Hepatitis A
(Hep A)
by
Rick Alan
Definition |
Causes |
Risk Factors |
Symptoms |
Diagnosis |
Treatment |
Prevention
Definition
Hepatitis A is an infection of the liver. It is caused by the hepatitis A virus.
Hepatitis
© 2009 Nucleus Medical Media, Inc.
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.
-
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:
- All children aged 12 months
- Children aged 12 months or older in high-risk areas
- People traveling to areas where hepatitis A is prevalent
- People who have anal sex
- Drug users
- People with chronic liver disease
-
People with blood-clotting disorders, like
hemophilia
- Children who live in areas where hepatitis A is prevalent
- People who will have close contact with an adopted child from a medium- or high-risk area
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/
.
¹9/25/2009 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed/what.php
:
Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees.
MMWR Morb Mortal Wkly Rep.
2009;58:1006.
Last reviewed January 2009 by David L. Horn, MD, FACP
Last Updated: 9/29/2009
