Thursday, September 29, 2022

What Is Hepatitis A Virus

Can A Man Give A Woman Hepatitis B

Hepatitis A Virus (HAV) for USMLE

Hepatitis B can be passed on via unprotected sex â including vaginal, anal and oral sex and other sexual activities â with someone who has hepatitis B, even if they don’t have symptoms. Some sexual activities are risker than others, such as anal sex or any type of sex where blood may be present.

How Do I Avoid Getting Sick

These tips will help protect you and your family from Hepatitis A:

  • Wash your hands after using the washroom and changing diapers, and before preparing or eating food.
  • When travelling, especially to developing countries:
  • drink water from a safe supply
  • avoid ice cubes in drinks
  • eat only freshly cooked food
  • avoid non-peelable raw fruit or vegetables
  • Talk to your doctor about getting a Hepatitis A vaccination before travelling.
  • Cook food to a safe internal temperature using a digital thermometer.
  • If you think that you have been exposed to the Hepatitis A virus, see your doctor immediately. Vaccination can prevent the onset of symptoms if given within two weeks of exposure.
  • If you have been diagnosed with Hepatitis A, or any other gastrointestinal illness, do not prepare food or pour water for other people.
  • Also, these safe food practices will reduce your risk of contracting Hepatitis A and other foodborne illnesses.

    Hepatitis A And International Travel

    Who should receive protection against hepatitis A virus before travel?

    All susceptible people traveling to or working in countries that have high or intermediate HAV endemicity are at increased risk for HAV infection. These travelers should be vaccinated or receive immune globulin before departure . For more information on international travel and hepatitis A, see CDCs travel page or ACIP updated recommendations on Prevention of Hepatitis A after Exposure to Hepatitis A Virus and in International Travelers.

    How soon before international travel should the first dose of hepatitis A vaccine be given?

    All unvaccinated people 12 months of age planning travel to an area with high or intermediate HAV endemicity should receive a single dose of vaccine as soon as travel is considered they should then complete the vaccine series with the appropriate dose and schedule. People traveling within 2 weeks should receive the initial dose of hepatitis A vaccine before departure and also simultaneously may be administered IG at a separate anatomic injection site for additional short-term protection . The hepatitis A vaccine series should be completed according to the routine schedule. Information on immune globulin dosing and additional information on hepatitis A vaccine and travel is available.

    What should be done to protect international travelers < 6 months of age and other travelers unable to receive hepatitis A vaccine?

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    How Is It Spread

    Hepatitis A is spread when a person ingests fecal mattereven in microscopic amountsfrom contact with objects, food, or drinks contaminated by feces or stool from an infected person.

    Hepatitis B is primarily spread when blood, semen, or certain other body fluids- even in microscopic amounts from a person infected with the hepatitis B virus enters the body of someone who is not infected. The hepatitis B virus can also be transmitted from:

    • Birth to an infected mother
    • Sex with an infected person
    • Sharing equipment that has been contaminated with blood from an infected person, such as needles, syringes, and even medical equipment, such as glucose monitors
    • Sharing personal items such as toothbrushes or razors
    • Poor infection control has resulted in outbreaks in health care facilities

    Hepatitis C is spread when blood from a person infected with the Hepatitis C virus even in microscopic amounts enters the body of someone who is not infected. The hepatitis C virus can also be transmitted from:

    • Sharing equipment that has been contaminated with blood from an infected person, such as needles and syringes
    • Receiving a blood transfusion or organ transplant before 1992
    • Poor infection control has resulted in outbreaks in health care facilities
    • Birth to an infected mother

    Managing Fever After Immunisation

    Its absolutely feasible to eliminate hepatitis C. Heres how.

    Common side effects following immunisation are usually mild and temporary . Specific treatment is not usually required.There are a number of treatment options that can reduce the side effects of the vaccine including:

    • Drinking extra fluids to drink and not overdressing if there is a fever.
    • Although routine use of paracetamol after vaccination is not recommended, if fever is present, paracetamol can be taken check the label for the correct dose or speak with your pharmacist .

