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Hepatitis A



Last week, a 24-year old male came to me for consult regarding his yellowish palpebral conjunctiva and allegedly tea-colored urine. He said he already sought medical opinion the week prior and was told it was a viral infection. Urinalysis turned out to be unremarkable.

The first thing that came to mind was Hepatitis A so I requested for anti-HAV(IgM) determination as well as HbsAg. The following day, he showed me the result and I was right. The anti-HAV was reactive.

Here's an article regarding Hepatitis A.
Hepatitis A, (formerly known as infectious hepatitis), is an acute infectious disease of the liver caused by Hepatitis A virus, which is most commonly transmitted by the fecal-oral route via contaminated food or drinking water.

The time between infection and the appearance of the symptoms, (the incubation period), is between two and six weeks and the average incubation period is 28 days.

Hepatitis A does not have a chronic stage and does not cause permanent liver damage. Following infection, the immune system makes antibodies against the hepatitis A virus that confer immunity against future infection.

The virus spreads by the fecal-oral route and infections often occur in conditions of poor sanitation and overcrowding. Hepatitis A can be transmitted by the parenteral route but very rarely by blood and blood products. Food-borne outbreaks are not uncommon, and ingestion of shellfish cultivated in polluted water is associated with a high risk of infection.

Early symptoms of hepatitis A infection can be mistaken for influenza.
Symptoms can return over the following 6-9 months which include:
  • fatigue
  • fever
  • abdominal pain
  • nausea
  • diarrhea
  • appetite loss
  • depression
  • jaundice (yellowish discoloration of skin and palpebral conjunctiva of the eyes)
  • pain in the right upper quadrant pain of the abdomen
  • weight loss itching
IgM antibody is only present in the blood following an acute hepatitis A infection. It is detectable from one to two weeks after the initial infection and persists for up to 14 weeks. The presence of IgG antibody in the blood means that the acute stage of the illness is past and the person is immune to further infection.

There is no specific treatment for hepatitis A. Sufferers are advised to rest, avoid fatty foods and alcohol (these may be poorly tolerated for some additional months during the recovery phase and cause minor relapses), eat a well-balanced diet, and stay hydrated.

Reference: wikipidia
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