Introduction

It is one of the viruses known to cause inflammation of the liver, commonly seen in the younger population. It is highly contagious but does not cause any permanent liver damage. It is usually acquired from contaminated food or water.

In Pakistan, where most of the regions experience hot and humid weather, people rely upon unhygienic means of hydration and this increases the chances of infection. School going children are especially vulnerable.

Another important aspect is some cultural myths associated with this disease herbal tonics and amulets. which have no scientific basis and are of no benefit.

Avoid going to quacks. Severe infection is rare but can be seen in those cases who have underlying chronic liver disease.

Symptoms

Symptoms appear after you have had the virus for a few weeks. They can include:

Nausea and vomiting

Loss of appetite

Pain in the upper part of abdomen

Dark urine and light-coloured stools

Tiredness and lethargy

Yellowish discolouration of skin and white part of the eye (jaundice)

The duration of symptoms is variable but can be prolonged in some cases which again does not mean that a specific drug therapy is needed.

Diagnosis

A specific set of blood tests are required initially for the diagnosis as recommended by your doctor. Liver function tests, hepatitis A antibodies and PT INR are some of the important investigations required for the diagnosis.

Frequent monitoring of liver chemistry is not required as it takes time to normalize, which is variable and it is not directly related to the prognosis of the disease.

Treatment

• No specific treatment exists. Most over-the-counter treatments and tonics advocated are of no use. Most patients can be managed at home. Hospital admission is required in those cases who developed an altered level of consciousness or severe derangements in specific blood tests like PT INR. Moreover, jaundice can take some time to improve and is not necessarily a marker of severity of disease
• Rest and good hydration are the cornerstones in management. Medicines can be given to improve nausea and vomiting. It is very important to understand that unnecessary medications such as herbal tonics should be avoided as they increase the chances of further liver injury and may result in serious outcomes.

Complications

Unlike other hepatitis viruses, hepatitis A does not cause any long-term liver damage. Severe infection that damages the liver is very rare and requires stay in hospital for monitoring and management.

Prevention

Practice good hygiene

Boil water before use

Hand washing

Proper washing of fruits and vegetables

Vaccination

A vaccine for prevention of hepatitis A is available and can be given as per your doctor’s recommendation. It consists of one shot followed by a booster dose 6 months later.