Hepatitis A

Hepatitis A is one of the most frequently reported infectious diseases in the US.

Hepatitis A is not a chronic disease.

Transmission usually precedes symptoms by 2 weeks, but can be up to 7 weeks, when stool viral concentrations are highest. Patients are considered noninfectious 1 week after onset of jaundice.

Symptomatic patients may present with abrupt-onset fever, abdominal pain, malaise, jaundice, dark urine or light-colored stools, or diarrhea.

Immunoglobulin M antihepatitis A virus test should be ordered when a patient is symptomatic or hepatitis A virus (HAV) virus is suspected.

Common exam findings are hepatomegaly and clinical jaundice with marked elevation of serum aminotransferases (usually >1000 units/L).

No specific therapy is available, and treatment is usually supportive.

Postexposure prophylaxis may be with active or passive immunization, depending on specific patient factors, and according to individual national guidelines.

HAV is an RNA virus. Mode of transmission is fecal-oral. Most infections in adults and older children are symptomatic; 70% develop jaundice. The majority of infections in children younger than 6 years are asymptomatic.[1]​Centers for Disease Control and Prevention. Hepatitis A. [internet publication]. https://www.cdc.gov/hepatitis-a/index.html ​ Average incubation period is 28 days (range 15-50 days).[1]​Centers for Disease Control and Prevention. Hepatitis A. [internet publication]. https://www.cdc.gov/hepatitis-a/index.html ​​

Unlike hepatitis B and C infections, hepatitis A infection is not associated with chronic liver disease.[1]​Centers for Disease Control and Prevention. Hepatitis A. [internet publication]. https://www.cdc.gov/hepatitis-a/index.html ​​[2]Langan RC, Goodbred AJ. Hepatitis A. Am Fam Physician. 2021 Oct 1;104(4):368-74. https://www.aafp.org/pubs/afp/issues/2021/1000/p368.html http://www.ncbi.nlm.nih.gov/pubmed/34652109?tool=bestpractice.com ​​