Hepatitis A is an infection of the liver caused by the hepatitis A virus.
Causes
Hepatitis A virus is usually found in the stool (bowel movement) of people who have the infection. Note: It's not found in everybody, only those who have the infection. It is spread by:
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Putting something in your mouth that has been infected with the hepatitis A virus
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Drinking water contaminated by raw sewage
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Eating food contaminated by the hepatitis A virus, especially if it has not been properly cooked
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Eating raw or partially cooked shellfish contaminated by raw sewage
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Sexual contact with a partner infected with the hepatitis A virus, particularly anal sex (Anal sex has an especially high risk, but all kinds of sexual intercourse can spread the disease.)
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
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Close contact with an infected person (Note: The virus is generally not spread by casual contact.)
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Using household items that were used by an infected person, but were not properly cleaned
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Sexual contact with multiple partners
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Sexual contact with a partner who has hepatitis A
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Traveling to or spending long periods of time in a country where hepatitis A is common or where sanitation is poor
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Injecting drugs, especially if you use shared needles
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Childcare workers who change diapers or toilet train children
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Children in daycare centers
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Institutionalized patients
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Hemophiliacs receiving plasma products
Symptoms
Hepatitis A does not always cause symptoms. Adults are more likely to have symptoms than children.
Symptoms include:
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Tiredness
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Loss of appetite
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Fever
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Nausea
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Abdominal pain or discomfort
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Jaundice (yellowing of the eyes and skin)
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Darker colored urine
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Light or chalky colored stools
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Rash
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Itching
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Muscle pain
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam.
Tests may include:
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Blood test – to look for hepatitis A antibodies (These are proteins that your body has made to fight the hepatitis A virus.)
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Liver function studies
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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:
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Keep the patient as comfortable as possible
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Prevent the infection from being passed to others
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Prevent more liver damage by helping the patient avoid substances (eg, 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 aftereffects, 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
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Wash your hands with soap and water after using the bathroom or changing a diaper.
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Wash your hands with soap and water before eating or preparing food.
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Carefully clean all household utensils after use by a person infected with hepatitis A virus.
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Avoid using household utensils that a person infected with hepatitis A may touch.
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Avoid sexual contact with a person infected with hepatitis A.
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Avoid injected drug use, especially with shared 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, and eat well-cooked food.
Immune (gamma) Globulin
This is a preparation containing antibodies that provides temporary protection from hepatitis A (about 1-3 months). It must be given:
Hepatitis A Vaccine
This vaccine is made from inactive hepatitis A virus and is highly effective in preventing infection. It provides full protection four weeks after the first injection. (The hepatitis vaccine takes a month to become fully effective.) A second injection provides protection lasting up to 20 years.
The vaccine is recommended for:
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People who have a chronic liver disease or a clotting factor disorder
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People who have close physical contact with those who live in areas with poor sanitary conditions
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People traveling to countries where sanitary conditions are poor
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Children who live in areas that have repeated hepatitis A epidemics
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People who inject illicit drugs
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Men who have sex with men
Check with your doctor to see if you should receive the vaccine, and if so, when and how many injections you should have.
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/dispPage.jsp?cw_page=home_e
Canadian Liver Foundation
http://www.liver.ca/Home.aspx
References:
Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov.
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/.
