{"id":8518,"date":"2016-11-25T08:47:29","date_gmt":"2016-11-25T07:47:29","guid":{"rendered":"http:\/\/www.fjala.info\/?p=8518"},"modified":"2021-06-01T03:44:50","modified_gmt":"2021-06-01T01:44:50","slug":"hepatiti-b-nje-semundje-vrasese-e-heshtur","status":"publish","type":"post","link":"https:\/\/jehonashqiptare.al\/fjala\/hepatiti-b-nje-semundje-vrasese-e-heshtur\/","title":{"rendered":"Hepatiti B \u2013 Nj\u00eb s\u00ebmundje vras\u00ebse e \u201cheshtur\u201d"},"content":{"rendered":"

WeSpeakScience.com<\/strong><\/a>, 14 n\u00ebntor 2016<\/em><\/p>\n

Hepatiti \u00ebsht\u00eb nj\u00eb s\u00ebmundje inflamatore e m\u00ebl\u00e7is\u00eb. S\u00ebmundja e hepatitit shkaktohet prej viruseve t\u00eb hepatitit. Njihen 5 tipe virusesh t\u00eb hepatitit: virusi i hepatit A (HAV-Hepatitis A Virus), virusi i hepatit B(HBV), virusi i hepatit C (HCV), virusi i hepatit D (HDV) dhe virusi i hepatit E (VHE); sipas t\u00eb cil\u00ebve s\u00ebmundja merr dhe emrin. Hepatiti n\u00eb aspektin epidemiologjik ndahet n\u00eb: a) hepatiti i cili bartet n\u00eb m\u00ebnyr\u00eb orale nga ushqimet e kontaminuara, k\u00ebtu b\u00ebn pjes\u00eb lloji i hepatiti A dhe E, t\u00eb cil\u00ebt kan\u00eb nj\u00eb periudh\u00eb t\u00eb shkurt\u00ebr t\u00eb inkubimit, nga 15-45 dit\u00eb; b) hepatiti i cili bartet gjat\u00eb kontaktit seksual apo kontaktit me gjak t\u00eb infektuar, ose l\u00ebngje t\u00eb tjera t\u00eb trupit, k\u00ebtu b\u00ebn\u00eb pjes\u00eb loji i hepatiti B dhe C, t\u00eb cil\u00ebt karakterizohen nga nj\u00eb periudh\u00eb m\u00eb e gjat\u00eb e inkubimit, deri n\u00eb 6 muaj.<\/p>\n

Hepatiti B \u00ebsht\u00eb nj\u00eb infeksion i m\u00ebl\u00e7is\u00eb, potencialisht i rreziksh\u00ebm p\u00ebr jet\u00ebn e individit. Ai \u00ebsht\u00eb nj\u00eb nd\u00ebr shkaktar\u00ebt e shumt\u00eb t\u00eb inflamacionit apo zmadhimit t\u00eb m\u00ebl\u00e7is\u00eb dhe p\u00ebr m\u00eb tep\u00ebr t\u00eb hepatitit kronik. Hepatiti B \u00ebsht\u00eb i shp\u00ebrndar\u00eb n\u00eb mbar\u00eb globin por, prevalenca m\u00eb e lart\u00eb e tij \u00ebsht\u00eb e p\u00ebrqendruar n\u00eb Afrik\u00ebn sub-Sahariane dhe Azin\u00eb Lindore. Statistikat tregojn\u00eb se 5-10% e popullsis\u00eb s\u00eb rritur n\u00eb k\u00ebto zona kan\u00eb hepatit B kronik. Shkalla e lart\u00eb e infeksioneve kronike jan\u00eb gjetur edhe n\u00eb Amazon\u00eb dhe pjes\u00ebt jugore t\u00eb Evrop\u00ebs Lindore dhe Qendrore; n\u00eb Lindjen e Mesme dhe n\u00ebn kontinentin Indian rreth 2-5% e popullsis\u00eb s\u00eb p\u00ebrgjithshme \u00ebsht\u00eb e infektuar me llojin kronik, dhe m\u00eb pak se 1% e popullsis\u00eb s\u00eb Evrop\u00ebs Per\u00ebndimore dhe Amerik\u00ebs s\u00eb Veriut ka infeksion kronik gjithashtu.<\/p>\n

