Degrees of hepatitis activity signs, markers, diagnosis and treatment

The hepatitis virus enters the human body unnoticed. A person still does not know anything about his infection, and the disease is already taking over the body, inflicting fatal blows on it. The main negative effect the diagnosis has on one of the most vital organs – the liver.

The degree of activity of hepatitis can vary from minimal to high. It is determined by the doctor based on the analysis of patient examinations. The degree of activity of hepatitis depends on what therapy the patient needs to be prescribed.

Also, based on this indicator, it is possible to predict what damage to the body was caused by the diagnosis, and whether a person’s full recovery is possible.

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Markers of hepatitis

When the hepatitis virus settles in the human body and begins to spread the effect through the systems and organs, the infected person still feels good, not even suspecting the danger hanging over him. At this time, the only possible way to identify the disease is with the help of a blood test.

Also, according to the blood test, the doctors make the final conclusion and confirmation of the diagnosis, when the symptoms of the disease become completely obvious, a concomitant numerous syndrome appears, but you need to make sure that it is hepatitis that dominates the body or establish its classification of the disease.

The so-called markers of hepatitis – antibodies that the body produces against the virus, can say that a diagnosis is present.

Depending on which marker is determined in the blood of a person, the doctor will draw a conclusion from them about which group the hepatitis belongs to in this patient, or it is of unspecified etiology. With the help of markers and the presence of antibodies, it is possible to understand in what form the disease at this stage is – in acute or sluggish.

Also, these indicators will tell that a person, in the absence of a disease, is a carrier of the virus, as well as that the patient has ever been ill with this virus.

Activity levels

As soon as the tests and other necessary examinations have confirmed that a person has hepatitis of a certain group, mixed or specific etiology, the doctor determines the degree of activity of this disease based on various indicators.

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Active hepatitis can be of four main types: minimal, low, moderate, and high.

A classification is determined by the degree of activity on the basis of a blood test, palpation, examination and questioning of the patient, as well as a biopsy study of liver tissue, which will show how seriously the liver has suffered.

The degree of activity of chronic hepatitis depends on the stage at which the virus is in the human body at this stage.

At the stage of viral replication, it does not yet fully dominate the body, and the body is ready to fight against the disease. But during the transition to the stage of integration, the genome of the disease is incorporated into the cells, and then the disease will most likely remain with the patient forever.

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Minimally active hepatitis – the name speaks for itself. With this degree of development of the virus, its carrier, most likely, does not feel any discomfort and does not suspect the presence of the disease.

Only occasionally does chronic viral hepatitis B with a minimal degree of activity make itself felt. An infected person starts nausea, often ending with vomiting, diarrhea is possible.

The patient loses all desire to eat, loses mood, he has a depressive state, a state of apathy, depression and incessant fatigue.


Signs of low activity of this disease do not differ much from hepatitis with minimal activity. Almost everything is the same: the patient feels great, only sometimes symptoms of the disease appear – no appetite, nausea, vomiting, excessive fatigue, loss of strength.

However, hepatitis of the second degree has already dealt a decent enough blow to the liver, and this will be shown by an analysis of the histology of organ tissues. In addition, when hepatitis of low activity develops, the doctor will be alerted by an overestimated level in the patient’s blood of ALT, ASAT, immunoglobulins and proteins.


Doctors state that hepatitis with a moderate degree of activity has the highest prevalence. And here the symptoms are already more pronounced. In addition to nausea with vomiting and a stronger indifference to food, excessive sleepiness and even greater fatigue are added.

The head begins to hurt badly and often, and the patient first feels discomfort and pressure, and then serious cuts in the liver area – under the ribs on the right side.


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The most difficult and tangible for the patient is the degree of disease activity. Active hepatitis of a high degree shows itself as symptoms of all the above degrees. That is, the patient develops nausea, followed by vomiting, diarrhea. The patient has absolutely no desire to take food, and in general to show any activity.

Drowsiness, fatigue, an apathetic state prevail over him – nothing pleases a person. In addition, in this case, the liver hurts more noticeably. Feelings of discomfort and pressure in the area of ​​this organ are transformed into sharp colic, pain, cramps and lumbago.

Also, during the development of this phase of the disease, the so-called jaundice appears – a yellow color of the integument of the skin, as well as the whites of the eyes, occurs. Subsequently, the patient begins to experience severe itching. In the most serious scenario, there is a fever.

The liver itself undergoes significant changes – it grows seriously in size. It can already be easily felt with hands during palpation, even for people without medical education. Following the liver, the pancreas also increases.

When conducting biochemical blood tests, the results may even shock doctors – with a high degree of activity, the ALT and ASAT indices increase from the norm by ten or more times, bilirubin and immunoglobulin also deviate from the norm upwards, the correct algorithm of protein metabolism is destroyed.

Cholestasis syndrome

Active viral hepatitis can also manifest itself as cholestasis syndrome. This subtype of the disease can also be called an atypical manifestation of the diagnosis. Because some signs appear here in reverse chronological order.

So, for example, at first there is an itching of the skin, and after a while, the skin turns yellow. When, as with other degrees and classifications of hepatitis, everything happens exactly the opposite.

In this case, the liver is enlarged, but not by much, and only an experienced, knowledgeable specialist can understand this by probing. But in general, the health and condition of an infected person with such a development of the disease is quite bearable.

It will be possible to understand that a person has hepatitis at this stage only by analysis. Moreover, even the usual superficial blood test will immediately alert the doctor. Indeed, with cholestasis syndrome, blood indices deviate sharply from the usual indicators.

Moreover, despite the apparent external well-being during the course of this class of disease, the forecasts here are quite difficult and even dangerous. This syndrome can very quickly transform into biliary cirrhosis, which is practically not amenable to therapy. And then the disease ends with the death of the patient.

Activity diagnostics

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Active hepatitis with any degree is diagnosed by a whole complex of tests, examinations and examinations of the patient. Only a complete study will give a complete clinical picture of the disease and tell about its degree of activity.

So hepatitis C with minimal activity will appear on a blood test for hepatic parameters, markers of hepatitis and immunoglobulin. And the higher the degree of disease activity, the more these indicators deviate from the norm.

In addition, liver biopsy studies will show the disease class. Here the logic is the same: the higher the degree of activity, the more damage hepatitis inflicted on this organ, and this will be noticeable when analyzing tissues.

Treatment depending on the degree of activity

Active hepatitis is treated in almost the same way. Treatment, depending on the degree of viral activity in the human body, differs mainly in the duration of therapy.

With the minimum degree of hepatitis activity, the prognosis in terms of cure is the most favorable. In this case, doctors prescribe antiviral drugs, as well as drugs that suppress the action of leukocytes. In addition, the doctor with this type of disease will prescribe drugs that restore damaged liver tissue.

According to medical statistics, moderate hepatitis is more common than others. So in this case, along with other means, drugs are also prescribed to remove accumulated toxins from the human body.

If the patient is diagnosed with the highest degree of activity, all of the above drugs are prescribed, plus painkillers are usually a plus, since this degree is accompanied by serious pains – headaches and in the liver.

Regardless of what degree of activity of the virus has to be treated, along with drug therapy, the doctor will prescribe a certain diet that will reduce the load of external factors on the liver.

The patient will need to give up alcohol, even a small strength, fried in oil, as well as fatty, smoked, overly salty and very sweet. In some particularly difficult cases, such restrictions will have to be adhered to for the rest of your life.

Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.