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L ' hepatitis is inflammation of the liver may be due to several causes: virus , farmaci, alcool , ecc. Molti virus possono modificare la morfologia del fegato nel contesto di infezioni che possono diventare anche di carattere sistemico. Tuttavia solo una minoranza di virus è epatotropa, cioè capace di portare come manifestazione clinica principale l'epatite. Alcuni (HAV e HEV) sono virus a trasmissione prevalentemente enterale, non cronicizzano o infezione; altri (HCV, HBV e HDV) sono virus a trasmissione prevalentemente parenterale e possono persistere nel tempo e quindi dare infezione e malattia di carattere cronico.

Le epatiti possono essere acute o croniche.
Le forme acute sono rappresentate dall' epatite virale e dall' epatite suppurata . L'epatite acuta virale is a process with inflammatory characteristics of liver necrosis induced by the virus that leads to:-cell swelling of hepatocytes, inflammation-infected hepatocyte regeneration may also have jaundice, loss of appetite, vomiting, fever, diarrhea, skin rash, joint pain.
Chronic forms are highlighted especially in the states of cirrhosis.

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Hepatitis E

The infectious agent of ' hepatitis E, HEV virus was provisionally classified in the family Caliciviridae. L ' Hepatitis E is an acute self-limiting and often jaundiced, assai simile all’ Epatite A . Caratteristica principale di questa infezione è l’alta frequenza di forme cliniche fulminanti (1-12% ) ed una particolare severità del decorso nelle donne in gravidanza, specialmente nel terzo trimestre di gravidanza, con mortalità che arriva fino al 40%. La malattia non cronicizza mai.

COME SI TRASMETTE: Come per l’ Epatite A , la trasmissione avviene per via oro-fecale, e l’acqua contaminata da feci è il veicolo principale dell’infezione. Il periodo di incubazione va da 15 a 64 giorni.
E’ presente in tutto il mondo: epidemie e casi sporadici sono stati recorded mainly in geographic areas with inadequate levels of hygiene and health. So you have been identified epidemics in India, Burma, Iran, Bangladesh, Ethiopia, Nepal, Algeria, Libya, Somalia, Indonesia, Mexico, China, Pakistan, Central Asian Republics and the former USSR. In industrialized countries, however, most cases involve people returning from travel to countries at risk.

PREVENTION: Regarding prevention, it was suggested that administration of gamma globulin, especially in pregnant women, but their effectiveness has yet to be demonstrated. Studies are underway to set up the a vaccine.

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Hepatitis E Hepatitis D (Delta)

Hepatitis Delta (D)

The infectious agent of ' Hepatitis Delta is known as HDV is classified among the so-called satellites or viruses that require subvirion presence of another virus to be able to replicate. The virus 'Hepatitis D to infect liver cells, in particular, requires the assistance of the virus' Hepatitis B, then the infection also occurs in patients affected by HBV.
Delta hepatitis infection can occur in two ways: la prima é l'infezione simultanea da virus B e D. In questo caso si verifica un epatite clinicamente simile all’ Epatite B . La seconda é la sovrainfezione di virus D in un portatore cronico di HBV. Si verifica a questo punto una nuova epatite acuta a volte fatale. Studi recenti hanno dimostrato che, in Europa e in Usa, il 25-50% dei casi di Epatite fulminante che si pensavano associati al virus dell’ Epatite B , erano invece causati da HDV.
In entrambi i casi l’infezione può diventare cronica e in questo caso ha generalmente un decorso più severo rispetto a quella da virus B.

MODE OF TRANSMISSION: mode of transmission is the same as' Hepatitis B and the incubation period ranges from 2 to 8 weeks.
were identified three genotypes of HDV. The genotype is the most common, genotype II was detected in Japan and Taiwan, while genotype III is present only in the Amazon.
D virus infection is widespread throughout the world, and it is estimated that about 10 million people with hepatitis D virus and its support, the EBV.

PREVENTION: As regards preventive measures, that is prophylaxis for EBV / HBV: the vaccine against 'Hepatitis B will be able to protect even against' Hepatitis D .

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Hepatitis C

The infectious agent, the virus (HCV Hepacavirus) is part of the family Flaviviridae. We identified six different genotypes and more than 90 sub-types. It is not yet clear whether there are differences in the clinical course of disease for different genotypes, but there are differences in the response of various genotypes to antiviral therapies.
acute HCV infection is very often asintomatica ed anitterica (in oltre i 2/3 dei casi ).