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    How Can I Avoid Getting Hepatitis A

    There is a safe and effective vaccine that can protect you from getting hepatitis A. The vaccine is usually given in two doses six months apart. The vaccine will give you protection for up to 20 years. A combined vaccine for hepatitis A and hepatitis B is also available. Since up to 40% of the reported cases of hepatitis A occur in travellers, it is advisable to protect yourself with a hepatitis A vaccination six weeks before you leave.

    Consider these additional safety precautions:

    • Wash your hands frequently and thoroughly especially after using the washroom, before preparing food and before eating.
    • Avoid raw or undercooked food.
    • If you are travelling to countries with high rates of hepatitis A:
    • Drink bottled or boiled water and use it for brushing your teeth.
    • Drink bottled beverages without ice.
    • Avoid uncooked food including salads.
    • Avoid food from street vendors.
    • Peel and wash fresh fruits and vegetables yourself.

    How Is Hepatitis A Diagnosed

    Your healthcare provider will listen to your symptoms and will take a blood test to confirm the diagnosis of hepatitis A. If the test finds immunoglobulin M antibodies, you have an acute hepatitis A. If there are antibodies, but not IgM antibodies, you are immune to the virus either because you had a case of it and recovered, or you got the hepatitis A vaccine.

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    Control And Prevention Of Hepatitis A

    In areas of high prevalence, most children are infected early in life and suchinfections are generally asymptomatic. Infections acquired later in life are ofincreasing clinical severity. Less than 10% of cases of acute hepatitis A inchildren up to the age of six are icteric, but this increases to4050% in the 614 age group and to 7080% inadults.

    Of 115,551 cases of hepatitis A in the USA between 1983 and 1987, only 9% of thecases, but more than 70% of the fatalities, were in those aged over 49. It isimportant, therefore, to protect those at risk because of personal contact withinfected individuals or because of travel to a highly endemic area. Other groupsat risk of hepatitis A infection include staff and residents of institutions forthe mentally handicapped, day care centers for children, sexually active malehomosexuals, intravenous drug abusers, sewage workers, certain groups of healthcare workers such as medical students on elective studies in countries wherehepatitis A is common, military personnel, and certain low socio-economic groupsin defined community settings. Patients with chronic liver disease, especiallyif visiting an endemic area, should be immunized against hepatitis A. In somedeveloping countries, the incidence of clinical hepatitis A is increasing asimprovements in socio-economic conditions result in infection later in life, andstrategies for immunization are yet to be developed and agreed.

    How Is Hav Infection Prevented

    What Is Viral Hepatitis?

    Vaccination with the full, two-dose series of hepatitis A vaccine is the best way to prevent HAV infection. Hepatitis A vaccine has been licensed in the United States for use in persons 12 months of age and older. The vaccine is recommended for persons who are more likely to get HAV infection or are more likely to get seriously ill if they get hepatitis A. Immune globulin is available for short-term protection against hepatitis A, both pre- and post-exposure. Immune globulin must be administered within 2 weeks after exposure for maximum protection.

    Good hygiene including handwashing or use of hand sanitizer after using the bathroom, changing diapers, and before preparing or eating food is also integral to hepatitis A prevention, given that the virus is transmitted through the fecaloral route.

    For more information on vaccination for hepatitis A contact the ADPH Immunization Division.

    Page last updated: May 13, 2021

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    How Long Does Hav Survive Outside The Body How Can The Virus Be Killed

    HAV can live outside the body for months, depending on the environmental conditions. The virus is killed by heating to 185 degrees F for one minute. However, the virus can still be spread from cooked food if it is contaminated after cooking. Adequate chlorination of water, as recommended in the United States, kills HAV that enters the water supply.

