Hepatitis A risk factors, prevention and treatment

Hepatitis A is the inflammation of the liver. It is caused by the Hepatitis A virus which is known as HAV. According to the World Health Organization, the HAV virus is commonly spread when uninfected and unvaccinated individuals ingest food or water that has been contaminated with stool from an infected person. “Hepatitis A is associated with unsafe water or food, poor personal hygiene, poor sanitation, contaminated environments, and oral-anal sexual acts,” the WHO states. This virus is highly contagious. For example, you can get it even where you ingest it in microscopic amounts.  In addition, the WHO cautions that Hepatitis A viruses persist in the environment and can withstand food production processes. Unlike Hepatitis B and C, Hepatitis A does not cause chronic liver disease. “However, Hepatitis A can result in debilitating symptoms. In rare cases, it can cause acute liver failure which is often fatal,” the WHO states.  

Because Hepatitis A is closely linked and transmitted through poorly sanitised environments, it is common in low and middle-income countries. It is also prone to spread in densely populated areas such as slums and other informal settlements. The WHO estimates show about 90 percent of children in informal areas will get infected with Hepatitis A before the age of 10 years. Most of these children will be asymptomatic.

The symptoms

Symptoms of Hepatitis A tend to last up to two months. According to the Centre for Disease Control, these symptoms will include fatigue, nausea, stomach pain, and yellowing of the skin and eyes (jaundice). Other symptoms will include poor appetite, diarrhea, malaise, and dark urine. The CDC recommends mandatory testing to determine this virus because some of its symptoms are closely related to those found in persons with Hepatitis B and hepatitis C.

When infected with Hepatitis A, you may be symptomatic or asymptomatic. Signs and symptoms tend to be more prevalent among adults than children. For instance, the WHO states in its guidelines on the management of Hepatitis A that children who are aged 6 years and below do not show any symptoms. Out of these children, only about 10 percent will develop yellowing skin and eyes. “The severity of this disease and the risk of fatal outcomes are higher among older people than younger populations,” the WHO says. One of the most noticeable developments in the management of Hepatitis A is the high chance of relapse. According to the WHO, patients with this virus will appear to recover, then suddenly relapse into acute symptoms. This relapse is however often countered by a strong recovery.

Risk factors

According to the CDC, some people will be more at risk of contracting this disease than others. Two of the high-risk categories for infection include people with chronic liver disease and people living with HIV.

Prevention

Unlike Hepatitis C, this virus can be prevented through a vaccine. Vaccines against Hepatitis A are injectable. “Vaccination with the full, two-dose series of hepatitis A vaccine is the best way to prevent infection,” the CDC states. The WHO does not, however, recommend vaccination of children aged one year and below. This is echoed by the CDC guidelines. The CDC adds that there is no known harm that is associated with the Hepatitis A vaccine for children under the age of one year. “However, the Hepatitis A vaccine dose(s) administered prior to 12 months of age might result in a suboptimal immune response, particularly in infants with passively acquired maternal antibody,” the CDC states. This vaccine can be administered concurrently with vaccines against Hepatitis B, diphtheria, poliovirus (oral and inactivated), tetanus, typhoid (oral and intramuscular), cholera, rabies, and yellow fever vaccines.

Treatment

According to the WHO, there is currently no specific treatment that is administered for Hepatitis A. Any form of treatment is aimed at alleviating the symptoms. This means that hospitalisation is not always necessary unless the risk of acute liver failure has been detected and determined to be high. “Persons with Hepatitis A can take longer to recover from their symptoms. The recovery can take weeks or even months in some cases,” says the WHO. In some cases, your physician might recommend a nutritional balance to replace fluids that you may have lost from vomiting and diarrhea. In the same breath, WHO recommends medications such as acetaminophen, paracetamol and other medications against vomiting should be avoided.