How is hepatitis A diagnosed. What are the primary treatment options for hepatitis A. Can hepatitis A be prevented after exposure. What are the long-term complications of hepatitis A infection. How effective is the hepatitis A vaccine in preventing the disease.

Understanding Hepatitis A: Causes and Transmission

Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus (HAV). It primarily spreads through the fecal-oral route, meaning that a person can contract the virus by ingesting contaminated food, water, or through close contact with an infected individual.

The virus is found in the stool and blood of infected people, and can be transmitted even in microscopic amounts. This makes personal hygiene, especially handwashing, crucial in preventing its spread.

Common Transmission Routes

• Person-to-person contact (including certain types of sexual contact)
• Caring for someone who is ill with hepatitis A
• Sharing drug paraphernalia
• Consuming contaminated food or drinks

How long can the hepatitis A virus survive outside the body? The virus can survive outside the body for months, making it particularly resilient and easily transmissible in various environments.

Diagnosing Hepatitis A: Methods and Challenges

Accurate diagnosis of hepatitis A is crucial for proper management and prevention of further spread. Healthcare professionals employ various methods to confirm the presence of the virus.

Diagnostic Techniques

1. Blood tests to detect HAV-specific antibodies
2. Liver function tests to assess liver damage
3. Physical examination to check for signs of liver enlargement or tenderness

What are the specific antibodies tested for in hepatitis A diagnosis? The primary antibodies tested are IgM anti-HAV (indicating recent infection) and total anti-HAV (showing past infection or vaccination).

Diagnosing hepatitis A can be challenging due to its similarity with other liver diseases. Therefore, a comprehensive approach considering symptoms, exposure history, and laboratory results is essential for accurate diagnosis.

Treatment Approaches for Hepatitis A

Unlike some other forms of viral hepatitis, hepatitis A does not have a specific antiviral treatment. The focus of treatment is on managing symptoms and supporting the body’s natural healing process.

Key Treatment Strategies

• Rest and adequate hydration
• Nutritional support
• Medication for symptom relief (e.g., for nausea, fever)
• Avoiding alcohol and hepatotoxic substances

How long does it typically take to recover from hepatitis A? Most people recover completely within a few weeks to several months, with proper care and rest.

In severe cases, especially in older adults or those with pre-existing liver conditions, hospitalization may be necessary. This allows for close monitoring and management of complications such as dehydration or liver failure.

Prevention Strategies: Vaccination and Hygiene

Prevention is key in controlling the spread of hepatitis A. The most effective preventive measure is vaccination, which has significantly reduced the incidence of the disease in many countries.

Hepatitis A Vaccine

The hepatitis A vaccine is highly effective and provides long-lasting protection. It is typically administered in two doses, six months apart.

Who should receive the hepatitis A vaccine? The Centers for Disease Control and Prevention (CDC) recommends vaccination for:

• All children at age 1 year
• Travelers to countries where hepatitis A is common
• Men who have sex with men
• People who use drugs
• People with chronic liver diseases
• People with occupational risk of exposure

Can the hepatitis A vaccine prevent infection after exposure? If administered within two weeks of exposure, the vaccine can effectively prevent infection in most cases.

Hygiene and Sanitation

Proper hygiene practices play a crucial role in preventing hepatitis A transmission:

1. Thorough handwashing, especially after using the bathroom and before handling food
2. Proper food handling and preparation
3. Avoiding consumption of raw or undercooked shellfish
4. Safe water practices in areas with poor sanitation

Managing Hepatitis A Outbreaks: Public Health Strategies

Hepatitis A outbreaks can pose significant challenges to public health systems. Effective management requires a multifaceted approach involving surveillance, vaccination, and education.

Key Components of Outbreak Management

• Rapid identification and reporting of cases
• Contact tracing to identify potential exposures
• Targeted vaccination campaigns
• Public education on prevention measures
• Collaboration between healthcare providers and public health agencies

How effective are targeted vaccination campaigns in controlling outbreaks? Targeted vaccination has proven highly effective in controlling outbreaks, especially when combined with other public health measures.

Recent years have seen an increase in hepatitis A outbreaks in the United States, particularly among high-risk groups such as people who use drugs and those experiencing homelessness. These outbreaks highlight the importance of ongoing surveillance and prevention efforts.

Long-Term Health Implications of Hepatitis A

While hepatitis A is typically an acute, self-limiting disease, it can have long-term health implications in some cases. Understanding these potential consequences is crucial for comprehensive patient care.

Potential Long-Term Effects

• Prolonged fatigue and weakness
• Intermittent liver enzyme elevations
• Rare cases of chronic hepatitis
• Increased risk of gallbladder disease

Can hepatitis A lead to chronic liver disease? Unlike hepatitis B and C, hepatitis A does not typically cause chronic liver disease. However, in rare cases, it can lead to fulminant hepatitis, which is a severe, acute liver failure.

The risk of severe complications increases with age and in individuals with pre-existing liver conditions. Therefore, close monitoring and follow-up care are essential, especially for high-risk patients.

