabolism | In the liver, proteins such as albumin and coagulation factors are synthesized, which are important for maintaining blood volume and blood clotting. |
Detoxification and excretion
| function | Description |
|---|---|
| Reduction of toxins | The liver filters harmful substances from the blood, including alcohol, medication and environmental toxins. These are converted into less harmful substances or excreted via the bile. |
| Ammonia reduction | The liver converts ammonia, a degradation product of the protein metabolism, into urea, which is then excreted via the kidneys. |
Production of bile
| function | Description |
|---|---|
| Biliary secretion | The liver produces bile, which is stored in the gallbladder and released into the small intestine if necessary. Galle is important for the emulsification and digestion of fats. |
Memory function
| function | Description |
|---|---|
| Storage of vitamins and minerals | The liver stores fat -soluble vitamins (A, D, E and K) as well as water -soluble vitamin B12 and important minerals such as iron and copper. |
Synthesis of blood proteins
| function | Description |
|---|---|
| Albumin production | Albumin is the most common protein in the blood plasma and important for the transport of hormones, vitamins and medication as well as for maintaining colloidosmotic pressure that keeps water in the bloodstream. |
| Coagulation factors | The liver produces several proteins that are crucial for blood clotting, including fibrinogen and proshrombin. |
Immune function
| function | Description |
|---|---|
| Defense against pathogens | The liver contains many immune cells, especially copper cells that remove and dismantle bacteria and foreign substances from the blood. |
Regulation of the hormone balance
| function | Description |
|---|---|
| Hormone metabolism |
The liver is involved in the regulation of hormones by breaking down and inactivating excess hormones. These include sex hormones, thyroid hormones and corticosteroids. |
Causes of hepatitis
Hepatitis can be caused by various factors that lead to inflammation of the liver. The most common causes are:
- Viral infections: The primary cause of hepatitis worldwide is viral infections. The hepatitis viruses A, B, C, D and E are the main causes, whereby each virus has different transmission paths, prevalence and health effects.
- Toxine: Certain substances such as alcohol, certain medication and industrial chemicals can damage the liver and cause toxic hepatitis.
- Autoimmune diseases: With autoimmune hepatitis, the immune system incorrectly attacks the liver cells, which can lead to chronic inflammation.
- Non -alcoholic fatty liver disease (NAFLD): This form of hepatitis often occurs in people with overweight, diabetes or metabolic syndrome and leads to a fat accumulation in the liver that causes inflammation.
- Genetic disorders: Some genetic diseases such as hemochromatosis or Wilson disease can lead to excessive storage of iron or copper in the liver, which can lead to inflammation and liver damage.
What symptoms do with hepatitis?
| symptom | Description | Typical occurrence (after infection) |
|---|---|---|
| Fatigue and exhaustion | Unusual fatigue and weakness due to the impaired liver function. | 1-2 weeks |
| Loss of appetite and nausea | Loss of appetite, nausea and possibly vomit. | 1-2 weeks |
| Fever | Easy fever, especially in acute shapes such as hepatitis A and E. | 2-3 weeks |
| Dark urine | Dark coloring of the urine, a sign of increased bilirubin values in the blood. | 3-4 weeks |
| Bright chair | Unusually bright chair caused by disturbed bilirubin excretion. | 3-4 weeks |
| Young fence (Ikterus) | Yellow coloring of the skin and eyes due to increased bilirubin levels in the blood. | 4-6 weeks |
| Abdominal pain | Pain or sensitivity to pressure in the right upper quadrant of the abdomen. | 2-3 weeks |
| Joint pain and muscle pain | Non-specific joint and muscle pain, especially with hepatitis B. | 2-4 weeks |
| Itching (Pruritus) | Itching due to the accumulation of bile acids in the blood, especially in chronic hepatitis. | 6+ weeks (often in later stages) |
Which groups of people are particularly at risk?
Hepatitis, especially forms B, C, D and E, can be favored by various risk factors that increase the risk of infection. Knowing these risk factors is crucial to take preventive measures and contain the spread of the disease. The most important risk factors for the different types of hepatitis are listed below:
Hepatitis A and E
- Travel to high -risk areas: People who travel to countries with low hygiene standards and high prevalence of hepatitis A and E have an increased risk. In particular, eating contaminated water, uncooked vegetables and raw or inadequate meat can increase the risk of infection.
