Are autoimmune diseases transmitted through blood transfusions?


Brief overview

  • What is hepatitis? Inflammation of the liver, which can be acute or chronic
  • To shape: Viral hepatitis (hepatitis A, B, C, D, E), viral hepatitis, autoimmune hepatitis
  • Symptoms: sometimes no symptoms; in other cases clear to severe symptoms such as nausea, fever, upper abdominal pain and possibly jaundice
  • Causes:Viruses, poisons (such as alcohol), drugs, metabolic diseases, autoimmune processes
  • Treatment: depending on the cause and severity of the disease; E.g. protection, light food, abstinence from alcohol, medication, possibly liver transplantation
  • Forecast: Acute forms usually heal on their own. Chronic forms can permanently damage the liver. Liver cirrhosis and liver cancer are possible consequences.

Forms of hepatitis

The term hepatitis means inflammation of the liver. But that’s the end of simplicity. Exactly what hepatitis is can only be answered a little more extravagantly, because there are different forms of the disease.

First of all, hepatitis can be divided into two forms based on its duration:

  • acute hepatitis: takes less than half a year
  • chronic hepatitis: lasts more than six months, develops mainly from hepatitis forms B, C and D.

Hepatitis can also be classified according to the cause:

  • Viral hepatitis: Liver inflammation caused by hepatitis viruses A, B, C, D or E (all notifiable)
  • Viral hepatitis: Liver inflammation as a "side effect" of another viral disease (herpes, glandular fever)
  • Autoimmune Hepatitis: Inflammation of the liver due to malfunction of the immune system

Very rarely, hepatitis is caused by parasites, fungi, or bacteria.

Hepatitis A

Hepatitis A will mainly be fecally-orally transmitted, for example through drinking water that has been contaminated by the excrement of patients. The contagion can also be about Smear infection happens: If patients do not wash their hands thoroughly after using the toilet, they can transmit the virus to door handles, taps, cutlery or towels, for example. From there, the pathogens can reach the hands and subsequently possibly the oral mucosa of healthy people.

Sometimes hepatitis A gets over too contaminated food (Seafood, ice cream, fruit, etc.).

After infection, 15 to 50 days pass before the first symptoms appear (incubation period). These include unspecific complaints such as fever, nausea or loss of appetite. Later, the skin and eyeballs sometimes turn yellow, the urine turns dark and the stool pale. It can take several months for the patient to recover. However, hepatitis A infection cannot become chronic. In addition, after surviving an infection, you are immune to hepatitis A viruses for life.

You can read everything you need to know about this form of liver inflammation in the article Hepatitis A.

Hepatitis B.

Hepatitis B is one of the most common viral hepatitis worldwide. Infection occurs through blood and sexual contacts (sperm, saliva). Hepatitis B viruses can also be transmitted through other body fluids such as tears, cerebrospinal fluid (liquor), urine, gastric juice and breast milk. Overall have mostly medical staff, Dialysis patients as drug addicts (Injections!) A high risk of infection.

Type B liver inflammation can be acute or chronic. The first symptoms appear on average two to four months after infection.

Chronic hepatitis B is widespread. According to the World Health Organization (WHO), around 240 million people worldwide suffer from it. As a result of chronic liver inflammation, shrink liver (cirrhosis) and a malignant liver tumor (liver cancer) can develop.

You can find more information about hepatitis B in the text Hepatitis B.

Hepatitis C.

Experts estimate that around 71 million people worldwide have chronic hepatitis C. The triggering viruses can be detected in almost all body fluids. The infection will though mainly transmitted through blood. The risk of infection is particularly high with contaminated cutlery for drug consumption, but also with tattoo or piercing tools. In about 30 percent of all patients with chronic hepatitis C, no clear transmission route can be determined.

Around ten percent of hepatitis C patients are also infected with the hepatitis G virus. So far, no symptoms are known that can be clearly assigned to this pathogen. In addition, it is difficult to detect hepatitis G viruses.

The symptoms of hepatitis C are usually mild and rather unspecific: those affected have muscle and joint pain, a slight fever, nausea and an aversion to certain foods. Later, dark urine, yellowing of the skin and eyeballs (jaundice), and discolored stools may occur.

