Hep A
Acute illness of hepatitis A typically subsides within two months; however, it may last for up to six months in more severe cases.

Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus, which is found in the stools and blood of infected people.

Hepatitis A is one of the most common infectious liver illnesses, affecting children all over the world.

  • Acute illness of hepatitis A is usually seen in patients for a few weeks and subsides within two months. However, it may last for up to six months in severe cases.
  • Death due to hepatitis A is rare and is mainly seen in older people or people with chronic liver diseases.

Hepatitis A is usually mild and self-limiting; it does not have a persistent viral shedding and no chronic stage of the illness. However, recurrences, acute fulminant hepatitis, and other serious consequences are possible.

Hepatitis A can occasionally result in acute liver failure, a serious, life-threatening illness. The vaccine prevents you from getting infected with the hepatitis A virus.

How does hepatitis A spread?

The hepatitis A virus is generally spread by the fecal-oral route, which occurs when an uninfected person consumes food or drink contaminated with the feces of an infected person. A person may be infected with the virus after consuming food prepared by an infected person with contaminated hands.

  • Although waterborne epidemics are not common, they are generally connected with sewage contamination or improperly cleaned water.
  • Close physical contact, such as oral-anal sex with an infected individual, may transfer the virus. However, casual contact between persons does not spread the virus.
  • An infected person may even spread the virus before they develop any symptoms.

The hepatitis A virus can spread in the following ways:

  • Consuming food touched by a person infected with the virus who does not properly wash their hands after using the restroom
  • Consuming raw shellfish from sewage-polluted water
  • Consuming tainted water
  • Not washing hands properly after
    • Handling diapers of an infected child
    • Cleaning up an infected person's stool
  • Having oral-anal sex with a person infected with the virus

What are the symptoms of hepatitis A?

The hepatitis A virus has an incubation period of 14 to 28 days. However, a person infected with it may spread the virus even before the symptoms show up.

Not all patients affected with hepatitis A develop symptoms, many stay asymptomatic and never know that they are infected but they may spread the virus to others.

If you develop symptoms of hepatitis A, they may include:

The symptoms caused by hepatitis A are usually minimal and resolve within a few weeks, but, with severe infection, the symptoms may last for months.

Adults have more probability to exhibit signs and symptoms of sickness than children. The severity of the illness is greater in senior age groups. Children aged younger than six years generally do not show any symptoms, and jaundice is seen only among 10 percent of infected children.

There are chances of relapse of hepatitis A, which means that a person who has recently healed becomes ill again with another acute episode. Relapse is usually seen after a complete recovery.

What are the risk factors of hepatitis A?

All age groups are prone to hepatitis A infection, especially immunocompromised patients.

It is very important to identify and prevent factors that cause hepatitis A, which include:

  • Men who have sex with men
  • Being in close contact with a person infected with hepatitis A
  • People who use illegal drugs
  • Use of needles contaminated with hepatitis A virus
  • Poor sanitation
  • Drinking contaminated water
  • International travelers
  • Traveling to endemic areas without immunization
  • Homeless people
  • Hemophilia
  • Patients with human immunodeficiency virus
  • People working in child care centers
  • Patients with chronic liver diseases, such as hepatitis B and C

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How is hepatitis A diagnosed?

A diagnosis for hepatitis A is done by a doctor based on the symptoms and blood work. However, it is not easy to clinically distinguish hepatitis A from other acute viral hepatitis.

Jaundice may be developed in more than 70 percent of hepatitis A virus-infected children and adults. Physical examination may show enlarged liver (hepatomegaly) and spleen (splenomegaly).

A specialized blood test is done to identify the presence of immunoglobulin M (IgM) antibodies that the body develops against the hepatitis A virus. 

An additional test, reverse transcriptase-polymerase chain reaction, is done to detect hepatitis A virus RNA (the genetic material of the virus) in the body.

What are treatment options for hepatitis A?

Hepatitis A has no particular treatment; however, infected people are treated based on their symptoms. The body will get rid of the virus eventually, although it may take a few months for complete recovery.

A person must maintain a proper diet, drink plenty of fluids, and get plenty of rest to recover. Their surroundings should be well ventilated, and the patient should wear loose clothing and avoid hot showers to reduce the intensity of itching if any. The doctor may prescribe antihistamine drugs to control itching.

The doctor will advise you to avoid alcohol, certain medications, such as acetaminophen, and vitamins that require the liver for metabolism. These may increase liver inflammation and damage. It is highly recommended to consult the doctor before taking any over-the-counter medications.

Hospital admission may be required in patients with severe diseases, such as those with acute liver failure or symptoms, such as severe pain, excessive vomiting, confusion, tremors, severe dehydration, and jaundice.

How to prevent hepatitis A?

Vaccination is the best method to prevent hepatitis A.

Other methods to prevent hepatitis A include:

  • Washing hands frequently and thoroughly with soap and water before eating, drinking, or cooking, after using the restroom, and after handling diapers of children or adults.
  • It is recommended to drink bottled or boiled water, especially if a person is in underdeveloped nations and high-risk endemic areas, to avoid drinking contaminated water.
  • Avoid eating food from streets where there is a higher risk of contamination of food and water. Always prefer an established eatery where maximum precautions are being taken to avoid such contamination.
  • Always wash fruits and vegetables before consumption.
  • Keep the house and surroundings clean; disinfect restrooms frequently.
  • Maintain a proper diet regimen and improve your immunity by following healthy habits, such as regular exercise and good sleep.
  • A person must consult a doctor immediately when they suspect exposure to the virus or identify any symptoms of the disease.

What are the guidelines for vaccination of hepatitis A?

  • The American Academy of Pediatrics recommends all children at ages between 12 and 23 months receive the hepatitis A vaccine.
  • Children and adolescents aged 2 to 18 years, who previously did not receive hepatitis A vaccine (“catch up” vaccination).
  • People who are at risk of acquiring hepatitis A virus as an occupational hazard, such as:
    • Working directly with the virus in laboratories
    • Working with infected primates in laboratories
  • Men who indulge in sexual relationships with men
  • Patients with chronic liver diseases
  • Patients with clotting disorders
  • Pregnant women who are at risk of hepatitis A infection or likely to develop a serious disease
  • Any person who requests vaccination

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Hepatitis A is… See Answer

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Medically Reviewed on 11/29/2021
References
Image Source: iStock Images

World Health Organization. Hepatitis A. https://www.who.int/news-room/fact-sheets/detail/hepatitis-a

Centers for Disease Control and Prevention. Viral Hepatitis. https://www.cdc.gov/hepatitis/hav/afaq.htm#D2

Matheny SC, Kingery JE. Hepatitis A. Am Fam Physician. 2012 Dec 1;86(11):1027-34; quiz 1010-2. https://www.aafp.org/afp/2012/1201/p1027.html

Avert. Hepatitis A Symptoms. https://www.avert.org/sex-stis/sexually-transmitted-infections/hepatitis-a