Hepatitis A (HAV): Rapid review
 | · Introduction. · Signs and symptoms. · Diagnosis. · Prevention. · Treatment. · Transmission. · Some hygiene information to protect yourself. |
Introduction:
· Hepatitis A(infectious hepatitis) is acute infectiousdisease of the liver caused by hepatitis a virus.
· The incidence of theinfection is high in the developing countries andin regions with poor hygiene standards and theillness is contracted in early childhood.
· The incubation period (time between the infection and theappearance of symptoms) is between 2 to 6 weeks{average 28 days}.
· Hepatitis a doesn'thave chronic stages, isn’t progressive, and doesn’t cause permanent liverdamage.
· HA infection causes no clinical signs and symptoms in over 90% of theinfected children and the infection confers lifelongimmunity as following the infection, AB are formed that confers immunityagainst further infection.
Signs and symptoms:
· Symptoms may bemistaken for influenza (fever ,fatigue,abdominal pain , diarrhea, appetite loss, itching, nausea, jaundice, urine of dark color, stool oflight color)
· The color of urineis due to the excretion of bile in it and the color of feces is due to lack ofbilirubin.
· Symptoms can returnover the 6-9 months
· Mortality is lessthan 0.5%
Diagnosis:
· IgM antibody isonly present in the blood following an acute hepatitis A infection (detectablefrom 1-2 weeks after the infection and persists for up to 14 weeks.
· the presence of IgGantibody in the blood mean that acute stage is past and the person is immune tofurther infection
· IgG is also found inthe blood after vaccination and tests for immunity to the virus are based onthe detection of this Ab.
Prevention:
· Hepatitis A can beprevented by (vaccination,good hygiene and sanitation).
· The vaccine is givenby injection into the muscle of the upper arm.
· The vaccines, (e.g. Havrix and VAQTA)contain no live virus and are very safe.
· Initial doseprovides protection for 2-4 weeks after vaccination and the second dose(booster dose) is given 6-12 months later, provides protection up to 20 years.
· N.B. vaccine is given before the infection as it doesn'twork after the exposure.
· Vaccine isn'trecommended for children younger than 2 years as it's ineffective for them.
· If you have beenexposed to person who is infected with HAV, there is treatment that may preventyou from becoming infected, it’s called immune globulinand is more likely to be effective when given 2 weeks of exposure.
· [Immune globulin isa preparation of Ab that can fight the virus in the body] given safely inchildren younger than 2 years, pregnant women and breast feeding.
· some samples takento study ocean water quality was found to have HAV specially after rains soit's advisable not to go to oceans in coastal areas in this time.
Treatment:
· There is no specific treatment for hepatitis A, but symptomatic treatment (rest, well balanced diet, stay hydrated)and avoid fatty foods and alcohols.
· N.B. avoid taking medicine or any substance can cause harmto the liver e.g. acetaminophen.
· The low % of deathsoccur usually in older ages (>50 years) and in those suffering another formof viral hepatitis (C or B).
Transmission:
· By fecal-oral route, poor sanitation, overcrowding,ingestion of shellfish cultivated in polluted water and by blood transfusionbut this is very rare.
· Fecal-oral routemean that when a person put something in his mouth that has been contaminatedwith faeces of an affected person.
· N.B. people whodon't have symptoms can still spread the virus.
Some hygiene information to protectyourself:
· Wash yourhands thoroughly every time you use the bathroom,before touching or preparing food, and before touching others. Wash carefullywith soap and warm water and dry thoroughly.
· Contaminated surfaces should be cleaned with household bleach tokill the virus. Heat food or water to 185°F or85°C to kill the virus.
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Prepared by: Pharmacist/ Mustafa Abdel Tawab. Resources: - Color atlas of pharmacology. - Drugs.com. - Master of Egyptian drugs. - Wikipedia. - Master of Saudi drugs. Copyrights: All rights are reserved for pharmacist development group 2009 - 2011. |  |