\"\"Figura 1 Prevalenca e Hepatit B n\u00eb bot\u00eb, sipas statistikave t\u00eb vitit 2016, nga CDC.<\/em><\/span><\/p>\n

Transmetimi<\/strong><\/p>\n

S\u00ebmundja zakonisht fillon si nj\u00eb hepatit B akut dhe m\u00eb pas kthehet n\u00eb kronike. Virusi i hepatitit B mund t\u00eb mbijetoj\u00eb jasht\u00eb trupit p\u00ebr t\u00eb pakt\u00ebn 7 dit\u00eb. Gjat\u00eb k\u00ebsaj kohe, virusi ende mund t\u00eb shkaktoj\u00eb infeksion n\u00eb qoft\u00eb se ai hyn n\u00eb trupin e nj\u00eb personi t\u00eb sh\u00ebndetsh\u00ebm dhe q\u00eb nuk \u00ebsht\u00eb i vaksinuar. Periudha e inkubacionit t\u00eb virusit t\u00eb hepatitit B \u00ebsht\u00eb mesatarisht 75 dit\u00eb, por mund t\u00eb ndryshoj\u00eb nga 30 deri n\u00eb 180 dit\u00eb. Virusi mund t\u00eb zbulohet brenda 30 deri n\u00eb 60 dit\u00eb pas infektimit, dhe mund t\u00eb vazhdoj\u00eb t\u00eb zhvilloj\u00eb infeksion kronik t\u00eb HBV. Virusi i hepatitit B mund t\u00eb transmetohet (p\u00ebrhapet) n\u00eb disa m\u00ebnyra:<\/p>\n

N\u00eb zonat shum\u00eb endemike, hepatiti B m\u00eb s\u00eb shpeshti p\u00ebrhapet nga n\u00ebna tek f\u00ebmija gjat\u00eb lindjes (transmetimi perinatal), apo n\u00ebp\u00ebrmjet transmetimit horizontale (ekspozimit t\u00eb gjakut t\u00eb infektuar), sidomos nga nj\u00eb f\u00ebmij\u00eb i infektuar tek nj\u00eb f\u00ebmij\u00eb i pa infektuar, gjat\u00eb 5 viteve t\u00eb para t\u00eb jet\u00ebs.<\/p>\n

Hepatiti B p\u00ebrhapet edhe nga ekspozimi perkutan ose mukozal ndaj gjakut t\u00eb infektuar dhe l\u00ebngjeve t\u00eb ndryshme t\u00eb trupit, si: sekrecionet vaginale, sekrecione nazale, sekrecionet nga syt\u00eb, p\u00ebshtyma dhe djersa.<\/p>\n

Transmetimi seksual i hepatitit B mund t\u00eb ndodh sidomos n\u00ebse nj\u00eb person kryen marr\u00ebdh\u00ebnie seksuale t\u00eb pambrojtur me nj\u00eb person t\u00eb prekur nga HBV, ose me shum\u00eb partner\u00eb seksual\u00eb. Apo, kur nj\u00eb mashkull i pa vaksinuar kryen marr\u00ebdh\u00ebnie seksuale me meshkujt t\u00eb tjer\u00eb.<\/p>\n

Transmetimi i virusit mund t\u00eb ndodh\u00eb edhe me an\u00eb t\u00eb rip\u00ebrdorimit t\u00eb ageve\/shiringave, t\u00eb makin\u00ebs rroje, brisqeve, limave e prer\u00ebseve t\u00eb thonjve, fur\u00e7ave t\u00eb dh\u00ebmb\u00ebve dhe \u00e7do objekt tjet\u00ebr q\u00eb e p\u00ebrdorim me t\u00eb infektuarin, e q\u00eb mund t\u00eb p\u00ebr\u00e7oj\u00eb nj\u00eb njoll\u00eb t\u00eb vog\u00ebl gjaku n\u00ebp\u00ebrmjet t\u00eb \u00e7arave t\u00eb l\u00ebkur\u00ebs.<\/p>\n

