All About Hepatitis A: Types, Symptoms, Causes, And Prevention

We often hear about hepatitis being a serious complication for the liver. So, let's first understand what is hepatitis, the types of hepatitis, symptoms of hepatitis, causes of hepatitis, and the test for hepatitis.

These will make it clear why it's so important to keep our liver — perhaps the hardest-working organ in the body — free of this disease, which doesn't easily show symptoms and also doesn't easily leave the body. What one must know is how to prevent hepatitis, since prevention is always better than cure.

In the simplest terms, hepatitis is inflammation/swelling of the liver, which happens when liver tissues are damaged by injury or infection. When allowed to develop beyond certain proportions, hepatitis can lead to liver cirrhosis, liver failure, or even liver cancer. Hence, timely diagnosis and early treatment are the best ways to arrest hepatitis before it turns fatal.

Types of hepatitis

• Viral hepatitis: The most common type, caused by viruses like Hepatitis A, B, C, D, and E. The spread of these viruses is either via the exchange of body fluids via sexual contact or through ingestion of contaminated food and water.
• Toxic hepatitis: Caused by ingestion or inhalation of certain medications, toxic chemicals, drugs, and nutritional supplements.
• Alcoholic hepatitis: Caused by oxidative stress resulting from the excessive consumption of alcohol.
• Autoimmune hepatitis: Caused when the body's immune system starts attacking the liver instead of attacking pathogens in the body. As a result, the liver gets chronically inflamed and prone to several problems.

Hepatitis A: What is it?

Hepatitis A is a contagious viral infection, which is categorized as acute/short-term, because the affected person can get better from it within 6-8 weeks to a maximum of 6 months, by following prescribed preventive steps and taking due medical precautions after being diagnosed.

While this viral infection can attack people in any age group, it's important to analyze your own risk for Hepatitis A, because age may determine how severe the impact of this infection will be.

Hepatitis A usually doesn't lead to very serious complications in younger people, but in people older than 50, the infection can cause further complications like relapsing hepatitis, cholestatic hepatitis, autoimmune hepatitis, or liver failure.

• Relapsing hepatitis can cause periodical jaundice (leading to inflammation).
• Cholestatic hepatitis obstructs the path of the bile flowing from the liver to the gall bladder, resulting in fever, jaundice, weight loss, etc.
• Autoimmune hepatitis causes inflammation, leading to other complications like cirrhosis and liver cancer.
• Liver failure, a rare occurrence due to Hepatitis A, can nevertheless happen in older people with prior liver problems.

Causes of Hepatitis A

While Hepatitis A infection is a highly contagious disease that spreads through the proliferation of the Hepatitis A virus, this virus does not spread through sneezing or coughing.

• It spreads through the fecal-oral route, usually by ingestion of contaminated food or water, especially food/water contaminated with fecal matter. It has been seen that ice, water, shellfish, and uncooked and unpeeled fruits and vegetables are common transmitters of the Hepatitis A virus.
• Drinking water that's not purified and is contaminated with fecal matter is a very common way of contracting Hepatitis A. Sewage-contaminated water is also responsible for this infection.
• Even if you eat cooked food, you're still at risk of Hepatitis A infection — even though the popular belief is that heat kills all germs. You could get the infection if that food has been cooked in unclean, feces-contaminated water and/or has been handled by a person who does not follow personal hygiene, such as washing hands thoroughly after using the toilet or washing hands before cooking.

Fecal-oral contact can also happen by:

• proximity to an infected person;
• coming in contact with the stool or blood of an infected person;
• having oral-anal sex with an infected person.

Who is at risk for Hepatitis A?

Anybody who hasn't been vaccinated against Hepatitis A in childhood is prone to catching the infection at any age, subject to the risk factors they're exposed to.

Some of the predominant risk factors for catching Hepatitis A infection are:

• Poor sanitation: People who live in places where the water supply is contaminated with sewage water or fecal matter are at a much greater risk of Hepatitis A.
• Indiscriminate eating: People who eat at unclean places, where the water used for cooking may be feces-contaminated, and/or the cook or food handler might have unwashed, feces-contaminated hands at risk.
• Drinking unsafe water: People who directly drink water that's contaminated with fecal matter or sewage are at risk.
• Proximity to an infected person: Hepatitis A spreads by the exchange of body fluids, especially through the mouth. Hence, people who share a spoon or a glass with another person who might have Hep A infection, are putting themselves at risk.
• Sexual contact with an infected person: Sexual contact, especially involving the anus and the mouth, can spread the Hepatitis A virus very fast. This factor has been seen more so in men having sex with men.
• Risking contact with infected blood: Those who use recreational drugs by sharing needles are at risk of contracting Hepatitis A through the spread of infected blood. In a different scenario, people working in hospitals or those who're caregivers for infected people are also at the risk of being exposed to the HepA virus.
• Being unvaccinated: Being unvaccinated against hepatitis viruses and traveling to, or staying at places that have endemicity of Hepatitis A can put a person at a high risk of contracting the disease.
• Having other health problems: People afflicted with other ailments such as HIV and blood-clotting disorders like hemophilia are especially vulnerable to Hepatitis A.

