Hepatitis A Self-Care at Home

The following measures can help a patient feel better while they are having symptoms.

• Take it easy; curtail normal activities and spend time resting at home.
• Drink plenty of clear fluids to prevent dehydration.
• Avoid medicines and substances that can cause harm to the liver such asacetaminophen (Tylenol) and preparationsthat contain acetaminophen.
• Avoid alcoholic beverages, as these can worsen the effects of HAV on the liver.
• Avoid prolonged, vigorous exercise until symptoms start to improve.

Call a health care 

practitioner

 if symptoms worsen or new symptoms appear.

Be very careful about personal hygiene to avoid fecal-oral transmission to other members of the household.

Hepatitis A Overview

Hepatitis is a general term that means inflammation (irritation and swelling) of the liver. Inflammation of the liver can result from infection, exposure to alcohol, certain medications, chemicals, poisons, or from a disorder of the immune system.

Hepatitis A refers to liver inflammation caused by infection with the hepatitis A virus (HAV). HAV is one of several viruses that can cause hepatitis, and is one of the three most common hepatitis viruses in the United States. The other two common types are hepatitis B and hepatitis C; however, there are other named types such as D, E, F, and G, and more types may be discovered in the future. Moreover, these infections are somewhat different from hepatitis A, and from each other.

Unlike hepatitis B and hepatitis C, hepatitis A does not cause chronic (ongoing, long-term) disease. Although the liver becomes inflamed and swollen, it heals completely in most people without any long-term damage. Once a person contracts hepatitis A, they develop lifelong immunity, and rarely contract the disease again.

Because of the way it is spread, the hepatitis A virus tends to occur in epidemics and outbreaks. As many as 1 in 3 adults (>age 19) in the United States have antibody to HAV , meaning they have been exposed to the virus, but most do not become ill. In 2011, researchers report no significant change in seroprevalence (the frequency of people in a population that have particular antibodies, usually reactive against a disease-producing organism in their blood serum) of HAV antibodies in adults before or after the HAV vaccine became available (see reference 3). The number of cases of hepatitis A in the United States varies among different communities, and has been reduced by the introduction of the hepatitis A vaccine. The rate of infection (number of infections per 100,000 people) has declined since 1999 from 6.3 to 0.9 per 100,000 people (2008 CDC statistics). About 2,500 to 3,600 cases of hepatitis A are reported each year in the U. S., but many more people may be exposed to the virus, but have few, if any, report symptoms. Vaccination at age one year may cause the rate and yearly case numbers of HAV to decline.

Hepatitis A Contagious Transmission

The hepatitis A virus is found predominantly in the stools (feces) of people with hepatitis A. HAV 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. However, variations of this primary way in which a contagious person transmits the disease are as follows:

• Food or drinking water 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.
• Eating raw or undercooked shellfish collected from water that has been contaminated by sewage
• Blood transfusions, although this is extremely rare
• Sexual contact, especially oral/anal

People who are infected can start spreading the infection (shedding virus) 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 theworld.

• 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 include:

• Household contacts of people infected with HAV
• Sexual partners of people infected with HAV
• International travelers, especially to developing countries
• Military personnel stationed abroad, especially in developing countries
• Men who have sex with other men
• People who use illegal drugs (injected or non-injected)
• People who may come into close contact with HAV infected people at work

Individuals who work 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, andresidential facilities; or work in or attend daycare facilities are at increased risk only if strict personal hygiene measures are not observed.

HAV essentials

Hepatitis A, B & C

What is Hepatitis?

'Hepatitis' refers to viral infections that cause inflammation of the liver. Hepatitis A, B and C are the most common types. Each have different causes and symptoms.

• Hepatitis A
• Hepatitis B
• Hepatitis C

Hepatitis A

Hepatitis A is the most common of the seven known types of viral hepatitis. Infection with the hepatitis A virus leads to inflammation of the liver, but complications are rarely serious.

How hepatitis A is spread

The hepatitis A virus (HAV) is found in the faeces of someone infected with the virus. It only takes a tiny amount of faeces getting inside another person’s mouth to cause hepatitis A infection. Personal hygiene, such as careful hand washing, can minimise the risk of the virus being passed on.

HAV is a common infection in many parts of the world where sanitation and sewage infrastructure is poor. Often people become infected with HAV by eating or drinking contaminated food or water.

Hepatitis A is also classed as a sexually transmitted disease (STD) because it can be passed on sexually, particularly during activities such as anilingus (rimming). The washing of genital and anal areas before sex, and the use of condoms or dental dams can help to prevent this risk.

Hepatitis A can affect all age groups. Once a person is exposed to the virus it takes between 2 and 6 weeks to produce symptoms.

Signs and symptoms of hepatitis A

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:

• A short, mild, flu-like illness;
• nausea, vomiting and diarrhoea;
• loss of appetite;
• weight loss;
• jaundice (yellow skin and whites of eyes, darker yellow urine and pale faeces);
• itchy skin;
• 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.

Where to go for help

If you have any symptoms or you are worried you may have been infected with hepatitis A, you should discuss your worries with a doctor. They may be able to run tests themselves, or else will refer you to someone who can.

Some countries have specific sexual health clinics that can help you directly.

What does a positive test result mean?

HAV is tested for using a blood test. A positive test result means the patient has either had a past infection or is currently infected. The type of antibody detected in the test will indicate whether the infection is current or has been cleared. A patient who tests positive may be asked about recent contacts and sexual partners that may need to be tested too. A patient who has already had the infection and fought it off is naturally immune to HAV.

What does a negative test result mean?

A negative test result means the patient is not infected with Hepatitis A. If the patient is believed to be at high or ongoing risk of infection, a doctor may advise immunisation.

Treatment for hepatitis A

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.

Hepatitis A immunisation

Hepatitis A immunisation 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, immunisation may be recommended for people whose sexual practices are likely to put them at risk.

Immunisation may also be recommended to prevent hepatitis A developing if a person suspects they have been exposed to the virus.

Follow-up

Someone who is infected with hepatitis A should limit the amount of alcohol they drink. Their doctor may also offer dietary advice.

The doctor will advise about any precautions necessary to avoid infecting others with the virus.