Hepatitis A is a liver disease where a virus causes inflammation of the liver. Many causes of hepatitis are viral infections, and hepatitis A is caused by the hepatitis A virus, or HAV. While it is highly contagious, most people recover from hepatitis A within three months and nearly all patients by six months. It is not a chronic disease and will not return (unless the person becomes reinfected). Hepatitis A is more common in developing countries where the virus is carried through contaminated water. In more developed countries, hepatitis A tends to occur in local outbreaks and is responsible for anywhere from 20 to 25 percent of acute hepatitis cases.
The most common way for hepatitis A to spread is through the fecal-oral route. This means that somehow, a person becomes infected by ingesting contaminated fecal matter from an already infected person. For example, if an infected person uses the bathroom and does not properly wash their hands, the contaminated matter on their hands can spread to other surfaces, including food. An infected person is usually contagious from two to six weeks.
Hepatitis A can be spread through many ways of person-to-person contact. For example, one can also become infected by being a caretaker of someone with hepatitis A because of the close contact. It also can be spread through sexual contact or from sharing drug needles. However, hepatitis A is not airborne, and it does not spread through coughing or sneezing or by being in the same room with an infected person. Also, infected mothers do not pass hepatitis A through their breast milk, so their infants are unaffected.
The risk factors for hepatitis A are higher for some populations than others. Risk factors for hepatitis A are highest for:
In every case, hepatitis A is always caused by HAV, the hepatitis A virus, no matter how it is spread. It can take two to eight weeks for an infected person to become symptomatic, also meaning that they are contagious during the incubation period.
It’s also good to keep in mind that shellfish can be contaminated if it is harvested in contaminated water, and both water and ice can be contaminated and infectious. Fresh fruits and vegetables are also at risk of carrying hepatitis A, which is why it is always important to wash your vegetables (and your hands!) before cooking.
If you are infected, your symptoms will likely present in roughly four weeks after contact. For some patients, symptoms can appear as early as two weeks after contact, while in others, it can take upward of eight weeks. Children and some adults infected with hepatitis A may feel no symptoms at all, however, they are still contagious. Some of the more common symptoms of hepatitis A include:
If you have one or more of these symptoms (particularly jaundice), it’s a good idea to make an appointment with your gastroenterologist for a checkup to either confirm a hepatitis A diagnosis or discover what is causing your symptoms.
Your healthcare provider can diagnose hepatitis A with a blood test. After the bloodwork is sent to the lab, it is checked for immunoglobulin M (IgM) antibodies. If these are present, this indicates acute hepatitis A. If you have antibodies, but IgM is not present, then this means you already had hepatitis A and recovered, or you received the hepatitis A vaccine. Bloodwork alone is enough for a hepatitis A diagnosis.
If you have not had a hepatitis A vaccine and your diagnosis has been confirmed, the first line of treatment may be for your physician to administer the hepatitis A vaccine or immune globulin (IG). This is only a viable treatment if it is provided within two weeks of exposure. If your diagnosis falls outside of this two-week window, there is no viable treatment, and you are likely to recover on your own without medical intervention. Hepatitis A is not progressive or chronic, so you no longer have hepatitis A once the infection is cleared. While you are recovering from hepatitis A, your doctor is likely to tell you to avoid alcohol, get a full night’s rest, drink liquids and plenty of water, and eat a healthy diet.
Some medications, including many over-the-counter drugs, can damage the liver, particularly if it is already inflamed. Discuss every medication and supplement you take with your healthcare team to decide if you should continue those medications.
The best way to prevent hepatitis A is to get the vaccine. The Advisory Committee on Immunization Practices (ACIP) recommends that all children aged 12 months and older receive the vaccine. Also, recreational drug users, those with hemophilia, the homeless population, men who have sex with other men, and those traveling to countries with a high hepatitis A infection rate should get the vaccine. Hepatitis A is also preventable in some instances by not partaking in risky behavior.
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