It takes a very microscopic quantity of infected matter to lead to the spread of the virus. Hence, be aware of your vulnerability to the risk factors, and be alert to any of the symptoms that can signal a Hepatitis A infection.

Symptoms of Hepatitis A

Sometimes, Hepatitis A comes as such a mild infection that no symptoms are noticeable at all. At other times, Hepatitis A symptoms take around 2-6 weeks to develop to noticeable proportions.

Some of the main symptoms of Hepatitis A are:

• Constant or prolonged fatigue
• Feeling feverish or having fever
• Loss of appetite
• Abdominal pain, especially below the right rib cage
• Passing dark yellow urine
• Passing clay-like, light-colored stool
• Joint pain
• Nausea
• Vomiting
• Diarrhea
• Itching
• Losing taste for cigarettes (if you're a smoker)

Test for Hepatitis A

The initial diagnosis of Hepatitis A includes a physical examination of the eyes, skin, and abdominal region. The doctor will check for signs of yellowness on the skin and in the eyes and will see if there's any pain in the abdominal region, especially on the right side.

This will be followed by a blood test to check the presence of immunoglobulin M antibodies. A positive report will confirm the presence of the Hepatitis A virus in your body because the body starts developing IgM to fight the Hepatitis A virus.

Vaccination against Hepatitis A

Vaccination is the first and best line of defense against Hepatitis A. Ideally, these vaccines are given to children before they turn 2 years of age. If not vaccinated at that time, they should be given the catch-up vaccines before turning 18.

Pregnant women living in conditions where they can easily get exposed to Hepatitis A, or people traveling to such places, are also recommended the vaccine in adulthood.

There are two types of vaccines available:

• Two-shot vaccine, which is given 6 months apart and protects against Hepatitis A
• Combination vaccine given as 3 shots over 6 months to protect against Hepatitis A and B both. Usually, this is recommended only for adults over 18 years.

The Hepatitis A vaccine usually has no side effects, and can even be given to people with immuno-compromised health problems.

Where it's not possible to take the vaccine due to the issue of age, or, having rare allergic tendencies, it can be substituted with IMG injections according to the doctor's advice.

How to prevent Hepatitis A

Since Hepatitis A is a highly contagious disease with no treatment after the virus attacks the body, prevention is indeed the best cure to protect oneself and others from it.

Some effective ways to prevent the affliction are:

• Vaccine: Follow the hepatitis vaccination schedule for your child without fail. Consider taking the vaccine yourself, even as an adult, if you're at risk.
• Hygiene and sanitation: Irrespective of where you're staying, inculcate a habit of washing your hands after visiting the toilet or changing a soiled diaper; washing your hands while cooking food; washing all utensils well. Also, keep your toothbrush, nail clippers, scissors, etc exclusive to you. If working in an environment where you're exposed to blood and body fluids, take care to wear gloves and sanitize your hands at regular intervals.
• Having protected sex: Avoid anal-oral sex with someone whose sexual history is not known to you. Alternatively, insist on a condom, and be sure to not follow anal sex with oral sex.
• Use filtered water: If you're not sure about the origin of the water you're using, go for bottled water for drinking, cooking, and brushing teeth. Alternatively, you can boil the water for 1-3 minutes, cool it, and refrigerate it for use. It helps kill the germs that spread Hepatitis A.

Hepatitis A, once acquired, does not have any medication. Ample rest, drinking clean water, eating nutritious food, and following hygiene and sanitation protocols are the only ways to recover from the infection as soon as possible.

Once afflicted with Hepatitis A, it pumps the body with antibodies that prevent a person from falling prey to the ailment again.

Conclusion

Hepatitis A is not as fatal as Hepatitis B can be, but it still can't be taken lightly. This is a very contagious disease that can cause severe discomfort for months on end. The accompanying problems that such a slow-moving ailment can bring along (such as loss of appetite, weight loss, joint pain, etc) can be challenging to overcome and get back to normalcy in the long run.

All hepatitis infections can affect the liver to grave proportions, and Hepatitis A is no exception. Since the liver performs immensely important functions for the body, try and prevent it from getting afflicted by debilitating diseases like Hepatitis A.