Hepatitis A in Special Populations

Certain populations may be at higher risk for contracting hepatitis A or experiencing more severe outcomes. Understanding these special considerations is crucial for targeted prevention and treatment strategies.

High-Risk Groups

1. International travelers to endemic areas
2. Men who have sex with men
3. People who use injection and non-injection drugs
4. People experiencing homelessness
5. People with chronic liver diseases

How does hepatitis A affect pregnant women? Pregnant women are not at increased risk for severe hepatitis A, but infection during pregnancy can potentially lead to preterm labor and other complications.

For these high-risk groups, vaccination and enhanced preventive measures are particularly important. Healthcare providers should be proactive in identifying at-risk individuals and offering appropriate counseling and preventive care.

Global Perspectives on Hepatitis A: Prevalence and Control

Hepatitis A prevalence varies significantly across different regions of the world. Understanding these global patterns is crucial for international health strategies and travel medicine.

Global Distribution

• High endemicity: Parts of Africa, Asia, and Central and South America
• Intermediate endemicity: Eastern Europe and parts of the Middle East
• Low endemicity: North America, Western Europe, Australia, and New Zealand

How has global hepatitis A prevalence changed over time? Improved sanitation and widespread vaccination programs have significantly reduced hepatitis A prevalence in many regions, particularly in developed countries.

Despite these improvements, hepatitis A remains a significant public health concern in many parts of the world. Global efforts focus on improving sanitation, increasing vaccine access, and enhancing surveillance systems to monitor and control the disease.

International Travel Considerations

For international travelers, hepatitis A vaccination is often recommended when visiting areas with high or intermediate endemicity. This preventive measure is crucial, as travelers can unknowingly bring the virus back to their home countries, potentially sparking outbreaks.

What precautions should travelers take to prevent hepatitis A infection? Besides vaccination, travelers should practice careful hygiene, consume only safe food and water, and be aware of the risks in their destination countries.

Future Directions in Hepatitis A Research and Management

As our understanding of hepatitis A evolves, new areas of research and management strategies continue to emerge. These advancements hold promise for improved prevention, diagnosis, and treatment of the disease.

Emerging Research Areas

• Development of more effective and longer-lasting vaccines
• Improved diagnostic techniques for rapid and accurate detection
• Understanding the molecular mechanisms of liver damage in hepatitis A
• Exploring potential antiviral therapies for severe cases

What role might genomics play in hepatitis A management? Genomic research could lead to personalized approaches in predicting disease severity and tailoring treatment strategies.

Another important area of focus is the development of strategies to reach and protect high-risk populations, particularly in resource-limited settings. This includes innovative vaccination programs and public health initiatives aimed at improving overall sanitation and hygiene practices.

Technological Advancements

Emerging technologies are playing an increasingly important role in hepatitis A management:

1. Mobile health applications for outbreak tracking and patient education
2. Point-of-care testing devices for rapid diagnosis in remote areas
3. Data analytics for predicting and managing outbreaks
4. Improved vaccine delivery systems for better coverage

How might artificial intelligence contribute to hepatitis A control? AI could potentially enhance surveillance systems, predict outbreaks, and optimize vaccination strategies, leading to more effective disease control.

As research progresses, we can expect to see more targeted and effective approaches to managing hepatitis A, both on individual and population levels. This ongoing work is crucial in the global effort to reduce the burden of this preventable disease.

Psychological and Social Aspects of Hepatitis A

While the physical symptoms of hepatitis A are well-documented, the psychological and social impacts of the disease are often overlooked. Understanding these aspects is crucial for comprehensive patient care and public health strategies.

Psychological Impact

Individuals diagnosed with hepatitis A may experience various psychological challenges:

• Anxiety about disease progression and transmission
• Depression related to physical symptoms and social isolation
• Stress from work absence and financial implications
• Stigma associated with infectious diseases

How can healthcare providers address the psychological needs of hepatitis A patients? Integrating mental health support into hepatitis A care, providing clear information about the disease, and offering counseling services can significantly improve patients’ psychological well-being.

Social Implications

Hepatitis A can have broader social impacts, particularly in the context of outbreaks:

1. Disruption of daily activities and work
2. Strain on healthcare systems during outbreaks
3. Economic impact on affected communities
4. Challenges in maintaining privacy in contact tracing efforts

What strategies can be employed to mitigate the social impact of hepatitis A outbreaks? Public education campaigns, support for affected businesses, and community-based prevention efforts can help minimize the social disruption caused by hepatitis A.

Addressing these psychological and social aspects is essential for a holistic approach to hepatitis A management. It not only improves individual patient outcomes but also enhances community resilience in the face of outbreaks.

Nutritional Considerations in Hepatitis A Management

Proper nutrition plays a crucial role in supporting liver function and overall recovery in patients with hepatitis A. While there’s no specific diet for hepatitis A, certain nutritional strategies can aid in managing symptoms and promoting healing.