P\u00ebrve\u00e7 k\u00ebsaj, infeksioni mund t\u00eb ndodh nga pajisje q\u00eb nuk jan\u00eb sterilizuar si\u00e7 duhet gjat\u00eb procedurave mjek\u00ebsore (si transfuzioneve, dializa), kirurgjikale dhe dentare, p\u00ebrmes tatuazheve, ose piercing (shpime n\u00eb trup).
\nEkspert\u00ebt e mjek\u00ebsis\u00eb pohojn\u00eb se virusi i hepatitit B nuk p\u00ebrhapet nga teshtima ose nga kolla, puthjet n\u00eb faqe, prekja e duarve, p\u00ebrqafimi, qum\u00ebshti i gjirit, p\u00ebrdorimi i mjeteve t\u00eb nj\u00ebjta t\u00eb kuzhin\u00ebs.<\/p>\n

Shenjat klinike<\/strong><\/p>\n

Shenjat klinike t\u00eb hepatitit B varen nga lloji i infeksionit akut apo kronik;<\/p>\n

1) Infeksioni akut: ku shumica e njer\u00ebzve nuk shfaqin asnj\u00eb shenj\u00eb gjat\u00eb faz\u00ebs akute t\u00eb infeksionit, megjithat\u00eb, disa njer\u00ebz me infeksion akut shfaqin shenja klinike q\u00eb zgjasin disa jav\u00eb duke p\u00ebrfshir\u00eb zverdhjen e l\u00ebkur\u00ebs dhe syve (verdh\u00ebz), urina e err\u00ebt, lodhje ekstreme, t\u00eb p\u00ebrzier, t\u00eb vjella, humbje e oreksit, ethe dhe dhimbje barku. Pastaj, s\u00ebmundja gradualisht p\u00ebrmir\u00ebsohet tek shumica e njer\u00ebzve t\u00eb prekur; kjo sepse n\u00eb hepatitin akut ndeshen n\u00eb t\u00eb nj\u00ebjt\u00ebn koh\u00eb si ndryshimet degjenerative dhe rigjeneruese t\u00eb parenkim\u00ebs, ashtu dhe grumbullimi i qelizave inflamatore mononukleare.<\/p>\n

Hepatocitet i n\u00ebnshtrohen degjenerimit balonizues, d\u00ebmtimi i hepatociteve (qelizat e m\u00ebl\u00e7is\u00eb) \u00e7on n\u00eb: a) prishjen e kanalikulave dhe retension t\u00eb bil\u00ebs, b) qelizat e shkat\u00ebrruara, rrethohen nga qelizat Kupffer-it dhe i n\u00ebnshtrohen fagocitoz\u00ebs. Mund t\u00eb kemi hipertrofi dhe hiperplazi por, indi hepatit i d\u00ebmtuar rigjenerohet dhe sh\u00ebrohet brenda 8-12 jav\u00ebsh. Megjithat\u00eb, nj\u00eb n\u00ebngrup i vog\u00ebl i personave me hepatit akut mund t\u00eb zhvillojn\u00eb nj\u00eb hepatit fulminant dhe q\u00eb p\u00ebrfundojn\u00eb me vdekje.<\/p>\n

2) Infeksioni kronik: ku prezenca e virusit detektohet nga testet laboratorike dhe shoq\u00ebrohet me inflamacion t\u00eb m\u00ebl\u00e7is\u00eb. Tek disa njer\u00ebz infeksioni kronik i hepatitit B m\u00eb von\u00eb mund t\u00eb \u00e7oj\u00eb n\u00eb ciroz\u00eb t\u00eb m\u00ebl\u00e7is\u00eb ose kancer t\u00eb m\u00ebl\u00e7is\u00eb. Kush \u00ebsht\u00eb n\u00eb rrezik p\u00ebr s\u00ebmundje kronike? Gjasat q\u00eb infeksioni t\u00eb b\u00ebhet kronik varen nga mosha n\u00eb t\u00eb cil\u00ebn nj\u00eb person infektohet me HBV. K\u00ebshtu m\u00eb t\u00eb predispozuar p\u00ebr t\u00eb zhvilluar infeksione kronike jan\u00eb:<\/p>\n

