Hepatitis A

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Hepatitis A is associated with acute hepatitis.

It does not cause chronic infection.

Transmission

Transmission – faecal-oral route

 

Incubation period

The incubation period is between 2 to 6 weeks.

Infectious period is between 2 weeks before the onset of jaundice until 1 week after.

 

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Clinical features

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Asymptomatic infection is common in children.

Pre-icteric phase

It is characterised by nausea, vomiting and abdominal discomfort.

 

Icteric phase

Shows increase in bilirubine level- Jaundice, clay stool, dark urine

 

Mortality is caused by acute hepatic failure

 

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Investigation

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LFT- increase in transaminase and alkaline phosphatase level is common

 

Diagnostic tests

Serum- Hepatitis A IgM

 

Hepatitis A

Acute/ recent infection                   +                                        +

 

 

Screening test

Screening is routinely done before vaccination in patients who is older than 50 years or immigrate from endemic country.

Hepatitis A IgG indicates past exposure or immunisation.

 

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Treatment

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Self-limiting.

Advise low intake of protein diet.

Avoid alcohol.

Occasionally some patients develop severe liver disease and may require liver transplant.

 

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Prevention

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Hand washing can prevent person to person transmission.

Vaccination is useful to prevent infection on travellers travelling to developing countries.

Vaccination is effective even after exposure to Hepatitis A.

Human Normal Immunoglobulin (HNIG) may be used to prevent or attenuate infection when given after exposure.

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