SINTOMI: I sintomi, quando presenti, sono caratterizzati da dolori muscolari, nausea , vomito, febbre, dolori addominali ed ittero. Un decorso fulminante fatale si osserva assai raramente (0,1%). L’infezione acuta diventa cronica in una elevatissima percentuale dei casi, stimata fino all’85%. Il 20-30 % dei pazienti con Epatite cronica C sviluppa nell’arco di 10-20 anni una cirrosi e l’epatocarcinoma può evolvere da una persistente cirrosi da HCV in circa l’1-4% dei pazienti per anno.
La distribuzione del virus è universale. L’infezione affects about 3% of world population. Individuals infected with HCV are 3.5000000 to 5,000,000 and about 4 million in the U.S.. In our country the proportion of infected individuals ranging from 3 to 12% of the general population with a gradient that grows in a north-south and with age. A particularly high frequency of infection was found in some African countries such as Cameroon and Egypt. The incubation period ranges from 2 weeks to 6 months, but for the most varied within 6-9 weeks.

HOW TO SEND: transmission occurs primarily via the parenteral apparent and not apparent. Are also been documented cases of infection through sexual contact, but this route seems to be much less efficient than for HBV. The infection can be transmitted vertically from mother to child via in less than 5% of cases. The control of blood donations, using the test for the detection of antibodies to HCV, has significantly reduced the risk of infection after blood transfusion and blood products.

PREVENTION: To date there is no vaccine for the 'Hepatitis C use of non-immunoglobulin was effective. The only really effective measures are represented by the observance of general hygiene the sterilization of instruments used for surgery and beauty treatments, the use of disposable materials and protection of high-risk sexual.

CARE Treatment of hepatitis C has improved considerably over the last ten years. Unlike any other chronic viral infection, a significant proportion of patients with chronic hepatitis C can be treated. However, the current standard of care - pegylated interferon alfa and ribavirin - has its limits. The limited effectiveness in patients with hepatitis C virus (HCV) genotype 1 and the side effect profile, require the development of new therapeutic approaches. New directions in treatment beyond interferon alpha-based therapies are on the horizon.

News probable treatment of hepatitis C

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Hepatitis C Hepatitis A Hepatitis B

Hepatitis B

The virus' Hepatitis B (HBV) is a DNA virus belonging to the family of Hepadnaviridae. Are known at present six genotypes (AF) with a different geographical distribution.

SYMPTOMS: L ' acute hepatitis B in most cases is asintomatica.In those in whom the disease occurs, the onset is insidious with vague abdominal discomfort, nausea, vomiting and jaundice often comes, sometimes accompanied by mild fever. However, only 30-50% of acute infections in adults and 10% in children leads jaundice. The fatality rate is about 1%, but the percentage increases in people older than 40 years.

In adults the disease can become chronic in 5-10% of cases. The risk of chronic increases with decreasing age at which the infection is contracted, so that in infants infected shortly dopo la nascita si verifica circa 9 volte su 10.
Nel 20% dei casi l’epatite cronica può progredire in cirrosi epatica nell’arco di circa 5 anni. Il cancro al fegato (epatocarcinoma) è un’altra complicanza frequente dell’epatite cronica, soprattutto nei pazienti con cirrosi. L’infezione da HBV nei paesi ad elevata endemia è responsabile fino al 90% dei carcinomi del fegato.
Si stima che più della metà della popolazione mondiale sia stata infettata dal virus dell’ Epatite B e che siano circa 350 milioni i soggetti con infezione cronica. Ogni anno si stima che in tutto il globo si verifichino più di 50 milioni di nuove HBV infection and that about one million people die from HBV infection. In highly endemic regions such as East Asia, Africa and the Amazon subshariana, the percentage of chronic carriers ranges from 10 to 25% in countries with low endemicity such as North America and Western Europe this figure is less than 2%.