30-50% e f\u00ebmij\u00ebve t\u00eb infektuar me HBV para mosh\u00ebs 6 vje\u00e7
\n80-90% e foshnjave t\u00eb infektuara gjat\u00eb vitit t\u00eb par\u00eb t\u00eb jet\u00ebs
\nm\u00eb pak se 5% e personave t\u00eb sh\u00ebndetshme q\u00eb jan\u00eb t\u00eb infektuar me HBV n\u00eb mosh\u00eb t\u00eb rriturit
\n20-30% e t\u00eb rriturve t\u00eb cil\u00ebt jan\u00eb t\u00eb infektuar kronik\u00eb do t\u00eb zhvillojn\u00eb ceroz\u00eb dhe \/ ose kancer t\u00eb m\u00ebl\u00e7ise.<\/p>\n

\"\"Figura 2 Progresi i s\u00ebmundjes s\u00eb Hepatit B<\/em><\/span><\/p>\n

Diagnoza<\/b><\/p>\n

Nuk \u00ebsht\u00eb e mundur dallimi klinik i hepatitit B nga hepatiti i shkaktuar nga agjent\u00ebt e tjer\u00eb viral dhe k\u00ebshtu konfirmimi laboratorik i diagnoz\u00ebs \u00ebsht\u00eb thelb\u00ebsor. Nj\u00eb num\u00ebr i testeve t\u00eb gjakut jan\u00eb n\u00eb dispozicion p\u00ebr t\u00eb diagnostikuar dhe monitoruar njer\u00ebzit me hepatitin B.<\/p>\n

Ekzaminimet kryesore q\u00eb kryhen p\u00ebr vendosjen e diagnoz\u00ebs p\u00ebrfshijn\u00eb:<\/p>\n

Ekzaminimet me an\u00eb t\u00eb mikroskopis\u00eb elektronike vihen re grimcat virale n\u00eb b\u00ebrtham\u00ebn e hepatociteve.
\nImunofluoreshenca evidenton pranin\u00eb e HBcAg n\u00eb b\u00ebrtham\u00ebn e hepatociteve, nd\u00ebrsa HBsAg n\u00eb citoplazm\u00eb. Qeliza hepatike nuk \u00ebsht\u00eb e vetmja q\u00eb d\u00ebmtohet nga virusi i hepatitit B, sepse sekuenca e ADN-s\u00eb s\u00eb HBV jan\u00eb gjetur edhe n\u00eb qelizat e palc\u00ebs s\u00eb kockave e n\u00eb limfocitet e gjakut periferik.<\/p>\n

Testet serologjike ku b\u00ebhet p\u00ebrcaktimi i antigjen\u00ebve viral t\u00eb virusit t\u00eb hepatitit B. Prania e antigjenit sip\u00ebrfaq\u00ebsor t\u00eb HBV (HBsAg) n\u00eb serum \u00ebsht\u00eb tregues i infeksionit akut apo kronik i HBV. Antigjeni e i HBV (HBeAg) prania e tij n\u00eb serum \u00ebsht\u00eb tregues i replikimit viral. N\u00eb k\u00ebt\u00eb faz\u00eb i s\u00ebmuri \u00ebsht\u00eb shum\u00eb infektiv, sepse n\u00eb gjakun e tij ka nj\u00eb p\u00ebrqendrim shum\u00eb t\u00eb lart\u00eb t\u00eb grimcave virale. Antitrupat anti \u2013HBc jan\u00eb imunoglobulinat IgM e IgG. Prania e anti\u2013HBc IgM n\u00eb serum \u00ebsht\u00eb tregues i replikimit viral dhe me sh\u00ebrimin e pacientit do t\u00eb zhduken. Kurse anti \u2013HBc IgG shfaqen m\u00eb von\u00eb se anti \u2013HBc IgM dhe vlerat e tij q\u00ebndron e lart\u00eb gjat\u00eb gjith\u00eb jet\u00ebs. Antitrupat anti- HBe prania e tyre n\u00eb serum tregon r\u00ebnien e replikim viral dhe fillimin e sh\u00ebrimit t\u00eb s\u00ebmundjes. Antitrupat HBs q\u00ebndrojn\u00eb me tit\u00ebr t\u00eb lart\u00eb gjat\u00eb gjith\u00eb jet\u00ebs. Prania e tyre n\u00eb serum tregon se pacienti \u00ebsht\u00eb sh\u00ebruar dhe ka fituar imunitet.<\/p>\n

