Flamengo defender David Luiz needed to be substituted in the first half in the match against Sao Paulo in the Copa Brasil, on Wednesday (24), and alarmed the fans. According to the information, the player had presented a suspected case of viral hepatitis, an inflammation of the liver that can cause mild, moderate or severe changes. In an interview with Eu Atleta, infectious disease specialist at UNIFESP, Jorge Figueiredo Senise, and hepatologist at Casa de Saúde São José, Carlos Terra explained what viral hepatitis is, what are the symptoms, risk factors and how to diagnose and treat it. Check it out below.
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David Luiz left the match against Sao Paulo in severe discomfort and is suspected of having viral hepatitis – Photo: Marcelo Cortes / Flamengo
Hepatitis basically means inflammation of the liver. This disease can be manifested by infection with a virus – in this case it is called a virus -, use of medications, autoimmune diseases, metabolic diseases, genetic diseases, or even consumption of alcohol and other drugs. Infectologist Jorge Senes also warns of cases in which a severe virus leads to hepatitis as an inflammatory reaction in the liver.
At the end of the match, David Luiz said he had a “more serious problem”. There is information that many athletes from the club contracted a virus, but David Luiz’s condition only worsened, which may mean that a severe virus would have led to hepatitis. So far, the club’s medical department has dismissed concerns about a more serious condition, but it has not yet announced what type of hepatitis the player has. In addition, doctors reported that further tests will be carried out to detect the severity of the condition. Results are scheduled for Monday.
Hepatitis causes inflammation of the liver – Photo: Istock Getty Images
The most common viral hepatitis in Brazil is caused by viruses A, B, and C. Hepatitis D is also known. It is more common in the northern region of the country and needs to be infected with B virus, as it does not live alone in the body. There is also hepatitis E, which is more commonly diagnosed in African and Asian countries.
Hepatitis A is the most common and mainly affects children. This disease has a positive trait compared to the others, in that it does not become chronic, unlike types B and C which have a high chance of becoming chronic. This happens when the patient cannot eliminate the virus that remains in the body and attacks the liver and causes serious complications that can develop into cancer or cirrhosis of the liver.
Yellow eyes are a symptom of hepatitis – Photo: iStock Getty Images
Symptoms are seen in all types of hepatitis in 10% to 20% of cases. In these cases, it can be mild, moderate or severe. Typical symptoms of hepatitis, similar to a virus, are:
- Stomach ache;
- yellowing of the skin and eyes;
- dark urine;
- Light stools – yellowish, gray or white.
According to the information, David Luiz has been suffering from headaches and fatigue for two weeks.
To diagnose hepatitis, it is necessary to evaluate the patient and perform blood tests or polymerase chain reaction. Symptoms of the disease can vary, and in most cases, they are asymptomatic or virus-like. According to studies conducted by the Brazilian Society of Hepatology, approximately 60% of the adult population in Brazil is infected or infected with the hepatitis A virus A. Carlos Terra.
Ways of infection with viral hepatitis depend on the type of virus.
- In the case of hepatitis A, transmission occurs via fecal-oral, i.e. the patient becomes infected by contact with contaminated water or food. the doctor. Jorge Senes also warns against consuming foods such as oysters and oysters, which are eaten raw and can concentrate the virus after coming into contact with infected seawater.
- Hepatitis B and C can be transmitted through contact with contaminated blood (sharing needles, syringes, personal hygiene items, and other objects for drug use), by cutting and intercourse without a condom and from mother to child at the time of birth.
Hepatologist Carlos Terra warns of the importance of basic sanitation campaigns and hepatitis prevention.
Personal hygiene, basic sanitation, and water and sanitation treatment are essential to prevent hepatitis A. Prevention campaigns are also necessary to avoid disease. In the case of hepatitis B and C, campaigning for safe sex (with condoms) and guidance to the population is essential – the doctor said.
Vaccination is also essential in fighting hepatitis. The hepatitis B vaccine, available at SUS, is taken in childhood in three doses: at birth, at one month of age and at six months. The hepatitis A vaccine is not yet available in the public health system, only in private clinics, for all ages. As for hepatitis C, there are still no vaccines, only medicines.
There is no specific treatment for hepatitis A. Patients are treated spontaneously within two to two months, but rest is often necessary.
In cases of chronic hepatitis C and B, treatments are specific with antiviral medications. Hepatitis C is administered with so-called direct-acting antivirals (DAA), with cure rates of over 95%. These are usually done for 8 or 12 weeks. Patients infected with the virus can receive treatment through the SUS, even if the diagnosis is made in the private health network. It is sufficient for the physician to prescribe treatment according to the guidelines of the clinical protocol and treatment guidelines for hepatitis C and co-infections (PCDT hepatitis C). In any case, rest is essential. That is, it is possible that David Luiz will not be able to play football for a few weeks if the diagnosis of hepatitis is confirmed.
Jorge Figueiredo Sines He is an infectious disease doctor at UNIFESP with a portfolio of research in viral hepatitis and sexually transmitted diseases.
Carlos Terra He is a hepatologist at Casa de Saúde São José (RJ) and president-elect of the Brazilian Society of Hepatology.
* Trainee under the supervision of Flavia Ribeiro.
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