Definition

Hepatitis A is an infection of the liver. It is caused by the hepatitis A virus.

Hepatitis

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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:

  • 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.