Hepatitis A : Symptoms, Causes, Stages & Treatment

Hepatitis A : Symptoms, Causes, Stages & Treatment - MalaysiaChronic Conditions

Hepatitis A : Symptoms, Causes, Stages & Treatment

Hepatitis A is a liver infection caused by the Hepatitis A virus (HAV). Find out more about Hepatitis A, its symptoms, causes, stages, and treatment options.

Primarily, hepatitis is a condition involving the inflammation of a person’s liver. This can range from mild to severe illness. Hepatitis is generally the result of a viral infection in the body, although other causes may be possible. Aside from the five main viral classifications of hepatitis (A, B, C, D and E), there are also autoimmune hepatitis and hepatitis as a secondary result of substances.

In this article, there will be an intentional focus on hepatitis A, which is caused by the hepatitis A virus (known as HAV). Statistically, hepatitis A occurs randomly and in the form of epidemics throughout the world, with a tendency to recur cyclically. Such epidemics would be related to contamination of food or water, in which the epidemic in Shanghai, 1988, can be referred to –affecting at least 300,000 persons. There may also be long-term effects, affecting groups and communities through person-to-person transmission.

Symptoms of Hepatitis A

If a person has contracted the hepatitis A virus, the symptoms typically emerge after a few weeks. However, some persons may not exhibit any signs at all. A person may have hepatitis A if the following signs and symptoms develop:

  • Fatigue and generally unwell
  • Sudden onset of nausea and vomiting
  • Experiencing pain in the abdomen or discomfort, particularly on the upper right side beneath the lower ribs (thus, the liver area)
  • Clay-coloured bowel movements
  • Loss of appetite
  • Mild fever sensations
  • Dark urine
  • Joint pain
  • Skin and eyes turning yellow (a condition called jaundice)
  • Severe itching

At times, the symptoms may be mild and go away after a few weeks. However, in other instances, hepatitis A infection may result in worsened conditions, with severe illness that may last several months at large.

Causes of Hepatitis A

Hepatitis A virus is most easily spread in poor sanitary and food hygiene conditions. Therefore, you may get infected with hepatitis A from:

  • Consuming food prepared by a person who has the infection, who did not wash their hands properly, or washed their hands in contaminated waters;
  • Drinking contaminated water, including ice cubes;
  • Eating raw or undercooked shellfish sourced from contaminated water;
  • Close contact with a person who has hepatitis A;
  • Engaging in sexual intercourse with someone who has hepatitis A; or
  • Injecting drugs with contaminated needles or equipment.

The incubation period is researched to be approximately two to six weeks, during which the individual is most contagious.

Hepatitis A Stages

What is the prognosis for persons infected with hepatitis A? On an overall basis,about 85 per cent of people recover within three months. The disease is not a condition that becomes chronic and does not bring long-term negative health implications.

For hepatitis A, there are three stages (this consists of a breakdown of common symptoms by phases).

Stage 1: Prodromal Phase

Otherwise known as the early stage in the disease progression, symptoms may range from fever, joint pain orarthritis, rashes or oedema (swelling).

Stage 2: Preicteric Phase

In the next stage, the following symptoms may manifest:

  • Fatigue
  • Myalgia (muscle pain)
  • Anorexia
  • The sensation of nausea and/or vomiting
  • Fever
  • Cough
  • Pain in the abdomen and/or diarrhoea
  • Dark urine and light stool colour

Stage 3: Icteric Phase

In this stage, jaundice develops. Anorexia, nausea and vomiting may worsen in severity. Skin itchiness may develop, while other symptoms may subside, however.

After the three stages, the individual would enter the convalescent phase (the stage of recovery).

Risk Factors of Hepatitis A

A person who is not vaccinated or previously infected can get infected. A person is at increased risk of contracting the hepatitis A virus if the following condition(s) are present:

  • Travel or work in areas of the world where hepatitis A is a common disease
  • Occupational factors such as sewage workers, working in a child care centre or working with animals such as monkeys, apes and gorillas
  • Live with a person who has hepatitis A
  • Is a man who is engaging in sexual relations with other men
  • Have sexual relations with a person who is infected
  • Is HIV positive
  • Experiencing homelessness
  • Have a blood clotting disorder
  • Use of illegal drugs
  • Poor sanitation

While hepatitis A does not cause long-term liver damage, or become chronic – in rare cases, hepatitis A can cause an unexpected loss of liver function. This is more likely in older adults or people who are experiencing a chronic liver disease.