- Contact with contaminated water and food: The transmission takes place and orally, therefore unclean water sources and poor food hygiene are significant risk factors.
- People in community facilities: People who live in densely populated community facilities such as kindergartens, schools or prisons are exposed to a higher risk because the hygiene standards are often more difficult to maintain.
Hepatitis B
- Unprotected sexual contact: Hepatitis B can be transmitted by blood, sperm and other body fluids, which is why unprotected sexual intercourse with several partners is a significant risk factor.
- Drug consumption (intravenous): The common use of needles and injections significantly increases the risk of transmission of hepatitis B.
- Mother-child transmission: Pregnant women who are infected with hepatitis B can transfer the virus to their child during birth.
- Medical staff: Employees in the healthcare system have a higher risk of getting into contact with needles base injuries or contact with infected blood with hepatitis B.
- Blood transfusions and organ transplants: Although the blood is thoroughly tested in many countries, there is a low residual risk, especially in countries with less strict regulations.
Hepatitis C
- Drug use (intravenous): The common use of needles and syringes is the main transmission of hepatitis C.
- Blood transfusions before 1992: In many countries, including Germany, blood products were only systematically tested on hepatitis C from the 1990s. People who received blood transfusions before this time have a higher risk.
- Tattoos and piercings: If these are carried out under unsanitary conditions, there is an increased risk of infection.
- Medical staff: As with hepatitis B, employees in the healthcare system have an increased risk due to needlestick injuries and contact with infected blood.
Hepatitis D
- Presence of a hepatitis-B infection: Since hepatitis D can only replicate in the presence of the hepatitis B virus, all risk factors that apply to hepatitis B are also relevant to hepatitis D. This includes in particular drug use (intravenous) and unprotected sexual contact.
- Migration from high -risk areas: People who come from regions with high hepatitis-D prevalence have an increased risk.
Hepatitis e
- pregnancy: Especially in endemic areas, infection with hepatitis E during pregnancy, especially in the third trimester, is associated with a higher risk of severe courses.
- Consumption of raw or inadequately cooked pork or wild meat: Hepatitis E can be transferred by eating meat infected animals, especially in regions where the virus is widespread in animal populations.
How is hepatitis diagnosed?
Anamnesis
The diagnosis of hepatitis is a complex process that includes various examination methods in order to identify the exact type of hepatitis, to determine the severity of the disease and to develop suitable treatment strategies. The diagnostic process usually begins with a thorough medical history, in which risk factors such as previous trips, sexual contacts, drug use and previous medical interventions are requested. This is followed by specific laboratory examinations that play a central role in the diagnosis of hepatitis.
Serological tests
These are often the first step in the blood test using one Butterflys. These tests are looking for antibodies or antigens that indicate infection with hepatitis viruses. For example, if hepatitis A is suspected, the detection of anti-hav-IgM antibodies that indicate acute infection is carried out. In hepatitis B, several serological markers are examined, including the hepatitis-B surface antigen (HBSAG), which indicates acute or chronic infection, as well as anti-HBS that indicates immunity after infection or vaccination. For hepatitis C, an antibody test (anti-HCV) is usually carried out first. If this is positive, an HCV-RNA test follows to confirm an active infection and determine the virus load.
Molecular biological tests
In particular, the polymerase chain reaction (PCR) are crucial to demonstrate the genetic material of the viruses and quantify the virus load. These tests are particularly important when diagnosing and monitoring hepatitis B and C, as they help to determine the active replication of the virus and to monitor the response to antiviral therapy.
Imaging procedures
In addition to the laboratory tests, imaging procedures play an important role in assessing liver health. An ultrasound of the liver is a non-invasive method to recognize changes in the liver structure, such as enlargement or signs of cirrhosis. The elastography (e.g. Fibroscan) measures the elasticity of the liver and helps to determine the extent of the scarring. A liver biopsy can be carried out in certain cases, especially in the event of unclear findings or for the exact assessment of the severity of liver damage. A small tissue sample is taken from being examined under the microscope to precisely determine the degree of inflammation and fibrosis.
Course control
After the initial diagnosis, regular progress control is crucial. This includes repeated blood tests for monitoring the liver enzyme values, bilirubin levels and the viral load to assess the course of the disease and the response to therapy. Repeated imaging examinations, such as ultrasound or elastography, may be necessary to continuously monitor liver health and to react early to complications.
