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LIVER DISEASES: HEPATITIS B, C, D, AND CIRRHOSIS
Sotvoldiyeva Zarifaxon Rustamjon kizi
Kokand University Andijan Branch
Faculty of Medicine, Department of Therapeutic Medicine
Student of Group 24-17
+998901457673, znsm777@gmail.com
Scientific Supervisor:
Maripjonov Jasurbek Ma’mirjon ugli
Lecturer at Kokand University Andijan Branch; jasurbekmaripjonov122@gmail.com;
https://orcid.org/0009-0001-3523-4865
Abstract:
This article provides extensive information about hepatitis B, C, D, and liver
cirrhosis. The origins, clinical course, diagnostics, treatment methods, and prevention
measures of these viral diseases are described in detail. The global epidemiology, statistical
indicators, and the impact of liver diseases on human health are highlighted. The article also
focuses on modern treatment methods and innovative approaches.
Keywords:
Hepatitis B, Hepatitis C, Hepatitis D, Liver Cirrhosis, Viral Hepatitis, Liver
Failure, Antiviral Therapy, Prevention, Diagnosis.
The liver is one of the most important organs of the div, and its main functions include
detoxifying the blood, regulating metabolism, and synthesizing vital proteins. Viral hepatitis
B, C, D, and liver cirrhosis are serious diseases of this organ that can lead to dangerous
consequences for human life. According to the World Health Organization (WHO), millions
of people suffer from these diseases every year.
Hepatitis B
Hepatitis B virus (HBV) is a virus that spreads through the hematogenous route, causing
inflammation of the liver. Viral hepatitis B primarily spreads through blood, sexual contact,
and perinatal transmission from mother to child. Worldwide, more than 296 million people
are carriers of this virus. Hepatitis B is a viral infection caused by HBV (Hepatitis B Virus),
which belongs to the Hepadnaviridae family. The disease affects the liver and can occur in
either acute or chronic forms. Hepatitis B is widespread globally, with millions of new cases
being diagnosed each year. When the virus enters the div, it multiplies in liver cells,
leading
to
inflammation
and
damage
to
these
cells.
Hepatitis B virus is transmitted through the hematogenous route, meaning:
Through blood (contaminated needles, syringes, medical or cosmetic instruments)
Through
sexual
contact
From mother to child (perinatal route): The disease is often transmitted to the baby during
childbirth or through breastfeeding. Additionally, the virus can also spread through
household
items
(toothbrushes,
nail
clippers).
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Hepatitis B infection can occur in either acute or chronic forms:
Acute рepatitis B: The disease usually lasts up to 6 months. Symptoms include jaundice,
fatigue,
nausea,
loss
of
appetite,
and
abdominal
pain.
Chronic hepatitis B: If the virus remains in the div for more than 6 months, the disease
progresses to a chronic form. Chronic hepatitis B can lead to liver cirrhosis and liver cancer.
Diagnosis :
To diagnose Hepatitis B, the following laboratory tests are conducted:
HBsAg: Hepatitis B surface antigen, indicates the presence of the disease.
Anti-HBc:
Indicates
either
acute
or
past
infection.
HBV DNA: Measures the amount of virus in the blood.
Liver enzymes (ALT, AST) – used to assess liver damage.
Treatment: In the acute form of Hepatitis B, no specific antiviral treatment is required, and
symptomatic support is provided to patients. In the chronic form, the following medications
are used to suppress the virus:
Interferons
(Peg-IFN)
Nucleoside
and
nucleotide
analogs
(Entecavir,
Tenofovir)
Patients with chronic Hepatitis B should be regularly monitored under medical supervision.
The most effective way to prevent Hepatitis B is vaccination. It is recommended that all
newborns and individuals in high-risk groups receive the HBV vaccine. Additional
preventive
measures
include:
Reducing
the
risk
of
bloodborne
transmission
Protected sexual intercourse Following personal hygiene rules
Hepatitis B is a serious disease with a high risk of progressing to chronic form. However, it
can be prevented as effective vaccines are available. Timely diagnosis and appropriate
treatment can reduce the severity of complications associated with the disease.
