{"id":774,"date":"2025-03-08T12:54:13","date_gmt":"2025-03-08T12:54:13","guid":{"rendered":"https:\/\/avo6.com\/?p=774"},"modified":"2025-03-08T12:54:14","modified_gmt":"2025-03-08T12:54:14","slug":"les-hepatites-virales-a-b-d-e","status":"publish","type":"post","link":"https:\/\/avo6.com\/?p=774","title":{"rendered":"Les H\u00e9patites Virales: A, B, D, E"},"content":{"rendered":"<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img loading=\"lazy\" width=\"675\" height=\"434\" src=\"https:\/\/avo6.com\/wp-content\/uploads\/2025\/03\/hepatite.jpg\" alt=\"H\u00e9patites Virales\" class=\"wp-image-776\" srcset=\"https:\/\/avo6.com\/wp-content\/uploads\/2025\/03\/hepatite.jpg 675w, https:\/\/avo6.com\/wp-content\/uploads\/2025\/03\/hepatite-365x235.jpg 365w\" sizes=\"(max-width: 675px) 100vw, 675px\" \/><\/figure><\/div>\n\n\n<h2>Introduction<\/h2>\n\n\n\n<ul><li>Les H\u00e9patites Virales sont caract\u00e9ris\u00e9 par une <strong>inflammation et n\u00e9crose h\u00e9patocellulaire<\/strong>,<\/li><li>H\u00e9patites <strong>A, B, D, E<\/strong> peuvent donner une h\u00e9patite grave <strong>fulminante<\/strong><\/li><li>Les h\u00e9patites <strong>B, C, D<\/strong> (co-virus du B) peuvent \u00e9voluer vers la <strong>chronicit\u00e9<\/strong> et le Carcinome h\u00e9pato cellulaire (<strong>CHC)<\/strong><\/li><\/ul>\n\n\n\n<h2><strong>H\u00e9patites Virales \u00e0 transmission ent\u00e9rale<\/strong><\/h2>\n\n\n\n<p><strong><a href=\"https:\/\/avo6.com\/?p=58\" title=\"\">H\u00e9patite A<\/a>\u00a0:<\/strong><\/p>\n\n\n\n<ul><li>La plus fr\u00e9quente, vir\u00e9mie br\u00e8ve<\/li><li>Transmission&nbsp;: ent\u00e9rale, sanguine, placentaire, sexuelle (homosexuelle)<\/li><li>Sujets jeunes<\/li><li>Cytolyse \u00e0 20 fois la normale<\/li><li>S\u00e9rologie&nbsp;: rechercher les Anticorps (AC) &nbsp;anti VHA de type IgM<\/li><\/ul>\n\n\n\n<p><strong>H\u00e9patite E&nbsp;:<\/strong><\/p>\n\n\n\n<ul><li>Vir\u00e9mie br\u00e8ve<\/li><li>Touche l\u2019adulte jeune<\/li><li>Mortalit\u00e9 \u00e9lev\u00e9 chez la femme au 3<sup>\u00e8me<\/sup>\u00a0 trimestre<\/li><li>Transmission\u00a0: ent\u00e9rale<\/li><li>S\u00e9rologie AC anti VHE de type IgM<\/li><\/ul>\n\n\n\n<h2><strong>H\u00e9patites Virales \u00e0 transmission parent\u00e9rale<\/strong><\/h2>\n\n\n\n<p><strong>H\u00e9patite B&nbsp;:<\/strong><\/p>\n\n\n\n<ul><li>Virus \u00e0 ADN<\/li><li>Souvent b\u00e9nigne 90% asymptomatique<\/li><li>Gravit\u00e9 li\u00e9e \u00e0 sa forme fulminante (0,1%) et au passage \u00e0 la chronicit\u00e9 (10%)<\/li><li>Incidence annuelle du CHC est de 3\u00e0 5%<\/li><li>Transmission\u00a0: placentaire, sexuelle, sanguine, salive lait maternelle (toutes les s\u00e9cr\u00e9tions biologique)<\/li><li>L\u2019Ag HBs est un Ag de surface, pr\u00e9sent en cas d\u2019infection aigue<\/li><li>L\u2019AC HBs marqueur de gu\u00e9rison totale<\/li><li>L\u2019Ag HBc constituant essentiel de la capside du