Hepatitis A: Description:The liver is one of the most important organs in the body. It regulates the amount of many chemicals that occur in the blood. It removes substances from the blood that are or may become toxic. A toxin is a poison. The liver changes these substances into less harmful forms. It then converts them into a form that will dissolve in water. In this form, the substances are eliminated from the body. If the liver is damaged, toxic substances may build up in the bloodstream. In the worst cases, these substances can cause serious illness Hepatitis A, B and even death.Most forms of hepatitis are caused by viruses. The viruses have names similar to those of the diseases they cause. Hepatitis A, for example, is caused by the hepatitis A virus (HAV). Hepatitis B is caused by the hepatitis B virus (HBV), and so on.Hepatitis A and B have been known for many years. At one time they were called infectious and serum hepatitis, respectively. When hepatitis C was first discovered, it was called non-A, non-B hepatitis. It is now known by its simpler name. Hepatitis D, E, and G were discovered during the 1970s, 1980s, and 1990s.Hepatitis A:Hepatitis A is an acute disorder. An acute disorder is one that comes on suddenly and usually does not last very long. An initial episode of hepatitis A is often followed by a relapse a few weeks later. A relapse is a reoccurrence of the disease. A few people have many relapses.Children are more likely to contract (catch) hepatitis A than adults, but their symptoms are usually much milder than those of adults.Among those at highest risk for hepatitis A are the following:1. Children who go to day-care centers.2. Troops living under crowded conditions at military camps or in the field.3. Anyone living in heavily populated and unsanitary conditions.4. Individuals who practice oral-anal sexual contact.5. Tourists visiting an area where hepatitis A is common.There are 2 main kinds of hepatitis, acute hepatitis (short-lived) and chronic hepatitis (lasting at least 6 months). If you have acute hepatitis, the liver might become inflamed very suddenly and you might have nausea, vomiting, fever and body aches. Or you may not experience any symptoms. Most people get over the acute inflammation in a few days or a few weeks. Sometimes, however, the inflammation doesn't go away. When the inflammation doesn't go away in 6 months, the person has chronic hepatitis.Hepatitis A causes inflammation of the liver, which leads to soreness and swelling. Hepatitis A is different from other types of hepatitis because it isn't typically as serious and doesn't develop into chronic hepatitis or cirrhosis like hepatitis B and C can.Hepatitis A symptoms are usually mild and go away on their own. Rarely will you develop complications such as relapsing hepatitis or liver failure. With relapsing hepatitis, symptoms improve, but then return.Death from hepatitis A is rare. The elderly, the very young, and people with advanced chronic liver diseases such as from hepatitis C are at greatest risk for complications from hepatitis A.Symptoms:It is possible to experience mild or no symptoms whatsoever, but even if this is the case the person's faeces will still be infectious to others. Many people who become infected with HAV will have symptoms that include:1. A short, mild, flu-like illness.2. Nausea, vomiting and diarrhea.3. Loss of appetite.4. Weight loss.5. Jaundice (yellow skin and whites of eyes, darker yellow urine and pale faeces).6. Itchy skin.7. Abdominal pain.The infection usually clears in up to 2 months, but may occasionally recur or persist longer in some people. Once a person has been infected and their body has fought off the virus they are permanently immune. Occasionally symptoms may be severe and require monitoring in hospital.There are rarely any complications with hepatitis A infection. Permanent damage to the liver is very unlikely, but in extremely rare cases the infection can be fatal, particularly in older people.Causes and Risk factors:The exact mechanism by which viruses cause hepatitis is not entirely understood. It appears that the disease is not caused by the virus itself, but by the body's immune system. The immune system is a network of organs, tissues, cells, and chemicals designed to protect the body against foreign invaders, such as bacteria and viruses.When a foreign invader enters the body, the immune system begins to respond. It produces chemicals designed to kill the invader. These chemicals are called antibodies. The presence of antibodies in the bloodstream may have other effects on the body, including inflammation, swelling, and other symptoms. It appears that the liver becomes inflamed because of the antibodies produced by the immune system, not because of the virus itself.Hepatitis can be caused by many things. Hepatitis is most commonly caused by one of the six hepatitis viruses (A, B, C, D, E or G). All types of hepatitis cause inflammation of the liver, which interferes with its ability to function. Lack of blood supply to the liver, poison, autoimmune disorders, excessive alcohol use, an injury to the liver and taking certain medicines can also cause