Key Nutritional Strategies

• Adequate hydration to support liver function and prevent complications
• Balanced diet rich in fruits, vegetables, and whole grains
• Moderate protein intake to support liver regeneration
• Avoiding alcohol and limiting fatty foods to reduce liver stress

What specific nutrients are beneficial for liver health during hepatitis A recovery? Antioxidants such as vitamin C and E, as well as B-complex vitamins, can support liver function and overall health during recovery.

Dietary Challenges

Patients with hepatitis A may face certain dietary challenges:

1. Nausea and loss of appetite
2. Difficulty digesting fatty foods
3. Taste changes affecting food preferences
4. Fatigue impacting meal preparation

How can these dietary challenges be addressed? Small, frequent meals, ginger-based foods for nausea, and easy-to-prepare nutrient-dense options can help overcome these challenges and ensure adequate nutrition.

It’s important for healthcare providers to offer individualized nutritional guidance to hepatitis A patients, taking into account their specific symptoms, preferences, and overall health status. This tailored approach can significantly contribute to a smoother recovery process.

What is Hepatitis A – FAQ

Overview

What is hepatitis?

Hepatitis means inflammation of the liver. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis, but it is often caused by a virus. In the United States, the most common hepatitis viruses are hepatitis A virus, hepatitis B virus, and hepatitis C virus.

What is the difference between hepatitis A, hepatitis B, and hepatitis C?

Hepatitis A, hepatitis B, and hepatitis C are liver infections caused by three different viruses. Although each can cause similar symptoms, they are spread in different ways and can affect the liver differently. Hepatitis A is usually a short-term infection and does not become chronic. Hepatitis B and hepatitis C can also begin as short-term, acute infections, but in some people, the virus remains in the body, resulting in chronic disease and long-term liver problems. There are vaccines to prevent hepatitis A and hepatitis B; however, there is no vaccine for hepatitis C.

The page “What is hepatitis?” more information about the differences between hepatitis A, hepatitis B, and hepatitis C.

What is hepatitis A?

Hepatitis A is a highly contagious, short-term liver infection caused by the hepatitis A virus.

How serious is hepatitis A?

People who get hepatitis A may feel sick for a few weeks to several months but usually recover completely and do not have lasting liver damage. In rare cases, hepatitis A can cause liver failure and even death; this is more common in older people and in people with other serious health issues, such as chronic liver disease.

How common is hepatitis A in the United States?

In 2018, a total of 12,474 hepatitis A cases were reported in the United States. Because some people don’t ever get diagnosed, the actual number of cases reported in that year is probably closer to 24,900. Since 2016, person-to-person outbreaks of hepatitis A have been occurring across the United States mainly among people who use injection drugs or are experiencing homelessness, resulting in more than 32,000 cases.

Are cases of hepatitis A increasing in the United States?

Since the hepatitis A vaccine was first recommended in 1996, cases of hepatitis A in the United States declined dramatically. Unfortunately, in recent years the number of people infected has been increasing because there have been multiple outbreaks of hepatitis A in the United States resulting from person-to-person contact, especially among people who use drugs, people experiencing homelessness, and men who have sex with men.

Transmission / Exposure

How is hepatitis A spread?

The hepatitis A virus is found in the stool and blood of people who are infected. The hepatitis A virus is spread when someone ingests the virus (even in amounts too small to see) through:

►Person-to-person contact

Hepatitis A can be spread from close, personal contact with an infected person, such as through certain types of sexual contact (like oral-anal sex), caring for someone who is ill, or using drugs with others. Hepatitis A is very contagious, and people can even spread the virus before they feel sick.

►Eating contaminated food or drink

Contamination of food with the hepatitis A virus can happen at any point: growing, harvesting, processing, handling, and even after cooking. Contamination of food and water happens more often in countries where hepatitis A is common. Although uncommon, foodborne outbreaks have occurred in the United States from people eating contaminated fresh and frozen imported food products.

Who is at risk for hepatitis A?

Although anyone can get hepatitis A, in the United States, certain groups of people are at higher risk for getting infected and for having severe disease if they do get hepatitis A.

People at increased risk for hepatitis A

• International travelers
• Men who have sex with men
• People who use or inject drugs (all those who use illegal drugs)
• People with occupational risk for exposure
• People who anticipate close personal contact with an international adoptee
• People experiencing homelessness

People at increased risk for severe disease from hepatitis A infection

• People with chronic liver disease, including hepatitis B and hepatitis C
• People with HIV

What should I do if I think I have been exposed to hepatitis A virus?

If you think you have been exposed to the hepatitis A virus, call your health professional or your local or state health department as soon as possible, ideally within 2 weeks. A health professional can decide next steps based on your age and overall health.

Can I prevent infection after an exposure to the hepatitis A virus?

A single shot of the hepatitis A vaccine can help prevent hepatitis A if given within 2 weeks of exposure. Depending upon your age and health, your doctor may recommend immune globulin in addition to the hepatitis A vaccine.

If I have had hepatitis A in the past, can I get it again?

No. Once you recover from hepatitis A, you develop antibodies, protecting you for life.

How long does hepatitis A virus survive outside the body?

