Dr. M.J. Bazos, MD Patient Handout


About Your Diagnosis

Hepatitis is an inflammation of the liver. There are at least five virus types that cause the disease. One of the types of viruses is the A virus. Hepatitis A infects about 150,000 individuals in the United States each year. The rate is much higher in underdeveloped countries. The hepatitis A virus is usually transmitted by food or fecal contaminated water. Contaminated shellfish are a common source of infection. Outbreaks have been reported in day-care centers, the military, at institutions for the disabled, and because of infected restaurant workers. Transmission can also occur through direct contact with an infected individual. In more than 40% of the reported cases, it is not known how the individuals were infected. Hepatitis A is detected by a blood test that is positive for the antibody to the virus. The antibody appears about 4 weeks after the infection. Liver function tests are abnormally elevated, often to very high levels. The vast majority of individuals who get hepatitis A recover within 6 months and do not have any serious health problems.

Living With Your Diagnosis
Not all individuals who have hepatitis A infection will have symptoms. This is particularly true if the patient is younger than 2 years. If a patient does have symptoms, they will normally appear during the first 4 weeks of infection. One of the main symptoms of hepatitis A is jaundice, a yellow color to the skin or whites of the eyes. The jaundice is caused by the excess bilirubin in the blood. The excess bilirubin can also lead to other symptoms such as pale or clay-colored stools, dark urine, and generalized itching. “Flulike” symptoms of fatigue, loss of appetite, nausea and vomiting, and low-grade fever, as well as pain in the liver area, may occur several days before the jaundice appears. A very small percentage of individuals infected with hepatitis A are at risk for liver failure. This group includes those individuals with alcoholic hepatitis, chronic hepatitis with cirrhosis, and those individuals older than 60 years. These patients may improve in their symptoms and liver function tests only to have a relapse. This usually occurs after 4 weeks and can occur more than once. There is no way to predict who will sustain a relapse. It is rare for hepatitis A–infected pregnant women or their newborns to have serious complications.

There is no specific treatment for hepatitis A. Most individuals can be cared for at home. Proper amounts of rest for 1–4 weeks after the diagnosis is made is important. During this time, intimate contact with other individuals should be avoided. The diet should include foods that are high in protein. Individuals who have come into contact with the patient should be given temporary immunization with immune serum globulin. This must be given within 2 weeks of exposure.
The DOs
• Bed rest may be necessary until the jaundice disappears and appetite returns.
• Eating a well-balanced diet with plenty of fluids is essential.
• Make sure you properly wash your hands if you have hepatitis or are caring for someone with the disease. This is particularly important after contact with fecal material.
• An individual with hepatitis A should use separate or disposable eating and drinking utensils.
• If you have multiple sexual partners, a latex condom should be used. It may prevent transmission of the virus.
• If exposed to blood, fecal material, and other body fluids on the job, use proper protective equipment such as gloves and eye protection to lessen the chance of accidental exposure.
• Day-care workers should use proper hand-washing techniques after changing a diaper and before doing anything else.
• Restaurant workers should use proper handwashing techniques at all times.
• If traveling to areas that have a high incidence of hepatitis A, a vaccine is available.
The DON’Ts
• Avoid any substances that may be harmful to the liver. The avoidance of alcohol is key.
• Eating fatty foods may not be well tolerated in individuals with hepatitis A
• If you are an intravenous drug addict, do not share needles and other equipment because they can be contaminated with the hepatitis A virus.
When to Call Your Doctor
• If you have been exposed to someone who has hepatitis A or if you have symptoms of the disease.
• Call if hepatitis A symptoms do not resolve within 4 weeks.