Infeksioni akut HBV \u00ebsht\u00eb i karakterizuar nga prania e HBsAg n\u00eb serum dhe anti-HBc IgM \u00ebsht\u00eb pozitive. Gjat\u00eb faz\u00ebs fillestare t\u00eb infeksionit, pacient\u00ebt jan\u00eb gjithashtu seropozitiv p\u00ebr antigjenin e hepatitit B (HBeAg). HBeAg \u00ebsht\u00eb zakonisht nj\u00eb marker i niveleve t\u00eb larta t\u00eb replikimit t\u00eb virusit HBV. Prania e HBeAg tregon se gjaku dhe l\u00ebngjet e trupit t\u00eb individit t\u00eb infektuar jan\u00eb shum\u00eb ngjit\u00ebse.<\/p>\n

Infeksioni kronik HBV karakterizohet nga prania e vazhdueshme e HBsAg p\u00ebr t\u00eb pakt\u00ebn 6 muaj (me ose pa bashkekzistenc\u00ebn e HBeAg). Prania e vazhdueshme e HBsAg n\u00eb serum \u00ebsht\u00eb tregues kryesor i rrezikut p\u00ebr zhvillimin e m\u00ebvonsh\u00ebm t\u00eb s\u00ebmundjeve kronike t\u00eb m\u00ebl\u00e7is\u00eb dhe kancerit t\u00eb m\u00ebl\u00e7is\u00eb. P\u00ebr infeksionet kronike, rekomandohet t\u00eb kryen analiza \u201cscreening\u201d: t\u00eb gjitha grat\u00eb shtatz\u00ebna, personat e lindur n\u00eb rajonet me norma t\u00eb nd\u00ebrmjetme apo t\u00eb larta t\u00eb Hepatitit B (prevalenca e HBsAg \u22652%); n\u00eb SHBA, personat q\u00eb nuk jan\u00eb vaksinuar n\u00eb f\u00ebmij\u00ebri dhe kan\u00eb prind\u00ebr q\u00eb kan\u00eb lindur n\u00eb rajonet me norma t\u00eb larta t\u00eb Hepatiti B (prevalenca e HBsAg \u22658%); foshnjat e lindura nga n\u00ebnat me HBsAg pozitiv; personat q\u00eb kan\u00eb kontakt me persona me HBsAg pozitiv; meshkuj q\u00eb kryejn\u00eb seks me meshkuj; p\u00ebrdoruesit e drog\u00ebs me injeksion; pacient\u00ebt me nivele t\u00eb larta t\u00eb transaminazave (ALT \/ AST) q\u00eb nuk iu dihet shkaku; pacient\u00ebt n\u00eb hemodializ\u00eb; personat q\u00eb kan\u00eb nevoj\u00eb imunosupresiv ose terapi citotoksike; personat e infektuar me HIV; dhe donator\u00ebt e gjakut, plazmave, organeve, indeve ose sperm\u00ebs.<\/p>\n

Testet e Biologjis\u00eb molekulare \u2013 Me an\u00eb t\u00eb testit PCR p\u00ebrcaktohet ADN virale n\u00eb serumin e pacientit t\u00eb infektuar me HBV e quajtur ndryshe ngarkesa virale. Edhe pse ngarkesa virale rezulton e rritur qysh para shfaqjes s\u00eb HBsAg, n\u00eb qarkullim, ky test pothuajse nuk p\u00ebrdoret n\u00eb diagnostikimin e infeksionit akut me HBV, por p\u00ebr t\u00eb vler\u00ebsuar gjendjen e pacientit t\u00eb infektuar dhe p\u00ebr t\u00eb monitoruar trajtimin.
\nTestet biokimike: N\u00eb diagnostikimin e hepatit B ndihmojn\u00eb edhe p\u00ebrcaktimi i analizave t\u00eb tjera, si\u00e7 jan\u00eb hemogrami, trasaminazat (ALT, AST, GGT) dhe bilirubinat.<\/p>\n