The hepatitis A virus can survive outside the body for months. Heating food and liquids to temperatures of 185°F (85°C) for at least 1 minute can kill the virus. Exposure to freezing temperatures does not kill the virus.

Symptoms

What are the symptoms of hepatitis A?

Not everyone with hepatitis A has symptoms. Adults are more likely to have symptoms than children. If symptoms develop, they usually appear 2 to 7 weeks after infection. Symptoms usually last less than 2 months, although some people can be ill for as long as 6 months.

If symptoms develop, they can include:

• Yellow skin or eyes
• Not wanting to eat
• Upset stomach
• Throwing up
• Stomach pain
• Fever
• Dark urine or light- colored stools
• Diarrhea
• Joint pain
• Feeling tired

Can a person spread hepatitis A virus without having symptoms?

Yes. Many people, especially children, have no symptoms but can still spread the infection. In addition, a person can transmit the hepatitis A virus to others up to 2 weeks before symptoms appear.

Diagnosis / Treatment

How is hepatitis A diagnosed?

A doctor can determine if you have hepatitis A by discussing your symptoms and ordering a blood test that can tell whether you have been recently infected with the virus that causes hepatitis A.

How is hepatitis A treated?

To treat the symptoms of hepatitis A, doctors usually recommend rest, adequate nutrition, and fluids. Some people with severe symptoms will need medical care in a hospital.

Prevention / Vaccination

How can I protect myself against hepatitis A?

The best way to prevent hepatitis A is through vaccination with the hepatitis A vaccine. To get the full benefit of the hepatitis A vaccine, more than one shot is needed. The number and timing of these shots depends on the type of vaccine you are given. Practicing good hand hygiene — including thoroughly washing hands after using the bathroom, changing diapers, and before preparing or eating food — plays an important role in preventing the spread of hepatitis A.

Who should get vaccinated against hepatitis A?

The following people should be vaccinated against hepatitis A:

Children

• All children aged 12–23 months
• All children and adolescents 2–18 years of age who have not previously received hepatitis A vaccine (known as “catch up” vaccination)

People at increased risk for hepatitis A

People at increased risk for severe disease from hepatitis A infection

Other people recommended for vaccination

• Pregnant women at risk for hepatitis A or risk for severe outcome from hepatitis A infection
• Any person who requests vaccination

How is the hepatitis A vaccine given?

There are two types of hepatitis A vaccine. The first type, the single-dose hepatitis A vaccine, is given as two shots, 6 months apart, and both shots are needed for long-term protection against hepatitis A. The other type is a combination vaccine that protects people against both hepatitis A and hepatitis B. The combination vaccine can be given to anyone 18 years of age and older and is given as three shots over 6 months. All three shots are needed for long-term protection for both hepatitis A and hepatitis B.

Is the hepatitis A vaccine effective?

Yes, both types of hepatitis A vaccine are highly effective in preventing hepatitis A virus infection. Receiving the entire vaccine series (all of the required shots) results in long-term protection.

Is the hepatitis A vaccine safe?

Yes, the hepatitis A vaccine is safe. No serious side effects have been reported from the hepatitis A vaccine. Soreness at the injection site is the most common side effect reported. As with any medicine, there is always a small risk that a serious problem could occur after someone gets the vaccine. However, the potential risks of hepatitis A are much greater than the potential risks associated with the hepatitis A vaccine. Millions of doses of hepatitis A vaccine have been given in the United States and worldwide since the first hepatitis A vaccine was licensed in 1995.

Who should not receive the hepatitis A vaccine?

People who have ever had a life-threatening allergic reaction to the hepatitis A vaccine or who are known to be allergic to any part of the hepatitis A vaccine should not receive the vaccine. Tell your doctor if you have any severe allergies. Also, the vaccine is not licensed for use in infants under age 1 year.

What is immune globulin?

Immune globulin is a substance made from human blood plasma that contains antibodies, which are the body’s natural defense against infection. Injections of immune globulin may be given under certain circumstances, like when someone is too young to get vaccinated or can’t get vaccinated because of a previous, life-threatening reaction to the hepatitis A vaccine or vaccine component. Unlike the hepatitis A vaccine, immune globulin does not provide long-term protection against infection.

Will the hepatitis A vaccine protect me from other forms of hepatitis?

No. The hepatitis A vaccine only protects against hepatitis A. There is a separate vaccine available for hepatitis B. There is also a combination hepatitis A and hepatitis B vaccine that offers protection for both viruses. There is no vaccine for hepatitis C at this time.

Can hepatitis A vaccine be given to people with compromised immune systems, such as hemodialysis patients or people with HIV/AIDS?

Yes. The hepatitis A vaccine can be given to people with compromised immune systems.

Is it harmful to have an extra dose of hepatitis A vaccine or to repeat the entire hepatitis A vaccine series?

No, getting extra doses of hepatitis A vaccine is not harmful.

What should be done if the last dose of hepatitis A vaccine is delayed?

If the second dose has been delayed (more than 6 months since the first dose was given), it should be given as soon as possible. The first dose does not need to be given again.

Where can I get the hepatitis A vaccine?

