Hepatitis A

The hepatitis A virus (HAV) causes a highly contagious short-term liver infection called hepatitis A. The virus is one of several forms of hepatitis viruses that causes inflammation and impairs the function of your liver. Hepatitis A is most commonly contracted by contaminated food or water or through close contact with an infected person or object. Hepatitis A cases that are mild do not require treatment. Most people who become infected recover completely, with no long-term effects on their liver. One of the most effective ways to prevent hepatitis A is to practice excellent hygiene, including frequent hand washing. 

The virus (HAV) that causes hepatitis A infects and inflames liver cells. The inflammation can affect how your liver functions. The virus spreads most usually when you eat or drink something that has been contaminated with feces, even in small amounts. It is not spread by coughing or sneezing.

The hepatitis A virus can spread in a variety of ways, including:

• Consuming food that has been handled by a virus-infected person who has not thoroughly cleansed their hands after using the toilet.
• Consumption of contaminated water.
• Eating raw shellfish from sewage-contaminated water.
• Being in close proximity to someone infected, even if they show no signs or symptoms.
• Having intercourse with a virus-infected person.

Hepatitis A symptoms and signs usually don't develop until after you've been infected for a few weeks. However, not everyone who has hepatitis A develops them. If you have hepatitis, you may experience the following signs and symptoms:

• Jaundice
• Nausea and vomiting
• Fatigue
• Abdominal discomfort or pain
• Loss of appetite
• Low-grade fever
• Dark-colored urine
• Clay-colored stools
• Itching
• Joint Pain

You're more likely to get hepatitis A if you:

• Travel to or work in places where hepatitis A is common.
• Are a man who engages in sexual activity with other men.
• Have any kind of sexual contact with a hepatitis A patient.
• Are living on the streets ( Homeless) 
• Have a disorder of clotting factors, such as hemophilia.
• Work in a child care center or attend child care.
• Live in the same house as someone who has hepatitis A.
• Have HIV ( Human Immunodeficiency virus) 
• Use any illegal drugs

Blood tests are used to check for hepatitis A virus signs in your body. A blood sample is obtained, most commonly from a vein in your arm. It's sent to a lab to be tested. Hepatitis A cases cannot be distinguished clinically from other kinds of acute viral hepatitis. The presence of HAV-specific immunoglobulin (IgM) antibodies in the blood allows for a specific diagnosis. The test is precise and sensitive. It stays positive for 3 to 6 months (up to 12 months). In relapsing hepatitis, it remains positive. IgG antibody to HAV arises shortly after IgM and lasts a long time. It indicates past infection or vaccination rather than acute infection when IgM is absent. IgG can be detected for the rest of one's life. Additional tests, such as reverse transcriptase-polymerase chain reaction (RT-PCR) to detect hepatitis A virus RNA, may be required in some cases. 

With the onset of symptoms, roughly four weeks after exposure, liver enzymes such as Alanine aminotransferase (ALT) rise more than aspartate aminotransferase (AST). Levels normally return to normal within a few weeks, although they can stay high for months. Alkaline phosphatase (ALP) levels also rise in conjunction with ALT and AST.

• Acute HIV infection
• Drugs ( Toxicity and Hypersensitivity)
• Cytomegalovirus
• Other types of hepatitis 

Hepatitis A does not have a specific treatment. The hepatitis A virus will be cleared by your body on its own. In most cases of hepatitis A, the liver recovers without causing long-term damage within six months.

Treatment for hepatitis A mainly focuses on keeping you comfortable and managing your signs and symptoms. You might have to:

Rest: Many people with hepatitis A are tired, unwell, and have little energy.

Manage nausea: It can be tough to eat when you have nausea. Instead of eating full meals, try snacking throughout the day. Eat more high-calorie foods to gain enough calories. Drink fruit juice or milk instead of water, for example. If vomiting occurs, it is important to drink plenty of fluids to avoid dehydration.

Avoid alcohol and use medications with caution: It's possible that your liver has difficulty processing medications and alcohol. If you have hepatitis, you should avoid consuming alcohol. It has the potential to harm the liver much more. Inform your doctor about all of your prescriptions, including over-the-counter medications.

Hepatitis A usually clears up in two months for most people, with no long-term effects.  Symptoms may arise and disappear for up to 6 months in about one out of every seven people who have the infection. Hepatitis A-related life-threatening consequences, such as liver failure, are uncommon, affecting less than 1 in every 250 people infected with the virus.

The hepatitis A vaccine can protect you from becoming infected with the virus. The vaccination is usually administered in two doses. The first one is followed by a six-month booster shot.

The following people should get a hepatitis A vaccine, according to the Centers for Disease Control and Prevention:

• All children under the age of one and older who have not received their childhood immunization.
• People who come into direct contact with hepatitis A patients.
• Adoptees from countries where hepatitis A is common.
• People who have clotting factor deficiencies.
• Anyone who is homeless and is at least one year old.
• Workers in laboratories who may be exposed to hepatitis A.
• Males who engage in intercourse with other men.
• People who work or travel in areas where hepatitis A is common.
• People who have chronic liver illness, such as hepatitis B or C
• Infants between the ages of 6 and 11 months who are traveling internationally.
• People who take illicit drugs of any kind, not only injectable ones.
• Anyone seeking protection (immunity).

Hepatitis A, unlike other types of viral hepatitis, does not cause long-term liver damage or become chronic. Hepatitis A can cause a rapid loss of liver function in some people, especially those who are elderly or have chronic liver disease. Acute liver failure requires a hospital stay for monitoring and treatment. A liver transplant may be required in some cases of acute liver failure.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 20, 2023. 

References

Hepatitis A (who.int)

https://www.who.int/news-room/fact-sheets/detail/hepatitis-a

What is Hepatitis A - FAQ | CDC

https://www.cdc.gov/hepatitis/hav/afaq.htm