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Hepatitis C
Hepatitis C is a viral disease that damages the liver, caused by the Hepatitis C Virus (HCV).
The disease is primarily transmitted through blood and has a very high potential to progress
to a chronic form. Hepatitis C can develop silently in the human div for years, ultimately
leading to liver cirrhosis and liver cancer. According to the World Health Organization
(WHO), more than 58 million people worldwide are infected with this virus, with 1.5
million new cases diagnosed each year.
How is hepatitis C transmitted?
HCV is mainly transmitted through blood, and the following factors increase the risk of
infection: Use of non-sterilized needles and medical instruments (injections, dental
procedures, tattoos, and piercings)
Blood transfusions or organ transplants (if the donor is a virus carrier)
Injecting drugs
Sexual contact (rare, but risk exists)
Perinatal transmission from mother to child The virus can also spread through household
items (toothbrushes, razors, nail clippers), but this is rare.
Hepatitis C infection can develop in either an acute or chronic form:
Acute hepatitis C develops within the first 6 months. Sometimes, patients have no symptoms,
or mild flu-like symptoms may appear.
Chronic hepatitis C – if the virus remains in the div for a long time, it progresses to a
chronic form in 80% of cases. This can lead to liver failure, cirrhosis, and liver cancer.
Symptoms of Hepatitis C
Many patients experience the disease without noticeable symptoms, but the following signs
may occur:
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Chronic fatigue
Loss of appetite
Nausea and vomiting
Pain in the upper right abdomen
Jaundice (yellowing of the skin and eyes)
Abdominal swelling (ascites) and other signs of liver cirrhosis
Due to the slow progression of the disease, people often realize they have it late.
Diagnostic tests for Hepatitis C include:
1. HCV antidiv test – indicates if the div has been exposed to the virus.
2. HCV RNA test – confirms the presence of the virus.
3. Liver enzyme test (ALT, AST) – assesses the degree of liver damage.
4. Fibroscan (elastography) or liver biopsy – used to determine the extent of liver damage.
Modern medicine has made Hepatitis C a treatable disease. Today, direct-acting antiviral
(DAA) drugs can cure the disease within 8-12 weeks. If chronic Hepatitis C progresses to
cirrhosis or liver cancer, a transplant may be required.
There is currently no vaccine for Hepatitis C, but the following preventive measures can
help reduce the risk:
Use of sterilized medical and cosmetic equipment
Not sharing needles and syringes
Practicing protected sexual intercourse
Maintaining liver health, avoiding alcohol, and harmful substances
Hepatitis C is a serious disease, and most patients experience it without symptoms for years.
However, with modern antiviral medications, it can be completely cured. Timely diagnosis
and proper treatment can prevent severe complications of the disease. Therefore, individuals
in high-risk groups are advised to regularly undergo tests.
Hepatitis D
Viral Hepatitis D is a liver infectious disease caused by the Hepatitis Delta Virus (HDV).
HDV is one of the five known hepatitis viruses: A, B, C, D, and E. HDV is considered a
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satellite disease (a type of subviral agent) because it can only spread in the presence of
Hepatitis B Virus (HBV). Hepatitis D infection can occur through co-infection with HBV
(simultaneous infection) or superinfection in chronic Hepatitis B patients or HBV carriers.
Hepatitis D is one of the rarer but most dangerous types of viral hepatitis, caused by the
Hepatitis D Virus (HDV). This virus cannot exist independently in the div and can only
develop when Hepatitis B Virus (HBV) is present. Therefore, Hepatitis D is found only in
individuals infected with HBV and leads to a more rapid progression of liver diseases.
