Hepatitis A
Definition
Hepatitis A is an infection of the liver. It is caused by the hepatitis A virus.
Hepatitis
Causes
This virus is usually found in the stool (feces) of people who have the infection. 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
Risk factors for hepatitis A include:
- Having close contact with an infected person although the virus is generally not spread by casual contact
- Using household items that were used by an infected person, but were not properly cleaned
- Having sex with multiple partners
- Having sex with a partner who has hepatitis A
- 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 share needles
- Working as a childcare worker, changing diapers or toilet training children
- Being in daycare centers
- Being institutionalized
- Receiving plasma products (such as people with hemophilia)
Symptoms
Hepatitis A does not always cause symptoms. Adults are more likely to have them than children.
Symptoms include:
- Tiredness
- Loss of appetite
- Fever
- Nausea
- Abdominal pain or discomfort
- Jaundice (yellowing of the eyes and skin)
- Darker colored urine
- Light or chalky colored stools
- Rash
- Itching
- Muscle pain
Diagnosis
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include:
- Blood test—to look for hepatitis A antibodies (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 done in severe cases
Treatment
There are no specific treatments. The goals of hepatitis A treatments 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 (eg, medications, alcohol) which might stress the liver while it's healing
The disease will usually go away without treatment within 2 to 5 weeks. About 15% of people who are infected by hepatitis A will have relapsing symptoms. This can happen for up to 9 months. In almost all cases, once you recover, there are no lasting effects. You will also be immune to the virus.
In rare cases, the infection is very severe. A liver transplant may be needed.
Prevention
Proper Sanitary Habits
- Wash your hands with soap and water. This is very important after using the bathroom or changing a diaper.
- Wash your hands with soap and water before eating or preparing food.
-
Avoid using household utensils that a person with hepatitis A may touch.
- Make sure all household utensils are carefully cleaned
- Avoid sexual contact with a person with hepatitis A.
- Avoid injected drug use. If you do, do not share needles.
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If you travel to a high risk region, take the following precautions:
- Drink bottled water
- Avoid ice chips
- Wash the fruits well
- Eat well-cooked food
Immune (Gamma) Globulin
This contains antibodies that provides temporary protection from hepatitis A. It can last about 1-3 months. It must be given before exposure to the virus or within two weeks after exposure.
Hepatitis A Vaccine
This vaccine is made from inactive hepatitis A virus. It is highly effective in preventing infection. It provides full protection four weeks after the first injection. A second injection provides protection lasting up to 20 years.
The vaccine is also used after exposure. If given within two weeks, it can prevent infection.
The vaccine is recommended for:
- People who have a chronic liver disease (including hepatitis C) or a clotting factor disorder
- People who have close physical contact with those 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
Check with your doctor to see if you should receive the vaccine.
RESOURCES:
American Liver Foundation
http://www.liverfoundation.org/
Hepatitis Foundation International
http://www.hepfi.org/
CANADIAN RESOURCES
Canadian Institute for Health Information
http://www.cihi.ca/cihiweb/
Canadian Liver Foundation
http://www.liver.ca/Home.aspx/
References:
Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov .
Hepatitis A: questions and answers. Immunization Action Coalition website. Available at: http://www.vaccineinformation.org/hepa/qandavax.asp . Updated May 2008. Accessed January 21, 2009.
Hepatitis Foundation International website. Available at: http://www.hepfi.org .
The Merck Manual of Medical Information . Simon and Schuster, Inc.; 2000.
National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ .
Last reviewed January 2009 by David L. Horn, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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