Viral hepatitis A is relatively harmless disease and many refer to it by most obvious symptom – jaundice. This disease of dirty hands occurs everywhere in the world, and is transmitted by food or water that has been in contact with infected feces. It is most common in children and young adults.
A person is most contagious one week before the onset of symptoms and during the first week of duration of symptoms.
The average period from the time of infection to onset of symptoms (incubation period) is 28 days.
Hepatitis A Symptoms
The symptoms are more often manifested in adults than in children and usually begin abruptly:
- fever
- fatigue
- loss of appetite
- nausea
- abdominal pain in the liver area
- dark urine
- light stool
- yellowing of the skin and the white sclera
- liver enzyme (serum aminotransferase alane – ALT and Aspartat aminotransferase – AST) are elevated and often show very high values
Symptoms usually last less than two months, with most patients recovering in six months without any consequences, in other words, there is no chronic form of the infection.
Symptoms: Occur 2-6 weeks after exposure to the virus. The patient feels itching, fever, and the skin turns yellow. In children the symptoms are usually very mild, in adults they’re acute. They can last from one to several months. Unlike hepatitis B and C, “jaundice” never becomes a chronic disease. When a patient is cured, he becomes immune to the new virus attacks. Complications of hepatitis A are extremely rare, and they can happen in patients with liver damage, for example in patients with hepatitis C or older than 50 years. There is no chronic form of the infection.
Prevention and treatment
Patients don’t need to take any special medications, but are recommended to rest and diet. Most patients need to rest during the 1-4 weeks after diagnosis. Hygiene is a major obstacle to the spread of this virus. Wash hands after going to the toilet, before preparing food, after handling diapers and condoms, and avoiding sharing cups and eating utensils should become a habit. Hygiene not only prevents hepatitis A, but also many other diseases. One of the ways of prevention of hepatitis A is vaccination. It is recommended to employees in kindergartens and other institutions that take care for children or the elderly, workers who work in the sewers or are in contact with the waste, homosexuals, drug users who shared needles and residents of areas where the disease often occurs. In order not to return home with an unpleasant souvenir virus, vaccination is recommended for those who travel to countries known for its large number of cases of the disease (almost the entire Africa, Asia, South America).
Hepatitis A virus (HAV) is an RNA virus that belongs to the family of Picorna viruses, non-envelopped, 27nm in size, resistant to heat, acid and ether, and was originally classified as Enterovirus type 72, and is now classified within the genus Heparnavirusa, family Picorna virus. Its virion contains four capsid polypeptides marked VP1 to VP4, which are formed post-translationally from the polyprotein cleavage product of the 7500-nucleotide genome. Inactivation of viral activity can be achieved by cooking to the boiling point for 1 minute, contact with formaldehyde and chlorine or ultraviolet radiation. Despite the variation of the nucleotide sequence of 20 % among HAV isolates, all strains of this virus identified to date are immune indistinguishable and belong to one of the serotypes. Incubation period of hepatitis A is approximately four weeks. Its replication is confined to the liver, and the virus is found in the liver, bile, stool and blood during the late incubation period and preicteric acute phase of the disease. Once jaundice becomes apparent, despite the persistence of the virus, an abrupt reduction of the virus in the stool occurs, there is no more viremia and there is a rapid decrease in infectivity. Unlike other hepatitis viruses, hepatitis A virus will replicate in tissue culture, but mildly in comparison to other Picorna viruses.
Antibodies to HAV (anti-HAV) can be detected during the acute disease when serum aminotransferase activity is elevated, while there is still HAV in stool. This early response is dominated by IgM class antibodies and it takes a few months, and only rarely 6-12 months. However, during convalescence, anti-HAV becomes dominant antibody of IgG class. That is why the diagnosis of hepatitis A is set during acute illness demonstrating a high titer of anti-HAV of IgM class. Following the acute disease, anti-HAV of IgG class remains detectable forever, and patients with serum anti-HAV are immune to reinfection. Indeed, the activity of neutralizing antibodies occurs simultaneously with the appearance of anti-HAV, and anti-HAV IgG, which is found in immunoglobulin , protects against HAV infection .