It is known as HAV and is present in the faeces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining immune from further HAV infections. However, HAV infections can also be severe and life threatening. Most people in areas of the world with poor sanitation have been infected with this virus. Safe and effective vaccines are available to prevent HAV.
Hepatitis also known as jaundice is a condition brought about by the inflammation of the liver. Though there are various causes for this, hepatitis is most commonly caused by a viral infection. When this infection of the liver is caused by the hepatitis A virus (HAV), the disease is termed Hepatitis A – a condition, according to the WHO estimation, where there are about 1.4 million cases of hepatitis A every year worldwide. So what causes it? What are its symptoms and how is it treated? Well, here are all the answers to those questions.
Lack of safe water and poor sanitation are the main predisposing factors of Hepatitis A. The virus spreads by the faeco–oral route and is transmitted through food and water contaminated with infected faeces or by foods prepared by an infected person. Insufficiently cooked shellfish is another common source. It can also be acquired through close personal contact with an infected individual or through certain unsafe sex practices. Less commonly, sewage-contaminated water can cause waterborne epidemics of the disease.
Once ingested, the virus enters the blood through the inner lining of the intestine and reaches the liver where it multiplies. It is then secreted into the bile and released in stool. The incubation period, i.e. time between first contact with the virus and development of symptoms, of the virus is usually 14–28 days and is the most infective period of the disease.
HAV infection is usually mild and patients can fully recover. Symptoms usually appear after the incubation period (14–28 days). Majority of children usually do not exhibit any symptoms.
Older children and adults may start showing symptoms like fever, tiredness, malaise, nausea, loss of appetite, abdominal discomfort, diarrhoea, dark yellow urine and clay-coloured faeces for around a week after the incubation period (prodromal or pre-icteric phase).
Within 10 days of the initial symptoms jaundice (yellowing of the skin and whites of the eyes) develops (icteric phase). Thereafter, the fever usually subsides. But the faeces may remain infectious for couple of weeks more.
Other symptoms may last for a month or two with slow resolution of the disease and complete recovery (convalescent period). Rarely, HAV infections can cause acute liver failure which can be potentially severe as well as life threatening.
Read more about 8 jaundice symptoms you need to watch out for.
Hepatitis A infection can be diagnosed by blood test. The test detects IgM and IgG antibodies to HAV in the blood. The presence of IgM antibody indicates acute stage of the illness. Liver function test can detect elevated levels of the liver enzyme alanine transaminase. The virus and/or antigen may also be detected in the faeces.
The infection does not have any specific treatment. Symptoms may be relieved with rest and medications. Stay hydrated. Have a well-balanced diet. Avoid fatty foods and alcohol. It is also advisable to consult a doctor before taking drugs that are toxic to the liver. Acute liver failure may require liver transplantation.
Hepatitis A is self-limiting and most people recover within 2 to 3 months. The infection usually resolves completely in nearly all patients within 6 months. But in a few people (around 3 – 20%), there may be a relapse 4 to 15 weeks after initial recovery. Relapse is usually milder than the first infection. The risk of acute liver failure is higher in the elderly and in individuals with chronic liver disease.
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The disease can be prevented by good hygiene like washing hands after using the restroom and before eating meals, improved sanitation and sewage disposal, food safety, properly cooking food and immunization. Chlorination of water can prevent waterborne epidemics.
An infection with hepatitis A provides lifelong immunity to the disease. If not already infected, hepatitis A vaccine can give protection against the virus. It is an optional vaccination in India. Two shots are given at least six months apart. The first dose is given when a child is above 12 months of age.
Read about 5 simple tips to prevent jaundice.
The content has been verified by
Dr. Vijay D'Silva
Medical Affairs & Critical Care, Asian Heart Institute, Mumbai.