Biopsia<\/strong><\/p>\n

\"\"Figura 3 Rezultatet e mundshme pas infeksionit t\u00eb hepatitit B;
\nA. infeksion akut; B. infeksion kronik.<\/em><\/span><\/p>\n

Terapia e Hepatitit B<\/strong><\/p>\n

Q\u00ebllimet e trajtimit p\u00ebr infeksionin kronik t\u00eb hepatitit B jan\u00eb: 1) suspension i replikimit viral, 2) statusi i serokonversionit n\u00eb anti-HBs pozitiv, anti-HBe pozitiv, ADN HBV negative, 3) p\u00ebrmir\u00ebsimi n\u00eb nekroinflamacionin hepatik, dhe 4) reduktimi i infeksionit HBV, pa kalim n\u00eb gjendje si cirroza apo kanceri i m\u00ebl\u00e7is\u00eb.<\/p>\n

Sipas t\u00eb dh\u00ebnave t\u00eb publikuara nga Johns Hopkins Medicine, Interferoni alfa-2b \u00ebsht\u00eb i vetmi produkt interferonesh i aprovuar nga FDA p\u00ebr trajtimin e hepatit B. Doza e rekomanduar \u00ebsht\u00eb 5 milion\u00eb nj\u00ebsi, aplikuar n\u00ebn-l\u00ebkur\u00eb, 5 her\u00eb n\u00eb jav\u00eb, p\u00ebr 4 muaj. Kjo \u00ebsht\u00eb shoq\u00ebruar me p\u00ebrfitim histologjik kryesisht n\u00eb pacient\u00ebt me humbjen e HBeAg n\u00eb serum. Megjithat\u00eb, shumica e pacient\u00ebve nuk e humbasin as HBeAg dhe as HBsAg (Figura 5).<\/p>\n

\"\"Figura 4 Mekanizmi i veprimit t\u00eb interferonit<\/em><\/span><\/p>\n

Koh\u00ebt e fundit, FDA ka aprovuar nj\u00eb analog sintetik nukleozid\u00eb, preparatin Lamivudine (Epivir-HBV\u2122), p\u00ebr p\u00ebrdorim tek pacient\u00ebt me infeksion kronik t\u00eb hepatitit B lidhur me provat e replikimit viral dhe inflamacionin aktiv t\u00eb m\u00ebl\u00e7is\u00eb. Preparati Lamivudine pengon aktivitetin e HBV polimeraz\u00ebs revers transkriptaz\u00eb duke rezultuar n\u00eb nd\u00ebrprerjen e zinxhirit t\u00eb porsa sintetizuar t\u00eb ADN-s\u00eb s\u00eb HBV. Ky preparat ka treguar q\u00eb ka gjithashtu aktivitet kund\u00ebr virusit t\u00eb imunodeficienc\u00ebs humane (HIV).<\/p>\n

Studimet paraklinike tregojn\u00eb nj\u00eb profil t\u00eb k\u00ebnaqsh\u00ebm t\u00eb siguris\u00eb, pa asnj\u00eb evidenc\u00eb t\u00eb mutagjeneciteti, kancerogjeneciteti, ose potencial teratogjenik. Lamivudine (Epivir-HBV \u2122) \u00e7on n\u00eb reduktim t\u00eb doz\u00ebs s\u00eb lidhur me nivele te ADN-s\u00eb s\u00eb HBV, pas p\u00ebrthithjes nga goja, me nj\u00eb efekt equimaximal n\u00eb doza m\u00eb t\u00eb m\u00ebdha se 100 mg \/ dit\u00eb. Lamivudin mund merret p\u00ebr nj\u00eb vit. Megjithat\u00eb ky preparate ka treguar se ka shum\u00eb \u201ckompleksite\u201d dhe paraqet nevoj\u00ebn p\u00ebr trajtime t\u00eb tjera n\u00eb ardhmen q\u00eb zgjidhin k\u00ebto \u00e7\u00ebshtje. N\u00eb t\u00eb v\u00ebrtet\u00eb sipas studimeve paraprake, trajtimi i kombinuar lamivudin\u00ebn me interferon duket se p\u00ebrmir\u00ebson rezultatet e pacient\u00ebve me hepatit B.<\/p>\n

