Hepatitis A

Hepatitis A

What is hepatitis A?

Hepatitis A is a viral infection that attacks the liver.  Infection usually results in a short illness that spontaneously resolves.  Symptoms vary from flu-like complaints to yellow jaundice.  Most infections are mild and patients do not need to seek medical care.  Rarely, the disease is severe and life threatening.  In these instances liver transplantation may be necessary.

Unlike hepatitis B or hepatitis C, hepatitis A does not cause chronic disease, meaning the virus does not stay in your liver for many years.  For this reason, hepatitis A does not cause an increased risk of liver failure over time or liver cancer.

How do I know if I have hepatitis A?

Since symptoms of hepatitis A mimic those of other common ailments, such as the flu, not everyone realizes they have been infected.  Initial symptoms may include fatigue, nausea, vomiting, loss of appetite, fever, and abdominal pain.  A week into the illness you may develop jaundice, dark urine or itching.  The liver may enlarge and you may notice arthritis, rashes, or enlargement of lymph nodes.

The incubation period of the infection ranges from 15 to 49 days (average of 30 days).  This means that it may take several weeks after you are exposed to the virus to develop illness and symptoms.  If you suspect infection, you should see your doctor for blood testing.  Hepatitis A infection is diagnosed by specific blood tests, which detect antibody to the virus.  Blood tests will usually turn positive within one month of contracting the virus.

What is the treatment?

Because the vast majority of cases of hepatitis A resolve on their own, treatment is supportive.  There are no specific anti-viral medications that speed up resolution of the disease.  Approximately 85% of patients infected with hepatitis A have full recovery within three months and over 99% are well by six months.  It is rare for hepatitis A to cause such severe infection as to require liver transplantation.

A vaccine for hepatitis A exists and is effective.  Vaccines stimulate your immune system to create antibodies against hepatitis A, but that can take several months.  The vaccine is indicated for certain groups of people at increased risk of the disease, such as individuals with other forms of liver disease, intravenous drug users, individuals with clotting factor deficiencies, men who have sex with men, and people traveling to areas with high infection rates.  For family members or contacts of someone known to be infected with hepatitis A, serum immune globulins are available to prevent disease.  These are “pre-formed” antibodies that can be injected into the person at risk in an attempt to prevent onset of disease.

How can I prevent hepatitis A?

Hepatitis A is transmitted by the “fecal-oral” route.  Anything that improves sanitation, such as adequate hand washing, thoroughly washing fresh fruits and vegetables, properly cooking meats (particularly seafood) and avoiding contaminated water sources are all vital.

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