What Is Hepatitis A?

Hepatitis A is one of five known viruses that cause inflammation of the liver (the others are B, C, D and E). The Centers For Disease Control and Prevention estimate that 150,000 people in the U.S. are infected each year by Hepatitis A, a low rate compared to the rate in underdeveloped countries. The vast majority of people recover from the infection within six months without any serious health problems

How Is Hepatitis A Transmitted?

Transmission is usually by drinking water or eating food that has been contaminated with fecal matter containing the virus. Unlike the Hepatitis B and C viruses, the Hepatitis A virus remains stable when liver cells secrete it into bile, which then enters the digestive tract. Fecal matter from an infected person has a high concentration of the virus during a certain period of infection, whereas saliva and other bodily fluids have a low concentration. The virus can survive in this contaminated fecal matter on a persons hand, for example, or on a surface for three to four hours at normal room temperatures. Thus, an eating utensil contaminated with the virus could be a way to transmit the infection to a person. Contaminated shellfish are a frequent source of infection. Direct contact with an infected person is another confirmed transmission route, as are kissing on the mouth and anal sex. Contamination of needles used for intravenous administration of drugs is a suspected route of transmission. In over 40% of the reported cases it is not known how these people were infected.

Who Is At Risk For Hepatitis A?

The risk of being infected with the Hepatitis A virus generally depends on the hygienic and sanitary conditions in an area. High risk geographic areas are the Middle East, South America, Eastern Europe, Central America, Africa and Southeast Asia. There are also areas in the United States where poor sanitary conditions or hygiene have resulted in outbreaks of Hepatitis A. It is also after symptoms appear or two to three weeks before that patients will shed the virus in high concentration in feces and thus they are most infectious to others. The Centers for Disease Control and Prevention (CDC) lists household or sexual contact, daycare attendance or employment and recent international travel as the major known risk factors for the transmission of Hepatitis A. The CDC estimates that a third of the U.S. population has been infected. Children at daycare centers spread the virus because of fecal-oral contamination through diaper changing. Outbreaks have been reported in the military, at institutions for the disabled and because of infected restaurant workers. Those using injectable drugs with contaminated needles have also been infected with the virus.

What Are The Symptoms For Hepatitis A Infection?

As with the other hepatitis viruses a person infected with Hepatitis A may not have any symptoms. However, in those who do have symptoms, they resemble the flu. These symptoms include fatigue, nausea, vomiting, pain in the liver area, dark urine or light colored stools and fever. Liver function tests are elevated, with many adults developing jaundice. Children under two rarely have symptoms. Most people recover within six months.

Can Hepatitis A Result In Serious Complications?

A very small percentage of people infected with Hepatitis A risk serious complications. These include people with alcoholic hepatitis, chronic hepatitis with cirrhosis or the elderly over 60 years old. These patients may suffer liver failure after becoming infected with Hepatitis A. Federal mortality statistics for 1992 list Hepatitis A as the primary cause of death for 82 people. In 1993 an estimated 121 people were hospitalized for Hepatitis A. Patients with Hepatitis A may show improvement in their symptoms and liver function tests only to suffer a relapse, usually after four weeks. A relapse can occur more than once and there is no way to predict who will suffer a recurrence of acute symptoms. In rare cases, jaundice lasts for two or more months. It is rare for pregnant women who are infected with Hepatitis A to suffer serious complications to themselves or their newborn children.

How Is Hepatitis A Diagnosed ?

Hepatitis A is diagnosed by a blood test that is positive for the antibody to the virus, which appears about four weeks after the infection. There are no false positives or negatives with this test. Liver function tests (serum alanine aminotransferase [ALT] and asparate aminotransferase [AST]) are elevated above normal, often to very high levels. Symptoms will normally appear during the first four weeks of infection. How Is Hepatitis A Treated? There is no specific treatment for Hepatitis A. Most patients are told to rest for one to four weeks after a diagnosis is made, to avoid intimate contact and to consume foods high in protein. People who have come into contact with the patient should be given temporary immunization with immune serum globulin (ISE), within two weeks of exposure.

What Is The Hepatitis A Vaccine?

The current vaccine for Hepatitis A in the U.S. is manufactured by SmithKline Beecham, Inc. The vaccine is made from an inactive Hepatitis A virus that has been suspended in a sterile solution. It is not made from infected blood. The body reacts with the inactive virus to produce an antibody that protects against infection of the liver by the Hepatitis A virus. Clinical trials have shown that the vaccine is effective in preventing infection in over 90% of people who were exposed. There are generally no known side effects, except for soreness at the site of the injection. Less than 10% of those vaccinated become tired and nauseous. Children between one and 18 should receive two initial doses of the vaccine and a booster between six and 12 months. Adults should receive an initial dose and then a booster six to 12 months later. It takes at least two weeks before protection is achieved. It is not certain how long protection will last.

American Liver Foundation
1425 Pompton Avenue,
Cedar Grove, NJ 070091-800-223-0179

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