S\u00eb fundi, nj\u00eb krahasim i kombinimeve t\u00eb shum\u00ebfishta t\u00eb preparateve (“koktej” HBV) kundrejt analog\u00ebt vijues nukleozid\u00eb (p.sh. Adefovirdipivoxil , Famciclovir, etj), \u00ebsht\u00eb i nevojsh\u00ebm p\u00ebr t\u00eb p\u00ebrcaktuar strategjit\u00eb m\u00eb t\u00eb mira afatgjate t\u00eb trajtimit p\u00ebr infeksionin kronik t\u00eb hepatitit B. Ky trajtim mund t\u00eb merret me preparate analoge nukleozidike p\u00ebr nj\u00eb vit.<\/p>\n

Gjithashtu trajtimi tjet\u00ebr \u00ebsht\u00eb transplanti i m\u00ebl\u00e7is\u00eb. Hepatiti B mund t\u00eb d\u00ebmtoj\u00eb shum\u00eb r\u00ebnd\u00eb m\u00ebl\u00e7in\u00eb tuaj, sa ajo nuk mund t\u00eb kryej asnj\u00eb funksion, n\u00eb k\u00ebt\u00eb rast e vetmja mund\u00ebsi trajtimi \u00ebsht\u00eb transplanti.<\/p>\n

Me kalimin e koh\u00ebs, normat e mbijetes\u00ebs jan\u00eb rritur dhe normat e p\u00ebrs\u00ebritje s\u00eb infeksioneve t\u00eb HBV kan\u00eb r\u00ebn\u00eb q\u00eb pas transplantit t\u00eb m\u00ebl\u00e7is\u00eb. Disponueshm\u00ebria e analog\u00ebt nukleozid\u00eb mund t\u00eb p\u00ebrmir\u00ebsoj\u00eb m\u00eb tej rezultatet n\u00eb periudh\u00ebn e post-transplantit.<\/p>\n

V\u00ebmendje trajtimi duhet t\u00eb b\u00ebhet vet\u00ebm sipas udh\u00ebzimeve t\u00eb mjekut.<\/p>\n

Parandalimi\u2013 Forma m\u00eb e mir\u00eb para ndaluese \u00ebsht\u00eb vaksinimi. Vaksina e Hepatitit B \u00ebsht\u00eb e rekomanduar p\u00ebr t\u00eb gjitha foshnjat n\u00eb lindje; f\u00ebmij\u00ebt m\u00eb t\u00eb rritur q\u00eb nuk kan\u00eb qen\u00eb m\u00eb par\u00eb t\u00eb vaksinuar; partner\u00ebt q\u00eb kryejn\u00eb marr\u00ebdh\u00ebnie seksuale me persona t\u00eb infektuar; personat me shum\u00eb partner\u00eb seksual\u00eb; personat q\u00eb k\u00ebrkojn\u00eb vler\u00ebsim ose trajtim p\u00ebr nj\u00eb s\u00ebmundje ngjit\u00ebse seksuale; meshkujt q\u00eb kryejn\u00eb seks me meshkuj; p\u00ebrdoruesit e drog\u00ebs me injeksion; personat e ekspozuar ndaj personave t\u00eb infektuar p\u00ebr shkak t\u00eb pun\u00ebs s\u00eb tyre; personat me s\u00ebmundje kronike t\u00eb m\u00ebl\u00e7is\u00eb, duke p\u00ebrfshir\u00eb personat e infektuar e HCV; personat t\u00eb infektuar me HIV; personat n\u00eb hemodializ\u00eb; personat q\u00eb udh\u00ebtojn\u00eb n\u00eb rajone me norma t\u00eb nd\u00ebrmjetme ose t\u00eb lart\u00eb t\u00eb Hepatitit B (prevalenca e HBsAg \u22652%); Personat e rriturit t\u00eb pa vaksinuar dhe q\u00eb kan\u00eb diabet mellitus 19-59 (p\u00ebr ata t\u00eb mosh\u00ebs \u226560 vje\u00e7) dhe \u00e7dokush tjet\u00ebr q\u00eb k\u00ebrkon nj\u00eb mbrojtje afat-gjate.<\/p>\n