What complications are possible through hepatitis?
Hepatitis, especially in their chronic forms, can have serious consequences and complications for health. These mainly affect the liver, but can also affect other organ systems. The most important consequences and complications of hepatitis are listed below:
| complication | Description |
|---|---|
| Cirrhosis | A progressive illness in which healthy liver tissue is replaced by scar tissue, which affects liver function. Often caused by chronic hepatitis B, C and D. |
| Liver cancer (HCC) | Hepatocellular carcinoma, a form of liver cancer that often occurs in connection with chronic hepatitis B and C. Increased risk due to chronic inflammation and cirrhosis. |
| Liver failure | A state in which the liver can no longer fulfill their functions. Can be acute or chronic. |
| Hepatic encephalopathy | A neurological disorder caused by the inability of the liver, toxic substances such as ammonia. Symptoms range from somnolence to a comatural state. |
| Portal hypertension | Increased blood pressure in the portal vein, often as a result of cirrhosis of the liver, can lead to varicose veins (varices) in the esophagus and in the stomach are life -threatening. |
| Ascites | Fluid accumulation in the abdomen, which is often associated with liver cirrhosis and portal hypertension. Can lead to infections and breathing difficulties. |
| Hepatorical syndrome | A serious complication in which kidney function is severely restricted, often as a result of advanced liver disease. Requires immediate medical treatment. |
| Coagulopathy | A disorder of blood clotting due to reduced production of coagulation factors in the damaged liver. Increased risk of bleeding. |
| Increased susceptibility to infections | Increased risk of bacterial infections due to weakened immune function, especially in cirrhosis of the liver (e.g. spontaneous bacterial peritonitis). |
| osteoporosis | Bone loss that can be caused by chronic liver diseases such as hepatitis. Increased risk of broken bones. |
| Depression and anxiety | Mental stress caused by chronic liver diseases that can lead to depression and anxiety. |
| Glomerulonephritis | An inflammatory disease of the kidneys, which can occur particularly in hepatitis B and C. Leads to impaired kidney function and protein loss in the urine. |
Hepatitis, especially in their chronic forms, can cause a variety of serious complications that affect the liver and other organ systems. The timely diagnosis and treatment of hepatitis are crucial to reduce the risk of such complications. Regular monitoring, preventive measures and early intervention can help to slow down the progression of the disease and to improve the quality of life of those affected.
How can you prevent hepatitis?
The prevention of hepatitis is crucial to prevent the spread of this potentially serious liver disease and to protect the health of the population. Prevention measures vary depending on the type of hepatitis virus and include vaccinations, hygiene measures, education and safe behaviors. The most important prevention strategies for hepatitis are listed below:
Vaccination
-
Hepatitis A: Vaccination against hepatitis A is available and is particularly recommended to travelers to countries with high prevalence, people with chronic liver diseases and people in professions with a high risk of exposure. The vaccination consists of two doses that are administered at a distance of 6 to 12 months and offer long -term protection.
-
Hepatitis B: Vaccination against hepatitis B is one of the most effective prevention measures and is routinely recommended for all infants as well as for people with high risk, including medical staff, drug use and people with frequently changing sex partners. Vaccination is usually done in three doses over a period of six months and offers long -term protection.
-
Hepatitis C, D and E: There are currently no vaccines against hepatitis C and D. Prevention therefore focuses on behavioral changes and the minimization of transmission risks. A vaccine against hepatitis E is available in some countries for certain risk groups, such as pregnant women in high -risk areas.
Safe injection and transfusion practices
-
Avoidance of jointly used needles: Since hepatitis B, C and D can be transmitted by blood, it is crucial to avoid the common use of needles and syringes. This applies in particular to intravenous drug users, but also in medical facilities.
-
Safe blood transfusions: In countries with high standards, blood products are routinely tested on hepatitis viruses. Nevertheless, it is important to ensure that blood transfusions are only carried out in qualified medical facilities in order to minimize the risk of transmission.
Protection in sexual contact
- Use of condoms: Since hepatitis B can be transmitted through sexual activities, the use of condoms reduces the risk of infection. This is particularly important for people with changing sexual partners or in regions with high hepatitis-B prevalence.
Hygiene measures
- Hygienic food and water handling: In order to avoid hepatitis A and E, travelers should only drink boiled water in high -risk areas or bottled water, do not consume raw or uncooked food and pay attention to hygiene when preparing dishes.
