Hepatitis A

Hepatitis A virus is one of six currently identified strains of viral hepatitis — the others are B, C, D, E and G. The strains differ in severity and in the way they spread. Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. Although not usually as serious as other types of viral hepatitis, hepatitis A causes inflammation that affects your liver’s ability to function.

Hepatitis A Causes

You’re most likely to contract hepatitis A from contaminated food or water or from close contact with someone who’s already infected — even if that person doesn’t appear sick. Hepatitis A virus is usually transmitted via the fecal-oral route. That means that someone with the virus handles the food you eat without first carefully washing his or her hands after using the toilet. You can also contract the virus by drinking contaminated water, eating raw shellfish from water polluted with sewage or being in close contact with a person who’s infected — even if that person has no signs or symptoms. In fact, the disease is most contagious before signs and symptoms ever appear. Hepatitis A can also be transmitted by having sex with someone who has the virus, by sharing needles with someone who has the virus or, rarely, through a blood transfusion with blood that contains the virus.

You’re at increased risk of hepatitis A if you:

  • Travel or work in regions with high rates of hepatitis A.
  • Are a sexually active gay or bisexual man.
  • Use injected or noninjected illicit drugs.
  • Work in a research setting where you may be exposed to the virus.
  • Have hemophilia or receive clotting-factor concentrates for another medical condition. In rare cases, hepatitis A may be transmitted through blood transfusions.

Hepatitis A Symptoms

Some people may have hepatitis A and never develop signs or symptoms. Young children, especially, tend to have mild cases, but signs and symptoms in older children and adults are likely to be more severe. In general, you’ll have the virus for up to one month — its average incubation period — before developing any problems. When signs and symptoms appear, they often come on suddenly, and you may mistake them for intestinal flu (gastroenteritis). They include:

  • Fatigue
  • Nausea and vomiting
  • Abdominal pain or discomfort, especially in the area of your liver on your right side beneath your lower ribs
  • Loss of appetite
  • Low-grade fever
  • Dark urine
  • Muscle pain
  • Itching

You also may experience yellowing of your skin and the whites of your eyes (jaundice). Not all people with hepatitis A develop jaundice.

You’ll likely regain more energy after signs and symptoms disappear, and your liver may heal completely within one or two months. Some people with hepatitis A have relapses over a six- to nine-month period.

Diagnosis Hepatitis A

Tests can accurately diagnose whether you’ve been infected. Blood tests can detect the presence of hepatitis by measuring:

  • Bilirubin. Normally your liver metabolizes this residue of worn-out red blood cells, and you excrete it in your urine. But hepatitis interferes with your liver’s ability to metabolize bilirubin, leading to higher levels in your blood.
  • Enzyme levels. Your doctor may also look for elevated blood levels of enzymes known as aminotransferases, which are released when your liver is damaged.

Pinpointing hepatitis
Although both of the above tests can suggest the presence of hepatitis, you’ll need a blood test called a radioimmunoassay to pinpoint the exact type of hepatitis you have. This test identifies antibodies your immune system has formed in response to the presence of antigens — proteins that are unique to a particular virus. Antibodies may not appear for weeks or even months after you develop hepatitis, so having the test too soon may give a false-negative result.

Treatment for hepatitis A

Mild cases of hepatitis A don’t require treatment, and most people who are infected recover completely with no permanent liver damage. Unlike hepatitis B and C, hepatitis A doesn’t develop into chronic hepatitis or cirrhosis — both potentially fatal conditions.

No specific treatment exists for hepatitis A. Instead, the main focus is on making sure you get adequate nutrition and avoid any permanent liver damage. If you’re nauseated, eating small snacks throughout the day instead of three large meals may help. Soft, easily digested foods, such as soup or broth, yogurt and toast, may be the most appealing. You may also find you can tolerate food better in the morning than later in the day. Talk to your doctor about any medications you take, including those you buy over-the-counter. Your doctor may recommend stopping or changing some of them. Also, avoid drinking alcohol while you have signs and symptoms of the illness. Even after you’ve recovered, don’t mix alcohol and acetaminophen (Tylenol, others). Doing so can cause liver damage even in people who haven’t had hepatitis.

Those who acquire fulminant hepatitis require hospitalization for monitoring and additional treatment such as providing adequate fluids and nutrition and managing complications such as bleeding. In some cases, people with fulminant hepatitis may even require a liver transplant.

Preventing Hepatitis A

Hepatitis A is highly contagious. Preventing the spread of the virus involves protecting both yourself and others from infection. Practicing good hygiene — including washing your hands often — is one of the best ways to protect against hepatitis A. Effective vaccines are available for people who are most at risk.