Speak with your health-care provider or call your local public health department, where free or low-cost vaccines for adults may be offered. For children, check the Vaccines for Children Program.

Hepatitis A Vaccine and International Travel

Who should get the hepatitis A vaccine before traveling internationally?

All unvaccinated people, along with those who have never had hepatitis A, should be vaccinated before traveling to countries where hepatitis A is common. Travelers to urban areas, resorts, and luxury hotels in countries where hepatitis A is common are still at risk. International travelers have been infected, even though they regularly washed their hands and were careful about what they drank and ate. Those who are too young or can’t get vaccinated because of a previous, life-threatening reaction to the hepatitis A vaccine or vaccine component should receive immune globulin. Travelers to other countries where hepatitis A does not commonly occur are not recommended to receive hepatitis A vaccine before travel.

How soon before travel should I get the hepatitis A vaccine?

You should get the first dose of hepatitis A vaccine as soon as you plan international travel to a country where hepatitis A is common. The vaccine will provide some protection even if you get vaccinated closer to departure. For older adults (age >40 years), people who are immunocompromised, and people with chronic liver disease or other chronic medical conditions the health-care provider may consider, based on several factors, giving an injection of immune globulin at the same time in different limbs.

What should I do if I am traveling internationally but cannot receive hepatitis A vaccine?

People who are allergic to a vaccine component or are younger than 6 months should receive a single dose of immune globulin before traveling to a country where hepatitis A is common. Immune globulin provides effective protection against hepatitis A virus infection for up to 2 months, depending on the dosage given. If you are staying longer than 2 months, you can get another dose of immune globulin during your visit for continued protection against hepatitis A.

Hepatitis A

Hepatitis A

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• Hepatitis A

Key facts

• Hepatitis A is an inflammation of the liver that can cause mild to severe illness.
• The hepatitis A virus (HAV) is transmitted through ingestion of contaminated food and water or through direct contact with an infectious person.
• Almost everyone recovers fully from hepatitis A with a lifelong immunity. However, a very small proportion of people infected with hepatitis A could die from fulminant hepatitis.
• The risk of hepatitis A infection is associated with a lack of safe water and poor sanitation and hygiene (such as contaminated and dirty hands).
• A safe and effective vaccine is available to prevent hepatitis A.

Overview

Hepatitis A is an inflammation of the liver caused by the hepatitis A virus (HAV). The virus is primarily spread when an uninfected (and unvaccinated) person ingests food or water that is contaminated with the faeces of an infected person. The disease is closely associated with unsafe water or food, inadequate sanitation, poor personal hygiene and oral-anal sex.

Unlike hepatitis B and C, hepatitis A does not cause chronic liver disease but it can cause debilitating symptoms and rarely fulminant hepatitis (acute liver failure), which is often fatal. WHO estimates that in 2016, 7134 persons died from hepatitis A worldwide (accounting for 0.5% of the mortality due to viral hepatitis).

Hepatitis A occurs sporadically and in epidemics worldwide, with a tendency for cyclic recurrences. Epidemics related to contaminated food or water can erupt explosively, such as the epidemic in Shanghai in 1988 that affected about 300 000 people (1). They can also be prolonged, affecting communities for months through person-to-person transmission. Hepatitis A viruses persist in the environment and can withstand food production processes routinely used to inactivate or control bacterial pathogens.

Geographical distribution

Geographical distribution areas can be characterized as having high, intermediate or low levels of hepatitis A virus infection. However, infection does not always mean disease because infected young children do not experience any noticeable symptoms.

Infection is common in low- and middle-income countries with poor sanitary conditions and hygienic practices, and most children (90%) have been infected with the hepatitis A virus before the age of 10 years, most often without symptoms (2). Infection rates are low in high-income countries with good sanitary and hygienic conditions. Disease may occur among adolescents and adults in high-risk groups, such as persons who inject drugs (PWID), men who have sex with men (MSM), people travelling to areas of high endemicity and in isolated populations, such as closed religious groups. In the United States of America, large outbreaks have been reported among persons experiencing homelessness. In middle-income countries and regions where sanitary conditions are variable, children often escape infection in early childhood and reach adulthood without immunity.

Transmission

The hepatitis A virus is transmitted primarily by the faecal-oral route; that is when an uninfected person ingests food or water that has been contaminated with the faeces of an infected person. In families, this may happen though dirty hands when an infected person prepares food for family members. Waterborne outbreaks, though infrequent, are usually associated with sewage-contaminated or inadequately treated water.

The virus can also be transmitted through close physical contact (such as oral-anal sex) with an infectious person, although casual contact among people does not spread the virus.

Symptoms

The incubation period of hepatitis A is usually 14–28 days.

Symptoms of hepatitis A range from mild to severe and can include fever, malaise, loss of appetite, diarrhoea, nausea, abdominal discomfort, dark-coloured urine and jaundice (a yellowing of the eyes and skin). Not everyone who is infected will have all the symptoms.

