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Hepatitis A
- Overview, Causes, & Risk Factors
- Symptoms & Signs
- Diagnosis & Tests
- Prevention & Expectations
- Treatment & Monitoring
- Attribution
Overview, Causes, & Risk Factors
Hepatitis A is an infection and inflammation of the liver caused by the hepatitis A virus. It is one of several types of hepatitis.
What is going on in the body?
The liver is an important organ located in the upper right quadrant of the abdomen. It is responsible for:
The liver is susceptible to hepatitis viruses. A hepatitis virus can cause sudden, severe inflammation of the liver cells. Infection can occur at any age. Classic yellowing of the eyes and skin, called jaundice, is usually the first sign of a problem. Hepatitis A does not cause problems or disease in other parts of the body, as other hepatitis viruses can.
After exposure to the virus, the hepatitis usually occurs within 2 to 4 weeks. In industrialized countries, hepatitis A usually occurs in an epidemic setting. This is a cluster of cases in a population that has previously been unexposed. These cases in an epidemic can have a common source of exposure.
Some parts of the world have persistent, ongoing cases in a large part of the population. This hepatitis, called endemic hepatitis A, occurs in nonindustrialized countries.
What are the causes and risks of the infection?
Hepatitis A is generally spread by food and water that is contaminated with the virus from an infected person. Rarely, it is spread when a person is exposed to the blood of another person with acute hepatitis. The following groups have a higher risk for this disease:
Symptoms & Signs
What are the signs and symptoms of the infection?
Symptoms can range from mild to moderate and include:
The symptoms gradually improve. Children with hepatitis A often do not have symptoms.
Rarely, acute fulminant hepatitis, which involves severe liver cell destruction and loss of liver function, occurs. It can be fatal. Symptoms include:
Diagnosis & Tests
How is the infection diagnosed?
The healthcare provider may suspect hepatitis A after doing a physical examination and checking liver function tests. Another blood test, often drawn at the same time as the liver function tests, can confirm that hepatitis A is the cause of the symptoms.
Hepatitis A recurs in about 10% of people. This results in symptoms that come and go, along with abnormal liver function tests over several weeks to a few months.
Prevention & Expectations
What can be done to prevent the infection?
To prevent the infection, a person should:
What are the long-term effects of the infection?
For most people, hepatitis A clears up and there are no long-term problems. Rarely, there are long-term problems such as:
What are the risks to others?
Anyone who comes into contact with a person with hepatitis A is at risk for the disease. It is most important that no one is exposed to the stool or urine of the infected person. Other bodily secretions are not likely to cause an infection.
Finding the source and preventing additional exposure to that source also is very important. People with active hepatitis A need to wash their hands well after using the toilet. Infected people may need to take 1 to 4 weeks of time off from work. They also may need to report to their local health department.
Treatment & Monitoring
What are the treatments for the infection?
Treatment of hepatitis A includes:
Antiviral and anti-inflammatory medications are not helpful for the treatment of hepatitis A.
Acute fulminant hepatitis can cause life-threatening liver failure. This requires a hospital stay and treatment for the bleeding disorder,as well as for neurological and nutritional problems. Sometimes, the only effective treatment is a liver transplant.
What are the side effects of the treatments?
The side effects of treatment for routine hepatitis A are minimal. Problems associated with the hepatitis A vaccine are minimal, as well. A person who has been exposed to the virus and is injected with serum immunoglobulin as a precaution may feel some pain at the injection site or have a mild, brief flu-like illness.
A liver transplant for acute fulminant hepatitis can cause many problems, including failure or rejection of the new liver. After a liver transplant, a person will need to take powerful antirejection medications for the rest of his or her life. Side effects of these medications increase the risk for infections, certain cancers, and other problems.
What happens after treatment for the infection?
After the hepatitis A is resolved, the person will no longer need medications. He or she can return to normal activities, even if some jaundice remains.
How is the infection monitored?
The healthcare provider will often repeat the liver function tests to assure that they are normal. Other tests, like liver ultrasound or CAT scans, are not needed.
Attribution
Author:Thomas Fisher, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:01/31/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:07/13/01