    What Are The Risk Factors

    Some people are at an increased risk for contracting HAV, including:

    • people traveling to areas of the world where hepatitis A is common
    • men who have sex with men
    • people who use injectable or noninjectable drugs
    • caregivers for those who have hepatitis A
    • people who are experiencing homelessness
    • people living with a child whos been adopted from an area where hepatitis A is common

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    Hbv And Hepatocellular Carcinoma

    When tests for HBsAg became widely available, regions of the world where thechronic carrier state is common were found to be coincident with those wherethere is a high prevalence of primary liver cancer. Furthermore, in these areas,patients with tumor almost invariably are seropositive for HBsAg. A prospectivestudy in Taiwan revealed that 184 cases of hepatocellular carcinoma occurred in3,454 carriers of HBsAg at the start of the study, but only 10 such tumors arosein the 19,253 control males who were HBsAg negative.

    Who Is At Risk

    Hepatitis A Virus: Wreaking Havoc for Public Health

    Anyone who has not been vaccinated or previously infected can get infected with the hepatitis A virus. In areas where the virus is widespread , most hepatitis A infections occur during early childhood. Risk factors include:

    • poor sanitation
    • living in a household with an infected person
    • being a sexual partner of someone with acute hepatitis A infection
    • use of recreational drugs
    • travelling to areas of high endemicity without being immunized.

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    How Is Hepatitis A Treated

    There is no formal treatment for hepatitis A. Because its a short-term viral infection that goes away on its own, treatment is typically focused on reducing your symptoms.

    After a few weeks of rest, the symptoms of hepatitis A usually begin to improve. To ease your symptoms, you should:

    • avoid alcohol

    How Is The Virus Spread

    Hepatitis A virus is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of a person with hepatitis A. This type of transmission is called the “fecal-oral” route. For this reason, the virus is more easily spread in areas where there are poor sanitary conditions or where good personal hygiene is not observed.

    Most infections in the United States result from contact with a household member or sex partner who has hepatitis A.Hepatitis A virus may also be spread by consuming food or drink that has been handled by an infected person. Waterborne outbreaks are infrequent and are usually associated with sewage-contaminated or inadequately treated water. Casual contact, as in the office, factory or school setting, does not spread the virus.

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    Who Is Likely To Be Affected By Hepatitis A

    Certain people are more at risk than others for hepatitis A. These include:

    • People who use recreational drugs, both injected and non-injected types.
    • Men who have sex with men.
    • People who have close contact with someone who already is infected.
    • People who have close contact with someone adopted from a country where hepatitis A is common, or people who travel to countries where hepatitis A is common.
    • People who work with non-human primates.
    • People who have clotting factor issues, including hemophilia.
    • People who work in child care, or children who are in childcare.

    When Should I See A Doctor

    Hepatitis A and B

    Make an appointment if you have any of the symptoms and you recently:

    • Traveled out of the country, especially if you went to Mexico, South America, Central America, or anywhere without good sanitation
    • Ate at a restaurant that reported a hepatitis A outbreak
    • Found out someone close to you, like a roommate or caregiver, was diagnosed with hepatitis A
    • Had sex with someone who has hepatitis A
    • Ate raw shellfish
    • Used illegal drugs

    When you see your doctor, they may spot some more signs that you’ve got the disease. For instance, they might find that you have:

    • A swollen liver and spleen
    • Tenderness in the right upper side of your belly

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    Who Should Be Tested

    Testing for hepatitis A is not routinely recommended.

    CDC recommends hepatitis B testing for:

    • Men who have sex with men
    • People who inject drugs
    • Household and sexual contacts of people with hepatitis B
    • People requiring immunosuppressive therapy
    • People with end-stage renal disease
    • People with hepatitis C
    • People with elevated ALT levels
    • Pregnant women
    • Infants born to HBV-infected mothers

    CDC recommends hepatitis C testing for:

    • All adults aged 18 years and older
    • All pregnant women during each pregnancy
    • About 24,900 new infections each year
    • About 22,600 new infections in 2018
    • Estimated 862,000 people living with hepatitis B
    • About 50,300 new infections in 2018
    • Estimated 2.4 million people living with hepatitis C

    When Will Symptoms Appear After You Have Been Exposed To Hav

    It generally takes about 4 weeks for symptoms to appear, but they can start at 2 weeks or they can start up to 8 weeks after you have been exposed. You probably wont get every symptom immediately, but they tend to emerge over days.