- Wash hands: Regular hand washing, especially after the toilet and before eating, is a simple but effective measure to avoid the transmission of hepatitis A and E. Manual disinfection Pathemar can be specifically killed and therefore further narrow down the transmission paths.
Enlightenment and behavioral change
-
Educational programs: Investigation initiatives in schools, communities and health centers can increase awareness of the risks of hepatitis and the importance of prevention measures. This includes information about safe sexual practices, the dangers of drug abuse and the importance of vaccinations.
-
Reduction of drug abuse: Programs to reduce drug abuse, in particular intravenous drug use, can help reduce the spread of hepatitis B, C and D. This can be achieved by clarification, support for withdrawal and access to clean needles and injections.
Regular tests and preventive examinations
-
Screening of risk groups: People in risk groups, such as drug users, medical staff, pregnant women and people with several sexual partners, should be regularly tested for hepatitis to enable early diagnosis and treatment.
-
Early detection: Regular preventive examinations and early tests can help recognize hepatitis infections at an early stage and prevent the spread of the disease.
The prevention of hepatitis is a multi -layered approach that includes vaccinations, safe behavior, hygiene measures and education. By combining these strategies, the risk of hepatitis infection can be significantly reduced. Compliance with these prevention measures is particularly important in regions with high hepatitis prevalence and for people who are exposed to increased risk of infection.
Who are the right contacts and contact points?
If a person with hepatitis is diagnosed or suspected of being infected, it is important to contact specialized contact points, specialist and centers in order to obtain the best possible care and treatment. Here are the most important contact points for people with hepatitis in Germany:
Family doctor or general practitioner
- First point of contact: The family doctor is usually the first point of contact if hepatitis is suspected. He can carry out a first examination, arrange blood tests and issue a transfer to a specialist if necessary.
- Treatment and monitoring: For mild or uncomplicated cases, the family doctor can take over treatment and regular monitoring.
Specialists in gastroenterology and hepatology
- Specialists for liver diseases: Gastroenterologists and hepatologists specialize in diseases of the digestive system and the liver. They carry out detailed diagnoses, monitor the course of the disease and introduce specialized treatments.
- Long -term care: Chronic hepatitis patients are often looked after by a gastroenterologist or hepatologist in the long term to monitor the progression of the disease and prevent complications.
Liver centers and specialized clinics
- Specialized care: In large cities there are specialized liver centers and clinics that focus on the diagnosis and treatment of liver diseases, including hepatitis. These centers offer the latest diagnostic procedures and therapy options.
- Multidisciplinary teams: Liver centers often work with a team of experts, including hepatologists, surgeons, oncologists and nutrition specialists to ensure comprehensive care.
Self -help groups and patient organizations
- Deutsche Leberhilfe e.v.: One of the most important self -help organizations in Germany that offers information, support and networking for people with liver diseases, including hepatitis. They organize regular meetings, information events and offer telephone advice.
- Internet forums and online communities: There are several online platforms on which those affected can exchange ideas and support each other. These forums offer a way to share experiences and get emotional support.
Health author
- Advice and education: Health offices offer information programs, information about prevention and vaccination options. You can also help you find specialists or specialized clinics.
- Vaccinations and prevention measures: Many health offices offer free or inexpensive vaccinations against hepatitis A and B, especially for people in risk groups.
Public health organizations
- World Health Organization (WHO): The WHO offers comprehensive information and global guidelines for hepatitis prevention, diagnosis and treatment. It supports campaigns worldwide to reduce hepatitis-related deaths.
- Robert Koch Institute (RKI): In Germany, the RKI provides important epidemiological data and information on hepatitis. It offers guidelines for the management of hepatitis infections and promotes prevention measures.
Hospitals and emergency rooms
- Acute care: In emergencies, especially with severe symptoms such as jaundice, strong fatigue or acute complications, those affected should go to a hospital or an emergency room immediately in order to receive quick medical care.
- Inpatient treatment: In the event of severe courses or complications such as liver cirrhosis or liver cancer, stationary admission to a hospital may be required.
There are numerous contact points in Germany that offer people with comprehensive support. From the first diagnosis to specialized treatment to social and emotional support, various institutions and experts are available to help those affected to cope with the disease and improve their quality of life. It is important to take medical help at an early stage and to contact the right specialists and organizations if necessary.
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