Chronic hepatitis C progresses mostly creeping and unnoticed over many years. However, the patients have a very high risk of liver cirrhosis or liver cancer.

Read more about this form of hepatitis in the article Hepatitis C.

Hepatitis D

Hepatitis D viruses can only multiply and cause infection with the help of hepatitis B viruses. This means: A hepatitis D infection is only possible in people who are either infected with hepatitis B at the same time or who already have a chronic hepatitis B infection.

Together, hepatitis B and D often lead to severe chronic inflammation of the liver

  • "Keep an eye on the liver if there are risk factors"

    Three questions to

    Dr. med. Markus Frühwein,
    Specialist in General Medicine
  • If the liver is inflamed, why doesn't it hurt?

    The liver tissue itself has no pain receptors, which is why the liver usually does not hurt if there is inflammation. However, inflammation often leads to swelling of the organ and thus to a stretching of the liver envelope, which is quite painful. However, unspecific symptoms such as tiredness, itching, loss of appetite or a feeling of pressure in the right upper abdomen are also troublesome.

  • Should you have your liver checked regularly?

    Regular liver checks are only recommended if there are special risk factors. It makes sense to keep an eye on the organ, especially if you are very overweight, have regular alcohol consumption, have diabetes or have chronic liver inflammation. In addition to the ultrasound examination, various laboratory parameters such as albumin, bilirubin or liver enzymes are groundbreaking.

  • How can I protect my liver?

    A healthy lifestyle with a balanced diet, moderate consumption of fat and alcohol, and exercise are good for the liver. There is no vaccination for hepatitis C and E. But against hepatitis A and B. Liver diseases are a great burden for the body and chronic diseases such as hepatitis B have a massive impact on quality of life. A healthy lifestyle and vaccinations can protect.

  • Dr. med. Markus Frühwein,
    Specialist in General Medicine

    Dr. med. Markus Frühwein is a specialist in general medicine, tropical medicine, travel medicine and nutritional medicine and owner of the Dr. Frühwein & Partner in Munich.

Hepatitis E.

The hepatitis E pathogen occurs mainly in Asia and Africa. The disease is mainly transmitted through drinking water or food. Human-to-human transmission is very rare.

Hepatitis E is acute and often only has mild symptoms, similar to hepatitis A. The symptoms become noticeable two to eight weeks after infection and subside after about six weeks.

Typically, hepatitis E is not particularly dangerous. Only in pregnant women can it be severe and even fatal in rare cases.

Read everything you need to know about this type of liver inflammation in the article Hepatitis E.

Autoimmune hepatitis

In contrast to the forms of hepatitis mentioned above, autoimmune hepatitis is not caused by viruses, but by a malfunction of the immune system. However, this form of liver inflammation is very rare. Autoimmune hepatitis most commonly occurs between the ages of 40 and 70 years. Most of the patients are female.

Autoimmune hepatitis is almost always chronic. Often there are no or only unspecific symptoms such as tiredness, loss of appetite, abdominal pain and headaches as well as nausea and vomiting for a long time. In severe cases, chronic autoimmune hepatitis leads to cirrhosis of the liver - with the risk of liver failure.

The therapy of autoimmune hepatitis consists in the administration of immunosuppressants. These are drugs that suppress the immune system. Liver transplantation may be necessary if the liver is cirrhosis.

Read more about risk factors, symptoms and disease progression in the article Autoimmune Hepatitis.

Hepatitis: symptoms

Hepatitis symptoms can vary widely. In some patients, the inflammation of the liver is severe. Others, however, have no symptoms whatsoever, and the disease is only discovered by chance due to elevated liver values. Sometimes, but not always, occurs Jaundice (Jaundice), which is often mistakenly equated with hepatitis.

Acute hepatitis: symptoms

The symptoms of acute hepatitis are in the Early phase unspecific and include:

  • Nausea and vomiting
  • Loss of appetite
  • fever
  • Upper abdominal pain
  • Joint or muscle pain
  • altered sense of smell and taste

The will follow after two to eight weeks Jaundice phase. The enlarged liver causes tenderness under the right lower costal arch. The skin may turn yellow, as may the eyeballs. This is because the bile pigment bilirubin is no longer released into the intestine via the bile, but is accumulated in the blood. Since part of it is excreted through the kidneys, the urine turns dark. The stool, on the other hand, loses its typical color due to the bacterial processing of the bilirubin. Itching is also a common symptom. It occurs because bile acids are deposited in the skin.