Hepatitis D has been detected in 12–15 million people worldwide, with its highest
prevalence in Central Asia, Africa, the Middle East, and South America. This virus
significantly increases the risk of cirrhosis and liver cancer in patients infected with HBV.
The Hepatitis Delta virus was initially described in patients with a more severe form of the
infectious disease caused by Hepatitis B virus. Hepatitis D infection can occur
simultaneously with Hepatitis B infection (co-infection) and is more likely to occur in cases
of chronic Hepatitis B (superinfection). In both cases, the disease symptoms are more
pronounced than those of Hepatitis B alone. In patients with both Hepatitis B and Hepatitis
D, the likelihood of developing end-stage liver failure due to acute infection, rapid
progression of cirrhosis, and the addition of hepatocellular carcinoma in chronic infections is
significantly higher.
Hepatitis D is a rare but highly dangerous type of viral hepatitis, caused by the Hepatitis D
Virus (HDV). This virus cannot exist independently in the div and can only develop in the
presence of Hepatitis B Virus (HBV). Therefore, Hepatitis D occurs only in individuals
infected with HBV and leads to a more rapid progression of liver diseases.
How does Hepatitis D spread?
Hepatitis D virus spreads through blood, and its transmission routes are similar to Hepatitis
B: Use of injectable drugs (non-sterile needles, syringes)
Blood transfusions (if the donor is infected with both HDV and HBV)
Sexual contact (less common, but still a risk)
From mother to child (perinatal transmission)
Through non-sterile medical and cosmetic instruments (tattoos, dental procedures,
manicures/pedicures)
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Hepatitis D can only develop when Hepatitis B is present. Cirrhosis of the liver is a chronic,
progressive disease of the liver, where the liver tissue becomes inflamed, and part of it is
replaced by connective tissue. Acute liver inflammation—such as in Hepatitis B, C, D, and
during the transition from acute to chronic hepatitis—can also occur in infectious diseases
like malaria, tuberculosis, toxoplasmosis, brucellosis, chronic inflammation of the
gallbladder and bile ducts, regular poisoning from various chemicals, alcoholism, and other
causes.
Cirrhosis of the liver is a slow-progressing chronic disease. Its manifestations vary
depending on the stage and form of the disease. Despite the liver becoming hardened and its
function impaired, the individual may not notice symptoms for a long time. As the disease
progresses, patients become weak, lose weight, lose appetite, become bloated, experience
nausea, sometimes vomiting, diarrhea or constipation, abdominal distension, fever, and fluid
accumulation in the abdomen (ascites). Nosebleeds, itching of the skin, occasional yellowing,
and anemia may occur. The liver, and particularly the spleen, may enlarge and harden. The
best protection against this disease is vaccination against HBV.
Conclusion
Hepatitis B, C, and D are dangerous viral diseases that damage the liver and can lead to
cirrhosis and liver cancer. These viruses are primarily transmitted through blood and often
remain asymptomatic for a long time.
Hepatitis B can be prevented through vaccination, but if it progresses to the chronic stage,
the risk of liver failure is high. Hepatitis C currently has no vaccine, but it can be treated in
99% of cases with modern antiviral drugs (DAA). Hepatitis D occurs only in individuals
infected with Hepatitis B and is the most rapidly developing and severe form. Efforts are
being made to treat it with Peg-Interferon and the new drug Bulevirtide. Liver cirrhosis
occurs at the later stages of these viral infections, resulting from liver tissue scarring and the
development of liver failure. The final stage of cirrhosis can only be treated with a liver
transplant.
Early diagnosis and treatment prevent the severe consequences of the disease!
References:
1. World Health Organization. Global hepatitis report. 2022.
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2. European Association for the Study of the Liver (EASL). Clinical practice guidelines for
hepatitis B and C.
3. John F. Butterworth, David C. Mackey. "Morgan & Mikhail’s Clinical Anesthesiology".
2020.
4. Harrison’s Principles of Internal Medicine, 21st Edition.