Copyright<\/strong>: Ky artikull \u00ebsht\u00eb pron\u00eb e We Speak Science, institutit jo fitimprur\u00ebs themeluar nga dy shkenc\u00ebtaret shqip\u00ebtare Dr. Detina Zalli (Harvard University) dhe Dr. Argita Zalli (Imperial College London). Artikulli \u00ebsht\u00eb shkruar nga Detina Zalli<\/strong> dhe Gjena Dura<\/strong> (MSc ne Biologji Molekulare ne Universitetin e Tiranes).<\/em><\/p>\n

Referencat<\/strong>:<\/p>\n

Hepatitis B. World Health Organization. http:\/\/www.who.int\/mediacentre\/factsheets\/fs204\/en\/<\/a>. Updated July, 2016.
\nGuidelines for the prevention, care and treatment of persons living with chronic hepatitis B infection. World Health Organization. Pub. March 2015
\nHepatitis B FAQs for the public. Centers for Disease Control and Prevention. https:\/\/www.cdc.gov\/hepatitis\/hbv\/pdfs\/hepbgeneralfactsheet.pdf<\/a>. Accessed May 4, 2016.
\nHepatitis B. Mayo Clinic. http:\/\/www.mayoclinic.org\/diseases-conditions\/hepatitis-b\/basics\/definition\/con-20022210<\/a>. Accessed Aug. 29, 2014.
\nHepatitis B FAQs for the public. Centers for Disease Control and Prevention. http:\/\/www.cdc.gov\/hepatitis\/Resources\/Professionals\/PDFs\/ABCTable.pdf<\/a>. Updated, 2016.
\nTherapy of Viral Hepatitis B. Johns Hopkins Medicine. https:\/\/gi.jhsps.org\/GDL_Disease.aspx?CurrentUDV=31&GDL_Cat_ID=AF793A59-B736-42CB-9E1F-E79D2B9FC358&GDL_Disease_ID=554180E5-387E-4246-9AB9-D29E025D417F<\/a>
\nhttps:\/\/k3dkebumen.files.wordpress.com\/2014\/09\/hepatitis-b.jpg<\/a> (Figura kryesore)
\nhttp:\/\/www.cdc.gov\/travel-static\/yellowbook\/2016\/map_3-04-small.png<\/a> (Figura 1)
\nhttp:\/\/worddirection.com\/wp-content\/uploads\/2015\/07\/Hepatitis-B_03.jpg<\/a> (Figura 2)
\nhttp:\/\/www.worldgastroenterology.org\/UserFiles\/image\/guidelines\/english\/hepatitis-b-english-figure-3.png<\/a> (Figura 3)
\nhttps:\/\/gi.jhsps.org\/Upload\/200710291256_32549_000.jpg<\/a> (Figura 4)<\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":"

WeSpeakScience.com, 14 n\u00ebntor 2016 Hepatiti \u00ebsht\u00eb nj\u00eb s\u00ebmundje inflamatore e m\u00ebl\u00e7is\u00eb. S\u00ebmundja e hepatitit shkaktohet prej viruseve t\u00eb hepatitit. Njihen 5 tipe virusesh t\u00eb hepatitit: virusi i hepatit A (HAV-Hepatitis A Virus), virusi i hepatit B(HBV), virusi i hepatit C (HCV), virusi i hepatit D (HDV) dhe virusi i hepatit E (VHE); sipas t\u00eb cil\u00ebve […]<\/p>\n","protected":false},"author":1,"featured_media":69239,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-8518","post","type-post","status-publish","format-standard","has-post-thumbnail","category-artikuj"],"yoast_head":"\nHepatiti B \u2013 Nj\u00eb s\u00ebmundje vras\u00ebse e \u201cheshtur\u201d - FJALA e LIR\u00cb<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jehonashqiptare.al\/fjala\/hepatiti-b-nje-semundje-vrasese-e-heshtur\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hepatiti B \u2013 Nj\u00eb s\u00ebmundje vras\u00ebse e \u201cheshtur\u201d - FJALA e LIR\u00cb\" \/>\n<meta property=\"og:description\" content=\"WeSpeakScience.com, 14 n\u00ebntor 2016 Hepatiti \u00ebsht\u00eb nj\u00eb s\u00ebmundje inflamatore e m\u00ebl\u00e7is\u00eb. 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