Hepatitis A (a liver disease) is an acute infectious disease of the liver caused by the hepatitis A virus, usually spread by the faecal-oral route; transmitted person-to-person by ingestion of contaminated food or water or through direct contact with an infectious person. In developing countries, and in regions with poor hygiene standards, the incidence of infection with this virus is high and the disease is usually contracted in early childhood. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease.
However, 10–15% of patients might experience a relapse of symptoms during the 6 months after acute illness. Acute liver failure from Hepatitis A is rare. Anyone can get hepatitis A, but those more likely to are people who, travel to developing countries, live with someone who currently has an active hepatitis A infection, have unprotected sex with an infected person and men who have sex with men are more likely to get hepatitis A. Less commonly, hepatitis A can be spread through sharing a needle with an infected person to inject drugs during sex; particularly anal sex. The condition can also spread through close personal contact in ‘closed environments’ such as student halls, boarding schools and army barracks.
Signs and symptoms of Hepatitis A
Most people do not have any symptoms of hepatitis A. Initial symptoms of hepatitis A are similar to flu and include, feeling tired, fever, muscle soreness, loss of appetite, diarrhoea, dark-yellow urine, light-coloured stools, yellowish eyes and skin. Symptoms usually clear up within two months, although occasionally last up to six months. Older adults tend to have more severe symptoms. Symptoms of hepatitis A can occur 2 to 7 weeks after coming into contact with the virus. Children younger than age 6 may have no symptoms. Older children and adults often get mild, flu like symptoms and Jaundice, a yellowing of the skin or whites of the eyes due to hyperbilirubinemia. Bile is removed from blood stream and excreted in urine, giving it a dark amber colour. In most cases the liver will make a full recovery.
Transmission of Hepatitis A
The virus spreads by the faecal-oral route and infections often occur in conditions of poor sanitation and overcrowding. Hepatitis A can be transmitted by the parenteral route but very rarely by blood and blood products. You could get hepatitis A through contact with an infected person’s stool. This contact could occur by, eating food made by an infected person who didn’t wash his or her hands after using the bathroom, drinking untreated water or eating food washed in untreated water, placing a finger or object in your mouth that came into contact with an infected person’s stool, having close personal contact with an infected person, such as through sex or caring for someone who is ill.
Hepatitis A is widespread in parts of the world that are poor, over-crowded and have limited access to sanitation and clean water, such as: Africa, India, Pakistan, some parts of the Middle East and South America. Hepatitis A is much less common in Western countries. You cannot get hepatitis A from, being coughed or sneezed on by an infected person, sitting next to an infected person, hugging an infected person.
Diagnosis of Hepatitis A
During the acute stage of the infection, the liver enzyme alanine transferees (ALT) is present in the blood at levels much higher than is normal. The enzyme comes from the liver cells that have been damaged by the virus.
Prevention of Hepatitis A
Hepatitis A can be prevented by vaccination, good hygiene and sanitation preventing the spread of infection. If you are diagnosed with hepatitis A it is important anyone you could have infected is tested for the condition. An infection can often be prevented if it is treated within two weeks of a person becoming exposed to the hepatitis A virus.
Testing may be recommended for: people who live with you, people you have recently prepared food for, any person you have had sex with. It is also important to take some basic precautions in terms of hygiene such as washing your hands after going to the toilet and before preparing food.
Treatment of Hepatitis A
There is no specific treatment for hepatitis A. Sufferers are advised to rest, avoid fatty foods and alcohol, eat a well-balanced diet, and stay hydrated. There is no specific treatment for hepatitis A so treatment involves making a person feel as comfortable as possible until the infection clears up. This involves: getting plenty of rest.
Complications of Hepatitis A
In most people the infection will pass without causing any long-term problems. And once the infection passes you normally develop life-long immunity against the hepatitis A virus. Complications tend to only occur in people with pre-existing liver disease and /or elderly people, with the most serious being liver failure. Once liver failure has occurred, it is usually possible to sustain life for several years using medication. However, a liver transplant is currently the only option for curing liver failure.