Adults have signs and symptoms of illness more often than children. The severity of disease and fatal outcomes are higher in older age groups. Infected children under 6 years of age do not usually experience noticeable symptoms, and only 10% develop jaundice. Hepatitis A sometimes relapses, meaning the person who just recovered falls sick again with another acute episode. This is normally followed by recovery.

Who is at risk?

Anyone who has not been vaccinated or previously infected can get infected with the hepatitis A virus. In areas where the virus is widespread (high endemicity), most hepatitis A infections occur during early childhood. Risk factors include:

• poor sanitation;
• lack of safe water;
• living in a household with an infected person;
• being a sexual partner of someone with acute hepatitis A infection;
• use of recreational drugs;
• sex between men; and
• travelling to areas of high endemicity without being immunized.

Diagnosis

Cases of hepatitis A are not clinically distinguishable from other types of acute viral hepatitis. Specific diagnosis is made by the detection of HAV-specific immunoglobulin G (IgM) antibodies in the blood. Additional tests include reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis A virus RNA and may require specialized laboratory facilities.

Treatment

There is no specific treatment for hepatitis A. Recovery from symptoms following infection may be slow and can take several weeks or months. It is important to avoid unnecessary medications that can adversely affect the liver, e.g. acetaminophen, paracetamol.

Hospitalization is unnecessary in the absence of acute liver failure. Therapy is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhoea.

Prevention

Improved sanitation, food safety and immunization are the most effective ways to combat hepatitis A.

The spread of hepatitis A can be reduced by:

• adequate supplies of safe drinking water;
• proper disposal of sewage within communities; and
• personal hygiene practices such as regular handwashing before meals and after going to the bathroom.

Several injectable inactivated hepatitis A vaccines are available internationally. All provide similar protection from the virus and have comparable side effects. No vaccine is licensed for children younger than 1 year of age. In China, a live attenuated vaccine is also available.

WHO response

 

Global health sector strategies on, respectively, HIV, viral hepatitis, and sexually transmitted infections for the period 2022–2030 (GHSSs) guide the health sector in implementing strategically focused responses to achieve the goals of ending AIDS, viral hepatitis (especially chronic hepatitis B and C)  and sexually transmitted infections by 2030.

The GHSS recommend shared and disease-specific country actions supported by actions by WHO and partners. They consider the epidemiological, technological, and contextual shifts of previous years, foster learnings across the disease areas, and create opportunities to leverage innovations and new knowledge for effective responses to the diseases. They call to scale up prevention, testing and treatment of viral hepatitis with a focus to reach populations and communities most affected and at risk for each disease, as well as addressing gaps and inequities. They promote synergies under a universal health coverage and primary health care framework and contribute to achieving the goals of the 2030 Agenda for Sustainable Development.

WHO organizes annual World Hepatitis Day campaigns (as 1 of its 9 flagship annual health campaigns) to increase awareness and understanding of viral hepatitis. For World Hepatitis Day 2023, WHO focuses on the theme “One life, one liver” to illustrate the importance of the liver for a healthy life and the need to scale up viral hepatitis prevention, testing and treatment to prevent liver diseases and achieve the 2030 hepatitis elimination target.

 

Global hepatitis report, 2017

World Hepatitis Day

Global health sector strategy on viral hepatitis

 

 


Publications

• Financing prevention, testing and treatment of hepatitis in the context of Universal Health Coverage
• Guidelines for viral hepatitis planning and tracking progress towards elimination
• Immunological basis for immunization: hepatitis A
• The global prevalence of hepatitis A virus infection and susceptibility
• WHO position paper on hepatitis A vaccines
• More WHO publications

 

More about hepatitis

• WHO’s work on hepatitis
• Global Hepatitis Programme

 

 

Treatment of hepatitis A – signs, causes, symptoms, diagnosis, prevention

Hepatitis A

07 Treatment of viral hepatitis A

• Prevention of hepatitis A
• Advantages of the Mama Papa Ya clinic
  
  

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Viral hepatitis A is an infectious disease that affects the liver, occurs in an acute form and is accompanied by short-term symptoms. Jaundice, hepatitis a, Botkin’s disease in everyday life are synonymous.

Causes of hepatitis A

The causative agent of hepatitis A is a virus that multiplies in the liver cells. More than 60% of patients are children of 3-7 years of age. The disease often takes the form of epidemic outbreaks.

How hepatitis a is contracted: this is a classic intestinal infection, so you can become infected by drinking contaminated water or food, and not observing hygiene rules.

Hepatitis A virus is excreted in the faeces of patients, as well as carriers of infection or patients with an erased form of the disease. Getting into the gastrointestinal tract of a healthy person, it penetrates through the blood into hepatocytes and destroys them. The disease proceeds only in an acute form and ends with recovery. In almost all adults, antibodies are found in the blood, indicating an infection.

It is impossible to infect a child through blood, sexual contact and from the mother.

The incidence increases in autumn and winter, and in the summer months, cases of the disease are rarely recorded. After infection, lifelong immunity remains.

Symptoms of viral hepatitis A

Acute hepatitis A occurs in stages.

