Hepatitis A

Hepatitis A virus (HAV) is an RNA picornavirus which is transmitted through faecal-oral contamination.47

Young children infected with HAV are usually asymptomatic, with the likelihood of symptoms tending to increase with age. Most patients recover within two months of infection, however up to 15% may relapse in the first six months. Hepatitis A virus does not result in chronic liver disease.47

Presenting signs and symptoms include:

Diagnosis

Because of its non-specific symptoms, HAV cannot be diagnosed on clinical grounds alone. Suspicion of HAV should be increased if the patient has been exposed to unwashed or uncooked food or untreated drinking water, or to a person with a confirmed HAV infection. Laboratory findings are non-specific and show marked elevation in liver enzymes.

Diagnosis is confirmed by the detection of serum immunoglobulin M (IgM) anti-HAV antibodies.47

47. Matheny SC, Kingery JE. Hepatitis A. Am Fam Physician 2012;86:1027-34; quiz 10-2.