The Hepatitis A virus was first discovered in 1973. The virus grows
in the liver and is carried into the gut by bile so that faeces (bowel
motions) can contain a large amount of the virus.
The hepatitis A virus can be passed from person to person (e.g. among
family members or sexual contacts) or among large groups of people (epidemics)
by food or water that has been contaminated with faeces.
How do I know if I have Hepatitis A?
The average time between exposure to the hepatitis A virus and developing
of symptoms is about 28 days.
Symptoms may begin suddenly or gradually. The most obvious sign of
infection is jaundice where the eyes and skin turn yellow and the urine
turns brown or tea-coloured. These symptoms are common in older children
and adults, however relatively few children under 6 years of age will
become jaundiced but may still be infectious for hepatitis A.
Other common signs of infection include loss of appetite, nausea, vomiting,
abdominal pain and fever. Less frequently there will be diarrhoea, itching
and muscle pain and occasionally joint pains and skin rashes.
How can the doctor tell if I have Hepatitis
A infection or liver damage?
Your doctor can do blood tests to measure the body’s response
to the hepatitis A virus.
Early in the illness a specific antibody to the virus, called IgM is
present indicating current infection. As 
the body’s immune system
fights off the virus, IgM disappears and is replaced with another antibody
called IgG. IgG provides life-long immunity to further infection. In
people who have recovered from hepatitis A virus, only IgG is present
in blood.
The doctor may also do blood tests to measure both liver function, including
bilirubin (the pigment that causes jaundice), and the amount of inflammation
in the liver
What is the treatment for Hepatitis A?
Treatment is usually just bed rest and adequate intake of fluids. Medications
should be limited to those that are absolutely necessary.
It is best not to take sedatives and strong painkillers if possible
and alcohol should be avoided. Occasionally people who are very ill
need to be admitted to hospital.
What is the outcome of Hepatitis A infection?
The majority of patients with hepatitis A will recover completely;
most by two or three months and the rest by six months.
A small number (about 5% or 1 in 500) will take longer to recover.
Death occurs in about 0.2 %( about 1 in 500) of people, more often in
older patients (over age 50) or in those with pre-existing liver damage.
In other words, if you are one of the 499 out of 500 who survive, the
liver will completely recover. Hepatitis A itself doesn’t cause
chronic liver damage.
If you have Hepatitis B or C and then develop Hepatitis A, there can
be very serious consequences, even death. All patients with these viruses
should be vaccinated against Hepatitis A (see section on vaccination
below).
Can Hepatitis A infection be prevented?
The risk of becoming infected with the hepatitis A virus varies around
the world.
In countries with poor sanitation and crowding in households most people
develop hepatitis A infection in childhood and are protected from repeat
infection for the rest of their lives.
Parts of Africa, Asia, Central and South America pose a high risk
of infection to travellers from more developed countries that have never
been infected.
In countries with a low rate of infection (North America, Western Europe,
and Australia) certain people are at higher risk of infection because
of sexual or occupational exposure.
Hepatitis A occurs more frequently in male homosexuals and among injecting
drug users. Workers in day care centres or residential institutions
are at risk because of exposure to young children who may be infected
but have no obvious signs that they are ill.
If you have Hepatitis B or C and then develop Hepatitis A, there can
be very serious consequences, even death. All patients with these viruses
should be vaccinated against Hepatitis A (see section on vaccination
below).
General measures to prevent hepatitis A virus infection include good
personal hygiene such as hand washing after using the toilet and before
eating meals.
Is there a Vaccine to prevent Hepatitis
A infection?
Yes. A vaccine has been developed which can provide long-lasting protection
to hepatitis A. The vaccine is made from inactivated virus and is given
as two separate injections; at day 0 and then a booster dose at 6-12
months.
The vaccine appears to be well tolerated and provides protection for
at least 10 years and probably longer.
Who should receive Hepatitis A Vaccination?
• Travellers from areas of low occurrence to high occurrence,
including military personnel.
• Men who have sex with men
• Injecting drug users
• Recipients of blood and blood products (such as those used for
treatment of inherited clotting disorders).
• Persons with occupational exposure to the virus:
- Day care centre or residential institutional workers
- Laboratory workers exposed to biological specimens
- Food handlers
- Nursing staff and other healthcare workers in contact with patients
in paediatric wards, infectious diseases wards, emergency rooms and
intensive care units.
- Sewage treatment workers
- Health care workers and teachers in remote aboriginal and Torres
Strait communities
- Patients with chronic liver disease (chronic hepatitis B or C, alcoholic
cirrhosis etc).
ACKNOWLEDGEMENTS
The Australian Gastroenterology Institute.
www.health.qld.gov.au
- access public health brochures on hepatitis A,B and C
