HEPATITIS A
Definition
Hepatitis A is an infection of the liver caused by the hepatitis A virus.
CAUSES
Hepatitis A virus is usually found in stool (bowel movement). It is spread by:
- Putting something in your mouth that has been infected with the hepatitis A virus
- Drinking water contaminated by raw sewage
- Eating food contaminated by the hepatitis A virus, especially if it has not been properly cooked
- Eating raw or partially cooked shellfish contaminated by raw sewage
- Sexual contact with a partner infected with the hepatitis A virus (particularly anal sex)
RISK FACTORS
A risk factor is something that increases your chance of getting a disease or condition.
- Close contact with an infected person (Note: the virus is generally not spread by casual contact.)
- Using household items that were used by an infected person, but were not properly cleaned
- Sexual contact with multiple partners
- Traveling to or spending long periods of time in a country where hepatitis A is common or where sanitation is poor
- Injecting drugs, especially if you use shared needles
- Childcare workers who change diapers or toilet train children
- Children in daycare centers
- Institutionalized patients
- Hemophiliacs receiving plasma products
SYMPTOMS
Hepatitis A does not always cause symptoms. Adults are more likely to have symptoms than children.
Symptoms include:
- Tiredness
- Loss of appetite
- Fever
- Nausea
- Abdominal pain or discomfort
- Jaundice (yellowing of the eyes and skin)
- Darker colored urine
- Rash
DIAGNOSIS
The doctor will ask about your symptoms and medical history, and perform a physical exam.
Tests may include:
- Blood test – to look for hepatitis A antibodies (These are proteins that your body has made to fight the hepatitis A virus.)
- Liver function studies
- Liver biopsy – removal of a sample of liver tissue to be examined (only in severe cases)
TREATMENT
There are no specific treatments for hepatitis A. The goals of hepatitis A treatment are to:
- Keep the patient as comfortable as possible
- Prevent the infection from being passed to others
- Prevent more liver damage by helping the patient avoid substances (medications, alcohol) which might stress the liver while it's healing
The disease generally will go away without treatment within 2-5 weeks. However, about 15% of people who are infected by hepatitis A will have relapsing symptoms for up to 9 months. In almost all cases, once you recover, there are no after affects, and you are immune to the virus.
In rare cases, hepatitis A infection will be so severe that a liver transplant may be needed.
PREVENTION
PROPER SANITARY HABITS
- Wash your hands with soap and water after using the bathroom or changing a diaper.
- Wash your hands with soap and water before eating or preparing food.
- Carefully clean all household utensils after use by a person infected with hepatitis A virus.
- Avoid using household utensils that a person infected with hepatitis A may touch.
- Avoid sexual contact with a person infected with hepatitis A.
- Avoid injected drug use, especially with shared needles.
IMMUNE (GAMMA) GLOBULIN
This is a preparation containing antibodies that provides temporary protection fromhepatitis A (about 1-3 months). It must be given:
- Before exposure to the virus
- Within 2 weeks after exposure to the virus
HEPATITIS A VACCINE
This vaccine is made from inactive hepatitis A virus, and is highly effective in preventing infection. It provides protection from infection for 4 weeks following the first injection. A second injection provides protection lasting up to 20 years.
The vaccine is recommended for:
- People who have a chronic liver disease or a clotting factor disorder
- People who have close physical contact with people who live in areas with poor sanitary conditions
- People traveling to countries where sanitary conditions are poor
- Children who live in areas that have repeated hepatitis A epidemics
- People who inject illicit drugs
- Men who have sex with men
Note: It is unclear how safe the vaccine is when given during pregnancy. The vaccine should not be given to children under 2 years old. Check with your doctor to see if you should receive the vaccine, and if so, how many injections you should have.
