Hepatitis A: Vaccinations, Symptoms, Transmission and Treatment

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What is Hepatitis A?

Hepatitis A is caused by a virus known as the Hepatitis A Virus (HAV) that leads to inflammation of the liver cells; hence it is a virus that is the causative agent and not bacteria. Hepatitis A is the commonest form of Hepatitis in the world and it is largely because of its mode of transmission (it can occur in epidemics). It has an incubation period of 15 to 50 days. In the United States, it has an infection rate of 93,000 people every year.

Hepatitis A virus characteristics
Hepatitis A virus characteristics

 

What is Hepatitis A Virus?

Hepatitis A virus belongs to a family of viruses known as Picornaviridae; it is an RNA virus with no envelope. Hepatitis A Virus is resistant to acid, heat or ether. The virus replicates in the liver but can be found in the stool, blood and bile. It can be viewed in the stool with an electron microscope

Hepatitis A transmission

Hepatitis A is transmitted by feco-oral route; this means it is transmitted when you drink water or eat food such as vegetables or shellfish (oysters, crayfish, and crabs) that are contaminated with feces containing Hepatitis A Virus. This is the reason why it is common in children because they often do not wash their hands before eating except someone helps them to wash their hands; most times this happens while the children are in school where they get to meet with other children that might be infected with Hepatitis A and also become infected. It can also be transmitted by sexual contact with infected persons or while caring infected persons. Hepatitis A can also be transmitted by homosexual activity.

Intravenous Drug Abuse can transmit Hepatitis A infection
Intravenous Drug Abuse can transmit Hepatitis A infection

 

Hepatitis A generally last for 2 weeks or 3 weeks and it is not as harmful as Hepatitis B or C. It does not lead to liver cancer. But your body does not develop permanent immunity to it; this means that whenever you have Hepatitis A infection, you can still get infected again even when you have been initially cured; a relapse of symptoms may occur. During the prodromal stage, Hepatitis A virus can be found in the blood but has been rarely transmitted by blood transfusion. The virus may be found in the saliva but transmission through saliva or kissing has not been demonstrated. Infected people are highly contagious about 1 to 2 weeks even before onset of symptoms.

Herbal drugs can exacerbate Hepatitis A and is also a cause of non viral hepatitis
Herbal drugs can exacerbate Hepatitis A and is also a cause of non viral hepatitis

 

Hepatitis A symptoms

  1. Nausea
  2. Distaste for cigarettes
  3. Anorexia
  4. Pale stool
  5. Jaundice (yellowish discoloration of the eyes)
  6. Dark urine
  7. Moderate Enlargement of the Liver and Spleen (hepatosplenomegaly) manifesting as abdominal swelling
  8. Skin Rash
  9. Enlarge lymph nodes that become painful when touch (tender lymphadenopathy)
  10. Joint pains
  11. Kidney problems (Renal failure) rare complications
  12. Heart problems (myocarditis) rare complications
  13. Scratch marks
  14. Swollen and reddish blood vessels on the skin
Yellowish eyes are symptoms of Hepatitis A
Yellowish eyes are symptoms of Hepatitis A

 

Diagnosis of Hepatitis A

Hepatitis A is diagnosed by serology tests where the presence of antibodies against the Hepatitis A Virus is tested and if found, the person is said to be Hepatitis A Positive.

The presence of IgM antibodies (anti-HAV) shows an acute infection. Hepatitis A does not cause chronic liver disease.

Hepatitis A Treatment

There is no specific treatment for Hepatitis A disease and the patient is only supported until his/her immune system fights the infection. Resting and eating of high carbohydrate diet (to boost the glycogen stores of the liver) and taking of fruits as source of vitamins. Avoid taking of alcohol or herbal medication and physical exercise should also be avoid until 3 months after the jaundice (yellowish eye and skin) disappears.

Complications of Hepatitis A

Hepatitis A may lead to fulminant liver necrosis which is a rare cause of death in Hepatitis A infection and is mostly due to poor nutrition.

Worldwide distribution of Hepatitis A across different continents and countries
Worldwide distribution of Hepatitis A across different continents and countries

 

Hepatitis A Prevention

  1. Taking a single dose of Hepatitis A Vaccine followed by a booster dose after 6 to 1 year.
  2. Avoid taking alcohol as it over tasks the liver, the same thing goes for herbs or herbal medications.
  3. Properly washing and eating of vegetables grown by non-human manure.
  4. Properly washing your hands before eating
  5. Washing of hands after going to the toilet and the same should be done to children

Hepatitis A Vaccinations

Hepatitis A can be prevented by vaccination and there are two schedules for the vaccines. The recommendation and guideline is as follows:

  1. It is recommended for children who have reached 1 year and above
  2. Travellers to places with high prevalence of Hepatitis A are to be vaccinated too
  3. Men who have sex with men are recommended to get the Hepatitis A vaccination
  4. Anyone with clotting factor disorder such as hemophilia
  5. People with Hepatitis B and C infection with chronic liver disease or anyone with chronic liver disease
  6. Drug abusers

The second dose (booster dose) is given 6 to 12 months after the first dose, making a total of two doses of the Hepatitis A vaccine. The vaccine is given by intramuscular injection into the arm. Examples of Hepatitis A vaccines include HAVRIX and VAQTA.HAVRIX is produced by GlaxoSmithKline while VAQTA is produced by Merck. VAQTA has no preservative; both vaccines have adult (19 years and above) and children (1 to 18 years) formulations. Twinrix is another vaccine but it is a combination of Hepatitis A and B vaccine and it is only given when there is an indication for both types of Hepatitides.