The Recovery phase (Convalescence phaseacute inflammation of the liver can last from a few weeks to months. During this time, those affected occasionally feel weak, tired, and exhausted.

Chronic hepatitis: symptoms

Chronic hepatitis manifests itself in symptoms such as

  • decreased performance
  • fatigue
  • Loss of appetite
  • Tension pain under the right costal arch
  • Joint pain
  • changing diarrhea

In mild (more) cases, however, it may well be that there are no symptoms at all. Relapses with enlarged liver and jaundice are typical. The menstrual cycle can also be absent in women. In men, the mammary glands may enlarge (gynecomastia), the testicles become smaller (testicular atrophy) and / or the hair on the abdomen and pubic area may be less (balding).

  • Hepatitis - Do You Live Dangerously?

    Chronic inflammation of the liver such as hepatitis B and C, if left untreated, can cause severe liver damage, liver cell cancer and even be fatal. In Germany alone, experts assume up to 600,000 infected people. The problem: hepatitis often goes unnoticed for a long time, so that the infected have no idea of ​​their disease. Read here how you can get infected and what is important then.
  • Hepatitis A - the dirty kid

    Hepatitis A is a comparatively harmless variant of hepatitis. However, it is also the quickest way to get infected. It is mainly transmitted through the fecal-oral route, for example through drinking water that has been contaminated with excrement. A smear infection is also possible with poor hygiene in the toilet. In addition, there is the consumption of contaminated seafood. It may take a few months for patients to recover. A vaccination protects against hepatitis A.
  • Hepatitis B - blood, sweat, and tears

    Hepatitis B is infected through blood and sex. Hepatitis B viruses can also be found in tears, urine, gastric juice and breast milk. Recognized in good time, it can now be combated well with drugs that have improved enormously in recent years. Virus control can now be achieved in almost every patient. You can protect yourself against hepatitis B with a vaccination.
  • Hepatitis C - drug kits and tattoos

    The hepatitis C virus is transmitted through the blood, especially when sharing syringes. You can also get infected when sharing sniff tubes, rolled banknotes or pipes if your nasal mucous membranes bleed a little. There is a high risk of infection from unprofessional tattooing and piercing with contaminated needles. Hepatitis C is rarely transmitted through sex.
  • Well effective drugs

    Untreated hepatitis C often results in cirrhosis or liver cell cancer. In the past, only very aggressive interferon therapy against the virus helped. Better tolerated drugs have been approved in Germany since 2014. They intervene directly in the virus replication cycle. This can cure hepatitis C in 90 percent of the sick. A vaccination against the hepatitis C virus (HCV) is not yet available.
  • Hepatitis - this is how you recognize it

    Patients with hepatitis often feel exhausted, have indigestion and fever. After two to eight weeks, the jaundice phase usually follows with yellowing of the skin and the whites of the eyes. The enlarged liver causes tenderness under the right costal arch. In some patients, however, the infection is so mild that it is only discovered by chance when checking the liver values.
  • Other causes of hepatitis

    Hepatitis D and E are also viral infections. However, they are hardly widespread in this country. In addition to viral hepatitis, poisons are a common cause of hepatitis - especially alcohol. In individual cases, bacteria can also be the trigger or a rare autoimmune disease.

Hepatitis: causes and risk factors

In the vast majority of cases, hepatitis is a viral disease (Viral hepatitis). It is mainly caused by type A, B, C, D or E hepatitis viruses. All of them are notifiable.

Sometimes other viruses can also trigger what is usually milder viral hepatitis. This applies, for example, to the Epstein-Barr virus (Pfeiffer's glandular fever), cytomegalovirus (CMV infection), Coxsackie virus and herpes viruses. Then doctors speak of one Viral Hepatitis.

Occasionally, inflammation of the liver is the result of dysregulation of the immune system (Autoimmune hepatitis).