Should there be acute liver failure, the person is required to stay in the hospital for monitoring and treatment. In urgent or worsened cases, some of these may require a liver transplant.

Diagnosis and Treatment of Hepatitis A

In general, there is no current cure for hepatitis A. However, there are treatment methods available to engage with throughout the months of the sickness journey. It is still recommended to go to the healthcare centre in order to diagnose the condition and check any underlying causes.

Your healthcare provider may carry out the following tests on you:

  • History and physical exam– This is a basic examination session in which the doctor checks if there is any risk factors (based on your family history). The doctor may also press down on your abdomen or check for swelling of the liver.
  • Liver function tests– This would require blood samples, thereby would determine the efficiency of your liver function. If there are abnormal results from the tests, this may be the first indicator of liver disease. For instance, high liver enzyme levels may indicate that your liver is not functioning properly.
  • Other blood tests– Other blood tests may be required to determine the source of the problem. This may also indicate whether you have infectious or autoimmune hepatitis.
  • Liver biopsy– This procedure involves taking a sample of tissue from the liver. The medical personnel is able to take the sample with a needle through your skin. There is no need to undergo surgery.
  • Abdominal ultrasound– This test will help the doctor to take a closer look at your liver and neighbouring organs. This can reveal if there is excess fluid, liver damage, liver tumours, or any abnormalities of the gallbladder.

After which, the treatment options as below may be prescribed to the patient. While the body will clear the virus on its own, these methods are meant to minimise the signs and symptoms of the disease.

  • Rest and stay in– Persons with hepatitis A infection usually feel incredibly fatigued and have less energy. Rest allows the body to repair and recover quicker as a general health decision. Stay in and do not go out for work or school activities.
  • Managing nausea– As nausea can make it challenging to eat, you may try to snack throughout the day instead, in smaller portions. Eat high-calorie foods and drinks such as fruit juice instead of plain water. Drinking fluids is vital to avoid dehydration if vomiting occurs.
  • Managing itchy skin– Keep your house in a cooling condition. Wear loose clothes to reduce skin irritation, and skip hot, scalding showers.
  • Avoid alcohol consumption and careful usage of medications– With a hurt liver, there may difficulty in processing medicines and alcohol. Avoid alcohol as it can cause more liver damage. Whereas for medicines, discuss with your doctor what is suitable and required for your healthy living.

Meanwhile, as hepatitis A is infectious, it is vital to take precautions to reduce the risk of passing it to others. Some measures are as follows:

  • Avoid engaging in sexual activity.Most sexual activities would spread the infection to your partner. Condoms are not a safety measure against infection.
  • Wash your hands thoroughly.This is a necessary step after using the toilet, changing diapers, etc. Scrub for at least 20 seconds (some people sing the “Happy Birthday” song as a counting method) and rinse well.
  • Don’t prepare food while unwell.The infection may pass to others through your food preparation. It is best to avoid this activity altogether.
  • Avoid sharing items.This would include sharing towels, or washing soiled laundry together.

Hepatitis A Prevention

Vaccination is one of the best methods to prevent hepatitis A. There are three main types of hepatitis A vaccination:

  • A vaccine for hepatitis A only
  • A combination of hepatitis A andhepatitis B
  • A combination of hepatitis A andtyphoid fever

Your healthcare provider would be able to recommend the best option for you. Almost any adult is able to get the vaccine unless you fall in one of the following categories:

  • Experienced a severe allergic reaction to hepatitis A vaccine or any other vaccine component;
  • Currently ill, unless it is a mild condition; or
  • Are pregnant, unless at a greater risk of contracting the virus (such as environmental factors or an outbreak).

Otherwise, practising effective hygiene is a way to avoid contracting the virus. As hepatitis viruses transmit from person to person via contact with contaminated bodily fluids, waters, and foods – avoid the following if you are travelling to a country with a high prevalence of hepatitis:

  • Local water
  • Ice cubes
  • Raw or undercooked shellfish
  • Raw fruit and vegetables

In addition, avoid contacting fluids by using your own needle, razor, and toothbrush. It is important to avoid spilt blood as well. In the community, there should be proper disposal of sewage and rubbish.

Improved sanitisation, food safety and immunisation are the best ways to combat hepatitis A.

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