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.

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