Are rarer bacteria like Leptospira (Leptospirosis), Brucella (Brucellosis) or Salmonella (Salmonellosis) as well Parasites (Causative agents of amoebic dysentery and malaria) trigger hepatitis.

At a toxic hepatitis on the other hand, alcohol is usually the "culprit". Doctors also speak of one here alcoholic fatty liver hepatitis (medical steatohepatitis, ASH). Excessive alcohol consumption damages the liver of those affected. As a result, more fat is stored and inflammation occurs. If you continue to drink alcohol, cirrhosis of the liver can develop.

There is also non-alcoholic fatty liver hepatitis (non-alcoholic steatohepatitis, NASH). For example, it is caused by obesity (obesity) or diabetes mellitus (diabetes).

An excess liver damaging drugs such as paracetamol or certain anesthetic gases (e.g. halothane) can also cause toxic hepatitis. The same applies Poisons like that of the death cap mushroom.

Chronic hepatitis results from existing acute hepatitis such as:

  • Hepatitis B, C, or D
  • toxic hepatitis (caused by certain drugs or alcohol, for example)
  • Autoimmune hepatitis
  • a liver disease caused by biliary stasis (cholestatic) such as inflammation of the internal and external bile ducts (primary sclerosing cholangitis)
  • liver disease originating in the internal bile ducts (primary biliary cirrhosis)

Furthermore you can congenital metabolic diseases cause chronic hepatitis. These include copper storage disease (Wilson disease) and iron storage disease (hemochromatosis).

In some cases of chronic liver inflammation, the cause can no longer be proven with certainty. The doctor can then only guess.

Hepatitis: transmission

The five most common forms of viral hepatitis (types A, B, C, D, and E) can be transmitted in different ways. In general, there is an increased risk of hepatitis infection in the following cases:

  • Drug addicts who inject the addictive substance into their veins and share the syringes among themselves
  • medical personnel who are often in contact with infected body exudates (such as blood) from patients
  • unprotected sexual intercourse, especially with frequently changing sexual partners
  • People who have their ears pierced, pierced or tattoos under non-sterile conditions
  • Travelers who are traveling in countries with poor hygienic conditions (especially applies to hepatitis A)
  • Babies born to mothers who are infected with hepatitis B or C (transmitted before or during birth)
  • Blood products (donor blood, blood coagulation factors, etc.) that are transmitted as a transfusion (since the introduction of strict controls in Germany only rarely a hepatitis transmission route)
  • Dialysis patients (if the dialysis machine has previously been used on a hepatitis patient and has not been thoroughly cleaned as prescribed)
Holiday season: high season for hepatitis
Germans catch most of the hepatitis A infections abroad. How to protect yourself on vacation. From Christiane Fux

Hepatitis: examinations and diagnosis

If you suspect liver inflammation, you should consult your general practitioner or internist. This will first be your in-depth discussion Collect medical history (Anamnese). He will have your complaints described in detail and inquire about possible liver-damaging influences. Possible questions from the doctor can include:

      • Do you drink alcohol? If so, which, how much and how long?
      • Do you have previous illnesses such as diabetes mellitus or cancer?
      • What do you do for a living? Have you come into contact with poisons such as carbon tetrachloride, vinyl chloride or phosphorus?
      • Are you taking medication such as acetaminophen, tetracyclines, methotrexate, isoniazid, rifampicin, or azathioprine?
      • Do you take drugs?
      • Did you have a blood transfusion?
      • Have you been abroad recently?
      • Have you had sexual contact with frequently changing partners?
      • Are there metabolic disorders such as Wilson's disease or a1-antitrypsin deficiency in the family?

The doctor will also ask you if your Weight has changed up or down. Also, tell him if you've been taking it lately Loss of appetite suffer or the The color of your stool and / or urine has changed. An important note can also be a increased tendency to bleed be. It can arise, for example, when the liver produces fewer blood clotting factors than normal due to a disease / damage.

Physical examination

The anamnesis will be followed by a physical examination. The doctor will palpate your stomach, among other things. If there is pressure pain in the right upper abdomen, this indicates a possible liver disease. When palpating, the doctor can also determine whether the liver and / or spleen are enlarged. He will also look for signs of jaundice during the exam.

To vaccinate or not? The fact check

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