How do you get: The source of infection of ' Hepatitis B is represented by patients with acute or chronic infection by porters, who have the virus in the blood but also in various body fluids: saliva, bile, nasal secretions, breast milk, semen, vaginal mucus, etc. ..
transmission, through the blood is therefore injecting, apparent or not apparent, sexually or by vertically from mother to child. The apparent that injecting is accomplished through blood transfusions or blood products contaminated with the virus, or cut / puncture with needles / instruments infected. The injecting apparently occurs when the virus enters the body through small skin lesions or mucous membranes (brushes, scissors, combs, razors, brushes, towels contaminated with infected blood, etc.).
With regard to the risk of contagion ' transfusion hepatitis B, still exists in developing countries, and is practically zero in industrialized countries. In fact, the monitoring of blood donation must be added the following processes that destroy the virus.
At the risk of contracting the ' hepatitis B so they are drug addicts, homosexuals, health care personnel in contact with infected people or working on the agent of infection, but also the family and sexual contacts with infected people and all those practice that involves contact with non-sterile needles and syringes, such as tattoos, piercing, manicures, pedicures, etc. .. The virus resists outdoor up to 7 days, so the infection is also possible to contact with contaminated objects. The incubation period varies between 45 and 180 days, but usually stands between 60 and 90 days.

PREVENTION: In terms of prevention, there is a vaccine that has been proven safe and provides long-lasting immunity against 'Hepatitis B . In Italy since 1991, vaccination is mandatory for all newborns and adolescents of 12 years. Vaccination is strongly recommended for the population groups most at risk of infection (drug addicts, living in chronic carriers, medical personnel, male homosexuals, etc...)

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Hep

L ' Hepatitis A is always caused by a picornaviruses, HAV is classified today as a prototype of the new genre of Hepatovirus , and has an incubation period ranging from 15 to 50 days. L ' Hepatitis A usually has a benign course and self-limiting, asymptomatic forms are frequent, especially during epidemics and in children. However

happen to have more severe forms of hepatitis A with protracted course and also forms fulminant and rapidly fatal. The disease is lethal in a proportion of cases that stood between 0.1% and 0.3%, but can reach up to 1, 8% in adults above 50 years. Typically the disease, which lasts for 1-2 weeks, the manifest with fever, malaise, nausea, abdominal pain and jaundice, accompanied by elevations in transaminases and bilirubin. Patients recover fully, without ever chronic. There is no chronic carrier state of virus A, nor in the blood or faeces.

HOW ARE TRANSMISSION: The transmission of ' Hepatitis A case for faecal-oral route. The virus is present in the faeces 70-10 days before the onset of symptoms until a week later, while in the blood for only a few days. Typically the infection occurs by direct contact from person to person or through consumption of food or water crudi o non cotti a sufficienza, soprattutto molluschi, contaminati con materiale fecale contenente il virus. Solo raramente sono stati osservati casi di contagio per trasfusioni di sangue o prodotti derivati.
L’ Epatite A è diffusa in tutto il mondo sia in forma sporadica, sia epidemica. Nei paesi in via di sviluppo con scarse condizioni igieniche-sanitarie, l’infezione si trasmette in maniera rapida tra i bambini, nei quali la malattia è spesso asintomatica, e molti adulti risultano pertanto già immuni alla malattia. Nei paesi economicamente più sviluppati, le migliorate condizioni igienico-sanitarie hanno invece determinato una riduzione della diffusione dell’infezione tra i bambini ed una resulting in more widespread among adults due to a higher proportion of susceptible individuals who also have an increased risk of severe clinical forms clear and pure. This is probably due to the fact that they were infected in the first years of life: in this case, the disease has a minimum and allows course of immunization. However, even with improved conditions of hygiene, the percentage of adults immunized in developing countries is much lower than in the past, so there has been an increase in outbreaks of hepatitis A .
In industrialized countries, transmission is common within families and occurs sporadically in the nursery, where children are present that use pannolini.L 'infection is also frequent among subjects who did travel to countries where the disease is endemic.

PREVENTION: From the standpoint of prevention for the ' Hepatitis A in Italy are two different vaccines that provide protection from infection as early as 14-21 days. Vaccination is recommended in patients at risk, including those who are suffering from chronic liver disease, homosexuals, those who travel in countries where the ' Hepatitis A is endemic, for those who work in environments where contact with the virus , for addicts, family members and contacts of patients with hepatitis A. acute Very important are the general rules of hygiene for the prevention of faecal-oral route (personal hygiene, washing and cooking vegetables properly, shellfish etc..) And the control of the cultivation and marketing of seafood.