hepatitis. Less commonly, viral infections such as mononucleosis or cytomegalovirus can cause hepatitis.The hepatitis A virus is found in the stools (feces) of people with hepatitis A. It is transmitted when a person puts something in his or her mouth that has been contaminated with the feces of an affected person. This is referred to as fecal-oral transmission.If food or drinking water becomes contaminated with stool from an infected person (usually because of inadequate hand washing or poor sanitary conditions), the virus can quickly spread to anyone who drinks or swallows the contaminated food or water.The virus can also be spread by eating raw or undercooked shellfish collected from water that has been contaminated by sewage.The hepatitis A virus can be transmitted through blood transfusions, although this is extremely rare.People who are infected can start spreading the infection about 1 week after their own exposure. People who do not have symptoms can still spread the virus. Infection with HAV is known to occur throughout the world.The risk of infection is greatest in developing countries with poor sanitation or poor personal hygiene standards.Infection rates are also higher in areas where direct fecal-oral transmission is likely to occur, such as daycare centers, prisons, and mental institutions.People at increased risk for hepatitis A infection:1. Household contacts of people infected with HAV.2. Sexual partners of people infected with HAV.3. International travelers, especially to developing countries.4. Military personnel stationed abroad, especially in developing countries.5. Men who have sex with other men.6. Users of illegal drugs (injected or non-injected).7. People who may come into contact with HAV at work.8. Workers in professions such as health care, food preparation, and sewage and waste water management are not at greater risk of infection than the general public.People who live or work in close quarters, such as dormitories, prisons, and residential facilities, or work in or attend daycare facilities are at increased risk only if strict personal hygiene measures are not observed.Diagnosis:Hepatitis can be diagnosed with blood tests, such as liver function tests. The provider must then try to figure out the cause of the hepatitis. Conditions such as alcoholism and viral infection of the liver are much more common than autoimmune hepatitis. Further blood tests, including one that measures antibodies to the person's own tissues, often help make the correct diagnosis. Special X-ray tests may be needed as well.Sometimes, a liver biopsy may be needed. This procedure involves getting a piece of liver tissue with a special needle inserted through the skin. The piece can then be examined under a microscope in the laboratory.Treatment:There is no specific treatment for HAV and most people fight off the virus naturally, returning to full health within a couple of months. The doctor will advise avoiding alcohol and fatty foods as these can be hard for the liver to process and may exacerbate the inflammation.Patients should get plenty of rest and eat a nutritious diet. They should also ensure they do not spread HAV by washing their hands after using the toilet and before preparing food. Patients with more severe symptoms may be monitored in hospital for a short period.Immunization: Hepatitis A immunization is given in a series of injections. The first single injection in the arm gives protection for a year. The second booster injection at 6 to 12 months extends protection for up to 10 years.The hepatitis A vaccine may be routinely recommended for young children living in areas with high incidence of hepatitis A, and anyone travelling to countries where hepatitis A is endemic. In addition, immunization may be recommended for people whose sexual practices are likely to put them at risk.Immunization may also be recommended to prevent hepatitis A developing if a person suspects they have been exposed to the virus.Medicine and medications:Although no medicine can treat HAV symptoms after they develop, the hepatitis A vaccine is the most effective means of preventing hepatitis A virus (HAV) infection. The vaccine provides 94% to 100% protection if you receive both of the shots in the vaccination series, but the vaccine may not be as effective in those with weakened immune systems, such as people who have human immunodeficiency virus (HIV).If you have had close personal contact with someone who has hepatitis A, you should get the hepatitis A vaccine or a shot of immune globulin (IG). If you receive either the vaccine or IG within 2 weeks of being exposed to HAV, you probably will not develop symptoms of HAV infection.IG is also recommended for: People who are known to be allergic to other vaccines containing the same ingredients found in the hepatitis A vaccine.Children younger than age 1 who have not been immunized with the hepatitis A vaccine and have been exposed to HAV, particularly children who spend time in day care centers.Medication Choices:Hepatitis A vaccine.Immune globulin.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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