    Also, you can have no symptoms and have the virus and be contagious. Children especially may be free of symptoms despite being infected.

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    How Common Is Hepatitis A

    Since the hepatitis A vaccine was first recommended in 1996, cases of hepatitis A in the United States have declined dramatically. Unfortunately, in recent years the number of people infected has been increasing because there have been multiple outbreaks of hepatitis A in the United States. These outbreaks have primarily been from person-to-person contact, especially among people who use drugs, people experiencing homelessness, and men who have sex with men.

    How Serious Is Hepatitis A

    Viral Hepatitis

    Most people who get Hepatitis A feel sick for several months, but they usually recover completely and do not have lasting liver damage. Sometimes Hepatitis A can cause liver failure and death, although this is rare and occurs more commonly in people older than 50 and people with other liver diseases.

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    Who Is At Risk For Hepatitis A

    Although anyone can get hepatitis A, you are at higher risk if you:

    • Travel to developing countries

    The symptoms usually last less than 2 months, although some people can be ill for as long as 6 months.

    You are at a higher risk of getting a more severe infection from hepatitis A if you also have HIV, hepatitis B, or hepatitis C.

    How Hepatitis A Is Spread

    Hepatitis A is most commonly spread when someone eats food or drinks water that contains the hepatitis A virus. This is more likely when travelling outside Canada in areas of the world where hepatitis A is more common. Contaminated sources may include:

    • ice
    • raw or frozen fruits and vegetables

    Hepatitis A can also spread:

    • from person to person through:
    • sexual contact with an infected person
    • contact with the feces of an infected person
    • blood transfusions or sharing needles for drug use
    • changing diapers or cleaning up stool from an infected person

    Even if you do not have symptoms, you can still infect others. Infected infants and children are more likely to be without symptoms than infected adults.

    You can spread the virus starting 2 weeks before you show any symptoms. You can continue to infect others until about a week after you get jaundice .

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    Can Hepatitis A Be Treated

    There is no drug treatment for hepatitis A. The disease will eventually run its course and an infected person will recover completely although recovery time varies for each person. Recovery from this virus infection means that you are protected for life from getting it again.

    The following are some ways of dealing with the symptoms:

    • You will feel tired and may have very little energy. You may need to take time off from daily activities, work or school to recover.
    • Nausea and vomiting may cause you to lose your appetite. Try to eat small snacks and soft foods such as soup or toast.
    • You may look yellow. Once you become yellow, you are no longer infectious. There is no need to isolate yourself. Let people around you know it is OK to be near you.
    • Try not to drink alcohol. Your liver may not be able to process alcohol and alcohol may make your symptoms worse.
    • Talk to your doctor before taking over-the-counter medications or complementary medicine. None of the alternative therapies have proved helpful in treating hepatitis A.

    Hepatitis B Antibody Escape Mutants

    Hepatitis A: How is it spread?

    Production of antibodies to the group antigenic determinant amediates cross-protection against all sub-types, as has been demonstrated bychallenge with a second subtype of the virus following recovery from an initialexperimental infection. The epitope a is located in the regionof amino acids 124148 of the major surface protein, and appears tohave a double-loop conformation. A monoclonal antibody which recognizes a regionwithin this a epitope is capable of neutralizing theinfectivity of hepatitis B virus for chimpanzees, and competitive inhibitionassays using the same monoclonal antibody demonstrate that equivalent antibodiesare present in the sera of subjects immunized with either plasma-derived orrecombinant hepatitis B vaccine.

    During a study of the immunogenicity and efficacy of hepatitis B vaccines inItaly, a number of individuals who had apparently mounted a successful immuneresponse and become anti-surface antibody -positive, later becameinfected with HBV.

    The region in which this mutation occurs is an important virus epitope to whichvaccine-induced neutralizing antibody binds, as discussed above, and the mutantvirus is not neutralized by antibody to this specificity. It can replicate as acompetent virus, implying that the amino acid substitution does not alter theattachment of the virus to the liver cell.

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