• The incubation period is from 2 weeks to a month. There are no symptoms of hepatitis A, but there is already a virus in the blood and abnormal liver function is determined.
• The preicteric period lasts from 3 to 8 days. Symptoms of hepatitis a in children occur acutely: the temperature rises, intoxication occurs, severe weakness, nausea, pain in the liver, headache, sleep and stool disturbances. Children become moody and irritable. After 1 – 2 days, the temperature decreases, and the patient’s condition improves somewhat. Adults at this time may experience the same symptoms, but in a milder form.
• The icteric period lasts up to 2 weeks. At the same time, the signs of hepatitis a weaken, the state of health of most patients returns to normal. Darkening of urine and discoloration of feces, jaundice is determined. The liver is enlarged.
• The post-icteric period lasts quite a long time. At this time, there is a gradual recovery of the liver.

The convalescence period lasts up to 3 months. At this time, patients feel quite healthy, sometimes complain of fatigue, abdominal pain. In the blood, an increase in the activity of liver enzymes is periodically determined.

The course of the disease can be acute (in 95% of cases), protracted, with exacerbations, with biliary dyskinesia and other complications. Therefore, in each case, the approach to the treatment of such a patient is individual.

Diagnosis of hepatitis A

In addition to epidemiological and clinical data, diagnosis of hepatitis A includes:

• biochemical blood test to determine the activity of liver enzymes and the level of bilirubin;
• analysis for hepatitis a – detection of viral antigen by PCR or IgM class antibodies to it.

Hepatitis A treatment

Hepatitis A treatment is usually done at home. Only patients with severe forms of the disease are hospitalized. Bed rest is recommended in the first days until you feel better, then it gradually expands.

Hepatitis A diet includes:

• proteins: dairy products, lean meat and fish, scrambled eggs;
• fats: butter, olive, sunflower oil;
• carbohydrates: rice, oatmeal, buckwheat, potatoes, pasta, sugar, vegetables, juices, fruits;
• allowed salads, vinaigrette, honey, marshmallow, jam, prunes, dried apricots, raisins, bread.

Prohibited:

• pork, other fatty meats, poultry or fish;
• canned food;
• sausage;
• legumes;
• confectionery and chocolate;
• marinades and spices;
• garlic, radish, spicy cheese, mayonnaise and other foods that irritate the digestive tract.

Cholagogues, vitamins, essential phospholipids, ursosan, enterosorbents are prescribed. Antiviral drugs and antibiotics are not used.

Traditional methods of treatment:

• infusion of valerian, hawthorn and mint;
• infusion of immortelle, yarrow, wormwood and dill;
• infusion of wild rose and rowan berries;
• raw potato juice.

Hepatitis A prophylaxis

There are non-specific and specific prophylaxis for hepatitis A. Anti-epidemic measures:

• when a case of illness is detected, all contact persons are examined and their blood is taken for analysis for early detection of the epidemic;
• current and final disinfection is carried out in the focus of the disease, the quality of water and food is carefully monitored;
• In contact with the patient, prepared antibodies are administered in the form of immunoglobulin.

Immunoglobulin is not a hepatitis A vaccine, but only a measure to support the body’s defense against the virus. It is administered in the first 7 days after the diagnosis of the disease in the focus.

The only way to reliably protect a child from the virus is the hepatitis A vaccine. Domestic preparations are allowed for use, as well as the vaccines Havrix, Avaxim, Vakta, Twinrix. They are well tolerated and rarely cause adverse reactions, mainly in allergic children.

Children are vaccinated against hepatitis A at one year of age, and then again after 6 to 12 months. This scheme provides reliable immunity in 95% of those vaccinated.

Benefits of the Mama Papa Ya Clinic

If a child is ill with viral hepatitis A, the Mama Papa Ya family clinic network offers services for the diagnosis and treatment of this disease. Our advantages:

• a large network of clinic branches in Moscow and other cities;
• affordable prices for services;
• careful laboratory diagnosis of the disease;
• prescribing modern drugs for a speedy recovery;
• nutritionist consultation;
• the possibility of vaccinating patients of any age with modern drugs;
• dispensary observation of a sick person in comfortable conditions, without queues.

To make an appointment for a consultation, you can call the clinic or leave a request on our website.

Reviews

Good clinic, good doctor! Raisa Vasilievna can clearly and easily explain what the essence of the problem is. If something is wrong, she talks about everything directly, not in a veiled way, as other doctors sometimes do. I don’t regret that I went to her.

Anna

I would like to thank the staff of the clinic Mom, Dad, me. The clinic has a very friendly atmosphere, very friendly and cheerful staff and highly qualified specialists. Thank you very much! I wish prosperity to your clinic.

Anonymous user

Today I removed a mole on my face at the dermatologist Kodareva I.A. Doctor is very thorough! Correct! Thanks a lot! Administrator Borshchevskaya Julia is friendly, clearly fulfills her duties.

Belova E.M.

Today I was served in the clinic, I was satisfied with the staff, as well as the gynecologist. Everyone treats patients with respect and care. We thank them very much and continue to prosper.

