Hepatitis A virus (HAV)

Hepatitis A is an inflammation of the liver due to the A type virus and is commonly known as infectious hepatitis. It is thought of as the least serious form of hepatitis as the person infected never goes on to experience the chronic form of the disease. People with this type of hepatitis generally make a full recovery.

Sign and Symptoms

Unpleasant, rather like combining a severe flu with jaundice. Jaundice is a yellowing of the skin and whites of the eyes caused by the accumulation of the yellow/brown colour bile pigment, bilirubin, in the blood.  Signs and symptoms do vary in their severity, some people may experience no symptoms at all, especially the young. Symptoms can include:

• Jaundice
• Fever
• Abdominal pain
• Poor appetite
• Nausea
• Vomiting
• Fatigue
• Dark, coca-cola coloured urine
• Light coloured stools
• Muscle and joint pains
• Rash
• The liver may be enlarged and tender

Some people, notably the elderly or those with pre-existing liver disease, are at risk of experiencing severe symptoms of acute hepatitis and may become so ill that they require a liver transplant. Hepatitis A will not lead on to liver cancer or cirrhosis.

How do you get it?

Transmitted by enteric (digestive) or by fecal routes. The infected person passes the virus to another person who ingests a small amount of infected material. Poor hygiene and poor sanitary conditions in some countries lead to high rates of infection. Some areas of the world are particularly prone to the Hepatitis A virus. India, South America, Bangladesh, and Central America are amongst these. One third of people in the USA have been exposed to the Hepatitis A virus.

Diagnosis of Hepatitis A

Your doctor will be able to diagnose Hepatitis A from the signs and symptoms you present. There are also a number of tests that can then confirm the diagnosis. Blood tests are the most common and include a blood test to diagnose or confirm the type of hepatitis virus present, known as Hepatitis A serology. Also:

Liver Function TestsThese tests show how well the liver is functioning but it does not accurately access all of the many and varied functions that the liver is responsible for in our bodies. They do check the level of liver enzymes, transaminases and cholestatic enzymes, bilirubin and liver protein levels. High levels of transaminases in the blood do not always reveal how badly the liver is inflamed or damaged. Elevations of them can also occur in genetic liver disease, liver tumours, heart failure. The normal ranges of AST and ALT transaminases are around 0 to 40 IU/L and 0 to 45 IU/L respectively.

Liver ProteinsAlbumin, prothrombin, and immunoglobulins, proteins made by the liver are checked and abnormal levels are indicative of severe liver disorder. Prothrombin times, because the liver produces many of the clotting factors required to stop bleeding needs to be determined.

Liver BiopsyLiver biopsy is one of the main and most accurate diagnostic procedures that can determine what is wrong with the liver and how badly it has been damaged. As most liver diseases affect the entire organ uniformly, the small sample obtained by biopsy, generally performed under a local anaesthetic, will show any abnormalities.For most people the guided liver biopsy is a safe and efficient diagnostic tool.

TreatmentThere is no specific treatment for Hepatitis A. Bed rest and general rest may be required depending on the severity of their symptoms. You can go to work if you feel well enough. In 0.2 percent of people infected with Hepatitis A a rare form called fulminant type is diagnosed. These patients will require intensive care in hospital. Thirty per cent of people with this type of hepatitis risk dealth if a liver transplant is not carried out. Of those that recieve a transplant 80 per cent will do well.

PrognosisThere are no long term problems following Hepatitis A and within 6 months all symptoms and blood chemistry should be back to normal. Chronic liver diseases such as cirrhosis or liver cancer does not occur and you are not infectious to others.

PrecautionsA vaccine is available and is advisable to certain groups of health and laboratory workers, chronic sufferers of liver disease, haemophiliacs, people who are at risk because of their sexual behaviour,(Gays and people who have multiple sexual partners) and for those travelling to high risk areas in various countries around the world.