Overview of Hepatitis A
Hepatitis A (HAV) is usually not a serious illness. It is prevalent in developing countries, especially those with overcrowding and poor sanitation, in men who have sex with men, and injecting drug users. HAV does not lead to chronic disease; it produces acute symptoms that may persist for several weeks. Only 1 percent of people with HAV experience fulminant, or acute, infection and require a liver transplant.
Causes and Risk Factors for Hepatitis A
HAV is transmitted primarily through feces-contaminated food and water, direct oral exposure to the virus (e.g., from a finger that has contacted infected feces), and sexual contact. In June 2013, a multi-state outbreak occurred in the United States. This outbreak was traced to a frozen fruit blend from a farm in Oregon.
Specific risk factors for hepatitis A include the following:
- Eating imported fruits, vegetables, and dairy products
- Eating raw or undercooked shellfish
- Kissing (when infection is present)
- Poor hygiene
- Using contaminated intravenous needles
- Unprotected sex (especially anal sex)
Signs and Symptoms of Hepatitis A
Some people, children particularly, experience no symptoms of HAV. Those that do usually develop signs and symptoms within a few weeks of infection:
- Dark urine
- Diminished appetite
- Inflammation of the liver
- Jaundice (yellowing of skin, eyes, and mucous due to bile pigment deposition and bilirubin enzyme release)
- Light-colored feces
- Loss of taste for coffee, alcohol, cigarettes
- Mild fever
Hepatitis A Diagnosis
Hepatitis may be detected by testing the liver for elevated levels of transaminase enzymes, which catalyze amino acids. Levels increase when the liver becomes inflamed. The immunoglobulin M (IgM) antibody to hepatitis A may be found with a blood test for up to a year following infection. Most people are no longer infectious by the time they are diagnosed.
Treatment for Hepatitis A
There is no specific treatment for HAV, which is a self-limiting virus. Immediate treatment with immune globulins (IG; antibodies normally present in blood) may be effective for those who are not vaccinated. People usually recover within a few weeks, experience no lingering symptoms, and develop immunity to the virus. Staying hydrated and avoiding alcohol and other toxins that tax the liver, including nonsteroidal anti-inflammatory drugs like Tylenol®, is important during recovery. Rehydration may be done intravenously (IV) and nausea and vomiting can be controlled with medication.
Hepatitis A Prevention
Hygiene, careful food preparation, safer sex, and avoiding used needles, can prevent the spread of HAV. HAV vaccination is available, is 95 percent effective, and has few side effects. It is given twice, 6 to 12 months apart. All men who have sex with men and people planning to travel to underdeveloped countries are advised to get an HAV vaccination.