Hepatitis A: symptoms

The increased consumption of raw foods and the habit of traveling in endemic areas mean that hepatitis A continues to spread today, even in Italy.

Hepatitis A is an acute liver infection, whose etiopathogenesis is due to the HAV virus, an RNA virus of the Picornaviridae family, capable of compromising the functions of the liver by attacking its cells.

How it contracts

Hepatitis A is contracted by the fecal-oral route, by ingesting water or food contaminated with feces infected with the virus, or by coming into contact with infected people.

In countries where hygiene conditions are still scarce, hepatitis A is unfortunately transmitted very quickly, especially among children, in whom, among other things, the disease is often asymptomatic. Once you come into contact with the disease, immunity develops for life.

In developed countries, on the other hand, contagion has become much less frequent among both children and adults, thanks to better hygienic-sanitary conditions.

The most common risk factors remain the consumption of raw foods, drinking contaminated water, making trips to risk areas, working in kindergartens or neonatal intensive care units.

Symptoms

The symptoms of hepatitis are very similar to those of influenza, and manifest, suddenly, 2 to 6 weeks after infection.

Symptoms differ before and after the onset of jaundice (see table). In children the most common symptom is diarrhea.

Pre-icteric phase	Jaundiced phase
General physical malaise	Dark urine
Fatigue	Clear stools
Lack of appetite	Itch
Nausea
Vomit
Fever

Diagnosis

Already after 1-2 weeks from infection, the presence in the blood of IgM antibodies against the HAV virus is the first sign that can lead to the diagnosis of hepatitis A, followed by the presence of viral particles in the faeces, detectable towards the end of the incubation period.

The presence of IgG antibodies, on the other hand, indicates a previous infection and guarantees immunity.

Another blood component to monitor is ALT (alanine transaminase), an enzyme released by a liver now damaged by the virus, whose values increase during acute infection.

The cure

Patients are generally recommended to rest and consume water and healthy foods, while alcohol intake is prohibited.

In the absence of other diseases, patients all recover without clinical complications. Age, however, greatly affects the course of the disease, which in some cases can lead to death from liver failure.

Prevention

The main prevention measures to follow to reduce the risk of contracting hepatitis A are hand washing and thorough washing and cooking of contaminated food.

To make sure you eliminate the virus you need:

• boil everything at a temperature above 60 °, so that the virions are inactivated
• Wash food using chlorine, to which this virus is sensitive.

The preventive measure of excellence, however, remains passive immunization or vaccination. Passive immunization with immunoglobulins, considered a “shock therapy”, is recommended in case of travel to tropical countries or in case of exposure to infected people. Passive immunization coverage is limited, lasting 3 to 6 months.

Vaccination, on the other hand, involves the injection of the attenuated or modified virus, so that it is the body itself that produces the antibodies capable of fighting the virus. The time it takes for antibodies to be produced is about 4 weeks: only from that moment an individual begins to be immune.

The coverage provided by the vaccine is at least 8 years, but, according to several studies, it can last a lifetime. For this reason, the vaccine is recommended for military, health personnel and employees in kindergartens and kindergartens, as well as patients in need of transfusions or with chronic liver diseases.