Anonymous

The Mama Papa Ya clinic in Lyubertsy is very good. The team is friendly and responsive. I recommend this clinic to all my friends. Thanks to all doctors and administrators. I wish the clinic prosperity and many adequate clients.

Iratiev V.V.

Visited the clinic “Mama Papa Ya” with a child. I needed a consultation with a pediatric cardiologist. I liked the clinic. Good service doctors. We didn’t stand in line, everything was the same price.

Evgeniya

I liked the first visit. I was carefully examined, additional examinations were prescribed, and good recommendations were given. I will continue the treatment further, I liked the conditions in the clinic.

Kristina

The doctor carefully examined my husband, ordered an ECG and made a preliminary diagnosis. She made recommendations about our situation and ordered additional examinations. So far, there are no comments. Financial agreements have been met.

Marina Petrovna

I really liked the clinic. Helpful staff. Was at the appointment with the gynecologist Mikhailova E.A. Satisfied, there are more such doctors. Thank you!!!

Olga

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Hepatitis A symptoms and treatment

Hepatitis A is a liver disease caused by the hepatitis A virus (HAV). HAV causes the liver to swell and prevent it from working properly.

HAV usually resolves spontaneously in almost all cases without serious complications. However, HAV can cause liver failure in some patients. About 100 people die of HAV every year in the United States. Those at risk for serious long-term consequences of HAV include people with other liver diseases and people over 60 years of age.

Facts in Brief

1. The incidence of hepatitis A in the United States has decreased by more than 95% since the hepatitis A vaccine became available in 1995 year.
2. Symptoms of hepatitis A usually last less than 2 months.

Information for the newly diagnosed

Who is at risk of contracting hepatitis A?

Anyone who has been in close contact with someone who has HAV, or who has eaten food or water contaminated with HAV, is at risk.

• Ever lived with an infected person
• Have ever been the sexual partner of an infected person
• Man who has sex with men
• Ever used drugs
• Ever traveled to countries where HAV is common;

HAV most commonly distributed:

• Do not wash hands before preparing or eating
• Do not wash hands after going to the toilet or changing a diaper.
• Eating raw or undercooked shellfish from sewage contaminated waters.

What are the symptoms of hepatitis A virus?

Low energy is the most common symptom of HAV. Other symptoms include fever, fatigue, loss of appetite, nausea, headache, itchy skin, muscle soreness, pain near the liver, and jaundice (yellowing of the skin and whites of the eyes).

Symptoms of HAV may appear two to seven weeks after infection and are often mild. Children may not have symptoms. Symptoms usually resolve within two months. If you think you have HAV, it’s important to see a doctor – HAV symptoms are similar to other, more serious liver diseases.

How is hepatitis A diagnosed?

Hepatitis A is diagnosed on the basis of a blood test.

A blood test is done to find out if you have antibodies to the hepatitis A virus. Antibodies are proteins created by the immune system in response to viruses.

How is hepatitis A treated?

HAV usually clears up on its own within six months.

Doctors often recommend bed rest, drinking plenty of fluids, eating a healthy diet, and avoiding alcohol. Medicines are not used to treat HAV. Talk to your doctor before taking prescription or over-the-counter medications, vitamins, or herbal supplements.

Itchy skin caused by HAV can be treated with over-the-counter anti-itch medicines.

It is important to see a doctor regularly to make sure your body is completely healed of the virus. Also talk to your doctor about hepatitis B vaccination.

What is the best way to stop the spread of hepatitis A?

Hepatitis A vaccination is the best way to prevent hepatitis A. Hepatitis A vaccine is given in two doses, usually about 2 months apart.

Other ways to stop the spread of HAV:

• Always wash your hands with soap and warm water immediately after going to the toilet or changing a diaper.
• Always wash your hands with warm soapy water before preparing or eating.

Who should be vaccinated against hepatitis A?

Those who should be vaccinated against HAV include:

• All children aged 1 year
• All children over 1 year of age living in areas where HBV is common.
• People with chronic liver disease
• People with bleeding disorders
• People who have had or are waiting for a liver transplant
• People who use drugs
• Men who have sex with men
• Travelers to countries where HAV is common
• Sexual partners and family members of people with HAV

If you think you have been exposed to HAV, your doctor may give you an HAV vaccination or immunoglobulin shot, which can help increase your protection against HAV.

Questions to ask your doctor

• What medicines can I take for a fever?
• Are there medicines for nausea that I should take?
• Do I need a hepatitis A booster?
• Should I get a hepatitis B booster?
• Am I contagious? How can I notify people I may have been in close contact with?

Finding Clinical Trials

Clinical trials are scientific studies that test how well new medical approaches work in people. Before an experimental treatment can be tested in humans in clinical trials, it must demonstrate benefit in laboratory or animal studies. The most promising treatments are then transferred to clinical trials to identify new ways to safely and effectively prevent, screen, diagnose, or treat disease.

Talk to your doctor about the current progress and results of these trials to get the latest information about new treatments. Participation in clinical trials is a great way to help treat, prevent, and manage liver disease and its complications.