virus\u00a0<\/li><li>L\u2019Ag HBc entraine la formation d\u2019AC IgM ou IgG<\/li><li>L\u2019Ag HBe marqueur de la r\u00e9plication virale<\/li><li>L\u2019Ag HBe est la forme soluble de l\u2019Ag HBc<\/li><\/ul>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img loading=\"lazy\" width=\"400\" height=\"324\" src=\"https:\/\/avo6.com\/wp-content\/uploads\/2025\/03\/hepatite-B.jpg\" alt=\"\" class=\"wp-image-775\" srcset=\"https:\/\/avo6.com\/wp-content\/uploads\/2025\/03\/hepatite-B.jpg 400w, https:\/\/avo6.com\/wp-content\/uploads\/2025\/03\/hepatite-B-365x296.jpg 365w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><\/figure><\/div>\n\n\n<p><strong>H\u00e9patite D&nbsp;:<\/strong><\/p>\n\n\n\n<ul><li>Co virus de l\u2019h\u00e9patite B qui est indispensable \u00e0 sa multiplication (enveloppe du virus D contient l\u2019AG Hbs)<\/li><li>Le vaccin du VHB prot\u00e8ge contre la VHD<\/li><li>Responsable d\u2019h\u00e9patites aigues fulminantes et de surinfection chez le porteur chronique<\/li><li>Transmission sanguine<\/li><li>S\u00e9rologie&nbsp;: AC anti HVD, +\/- AC anti HBc, Ag HBs,<\/li><\/ul>\n\n\n\n<p><strong>H\u00e9patite C&nbsp;:<\/strong><\/p>\n\n\n\n<ul><li>L\u2019h\u00e9patite post-transfusionnelle la plus fr\u00e9quente 90%<\/li><li>Evoluent dans 80% des cas vers la chronicit\u00e9, 30% \u00e9voluant vers la cirrhose<\/li><li>Incidence du CHC 3 \u00e0 5%<\/li><li>Transmission&nbsp;: sanguine, professionnelle, sexuelle<\/li><li>S\u00e9rologie&nbsp;: AC anti HCV (PCR)<\/li><\/ul>\n\n\n\n<h2>Manifestation clinique<\/h2>\n\n\n\n<ul><li><strong>Forme commune ict\u00e9rique&nbsp;:<\/strong><\/li><li>Phase d\u2019incubation&nbsp;<\/li><li>Phase pr\u00e9 ict\u00e9rique&nbsp;: syndrome pseudo grippal, asth\u00e9nie quasi constante, troubles digestifs, parfois triade de Caroli (c\u00e9phal\u00e9e, urticaire, arthralgie)<\/li><li>Phase ict\u00e9rique&nbsp;: ict\u00e8re + syndrome de chol\u00e9stase (prurit, urine fonc\u00e9, selle d\u00e9color\u00e9s)&nbsp; + syndrome de cytolyse constant<\/li><li>Phase de convalescence&nbsp;: recoloration des selles puis crise polyurique franche<\/li><\/ul>\n\n\n\n<ul><li><strong>H\u00e9patite fulminante\u00a0:<\/strong><\/li><li>H\u00e9patite aigue n\u00e9crosante entraine une insuffisance h\u00e9patique grave avec <a href=\"https:\/\/www.msdmanuals.com\/fr\/accueil\/troubles-du-foie-et-de-la-v%C3%A9sicule-biliaire\/manifestations-cliniques-des-maladies-du-foie\/enc%C3%A9phalopathie-h%C3%A9patique\" title=\"\">enc\u00e9phalopathie h\u00e9patique<\/a><\/li><li>80% mortelle<\/li><li>Histologie\u00a0: n\u00e9crose h\u00e9patocellulaire \u00e9tendue + atrophie h\u00e9patique<\/li><li>Effondrement du facteur V<\/li><li>Signes d\u2019alarmes\u00a0:<\/li><li>Douleurs abdominale<\/li><li>Reprise de l\u2019asth\u00e9nie ou de la fi\u00e8vre<\/li><li>Diminution de la matit\u00e9 h\u00e9patique<\/li><li>TP &lt; 50%<\/li><li>Enc\u00e9phalopathie