Causative and risk factors
Hepatitis A is caused by infection with the Hepatitis A virus, which is transmitted through the faecal-oral route. The excretion of Hepatitis A virus in the stools begins even before the patient develops any symptoms. The mode of transmission is through consumption of contaminated food and water, especially by eating infected shellfish. Person to person transmission can occur by handling someone’s food or drink with infected hands.
Clinical presentation
The onset of the illness is usually abrupt. Some patients especially children may remain asymptomatic. Initial symptoms include fever, malaise and fatigue. Other symptoms include anorexia, pain in the abdomen or vomiting. Later jaundice develops giving rise to symptoms like dark yellow urine and clay colored stools.
Rarely hepatitis A can give rise to complications like acute liver failure, cholestatic hepatitis or autoimmune hepatitis.
Diagnosis & Investigations
Hepatitis A must be differentiated from other forms of viral hepatitis, cytomegalovirus and Budd-Chiari syndrome.
Hepatitis A can be diagnosed on the basis of detection of IgG or IgM antibodies against hepatitis A virus in the patient’s bloodstream.
Treatment
Hepatitis A is a self-limiting illness and hence does not require any specific treatment.
The patient is advised to rest, eat nutritious food and have plenty of liquids. Alcohol must be completely avoided.
Anti-emetic drugs if vomiting is severe. Antihistamine drugs are given to patients with severe itching.
Hepatitis A can be prevented by:
- Drinking clean water
- Good hygiene practices by food handlers
- Washing hands thoroughly after using the toilet
- Proper sewage disposal
- Getting vaccinated against hepatitis A virus