h\u00e9patique\u00a0\u00a0<\/li><\/ul>\n\n\n\n<p>&#8211;&nbsp; stade 1&nbsp;: ast\u00e9rixis, inversion du rythme du sommeil<\/p>\n\n\n\n<p>&#8211;&nbsp; stade 2&nbsp;: confusion, agitation<\/p>\n\n\n\n<p>&#8211;&nbsp; stade 3&nbsp;: stupeur, patient souvent endormi<\/p>\n\n\n\n<p>&#8211;&nbsp; stade 4&nbsp;: coma h\u00e9patique<\/p>\n\n\n\n<p>EEG&nbsp;: ralentissement du rythme de base + apparition d\u2019ondes triphasiques<\/p>\n\n\n\n<h2>Traitement<\/h2>\n\n\n\n<p>Repos, arr\u00eat de tout m\u00e9dicament non indispensable (parac\u00e9tamol\u2026)<\/p>\n\n\n\n<ul><li><strong>H\u00e9patites &nbsp;A et E&nbsp;<\/strong>: traitement symptomatique<\/li><\/ul>\n\n\n\n<ul><li><strong>H\u00e9patite B <\/strong>aigue : symptomatique<\/li><\/ul>\n\n\n\n<ul><li><strong>H\u00e9patite C&nbsp;<\/strong>aigue : interf\u00e9ron<\/li><\/ul>\n\n\n\n<ul><li><strong>H\u00e9patite fulminante&nbsp;:<\/strong> hospitalisation en r\u00e9animation, symptomatique, transplantation h\u00e9patique.<\/li><\/ul>\n\n\n\n<h2><strong>Prophylaxie<\/strong><\/h2>\n\n\n\n<ol type=\"1\"><li><strong>H\u00e9patite ent\u00e9rales&nbsp;:<\/strong><\/li><li>Mesures d\u2019hygi\u00e8nes<\/li><li>S\u00e9roth\u00e9rapie&nbsp;: r\u00e9alis\u00e9e dans les deux semaines qui suivent la contagion possible pour les personnes en contact<\/li><\/ol>\n\n\n\n<ul><li><strong>H\u00e9patites parent\u00e9rales&nbsp;:<\/strong><\/li><\/ul>\n\n\n\n<ul><li><strong>H\u00e9patite B, D\u00a0:<\/strong><\/li><li>hygi\u00e8ne et pr\u00e9cautions<\/li><li>immunisation passive\u00a0: injection imm\u00e9diate d\u2019Ig anti HBs<\/li><li>accident d\u2019exposition au sang<\/li><li>Nouveau N\u00e9e de m\u00e8re porteuse HVB<\/li><li>Rapport sexuel avec sujet fortement contagieux<\/li><\/ul>\n\n\n\n<p><a href=\"https:\/\/avo6.com\/?p=66\" title=\"\">vaccination\u00a0<\/a>: 2 injection 1 mois d\u2019intervalle + rappel a 6 mois (programme national)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Introduction Les H\u00e9patites Virales sont caract\u00e9ris\u00e9 par une inflammation et n\u00e9crose h\u00e9patocellulaire, H\u00e9patites A, B, D, E peuvent donner une&hellip;<\/p>\n","protected":false},"author":1,"featured_media":776,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0},"categories":[3],"tags":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts\/774"}],"collection":[{"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=774"}],"version-history":[{"count":1,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts\/774\/revisions"}],"predecessor-version":[{"id":777,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts\/774\/revisions\/777"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/media\/776"}],"wp:attachment":[{"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=774"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=774"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=774"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}