Hepatitis A: Symptoms, Diagnosis, Treatment

Hepatitis A (infectious hepatitis, Botkin's disease) is a disease that occurs with liver and biliary system and is caused by a virus. It is transmitted by contact-household.

Most often, viral hepatitis A diagnosed in children: 60% of cases of the disease.

The disease characterized by seasonality, virus outbreaks are observed in autumn and winter. It is noted that mainly suffers from hepatitis A population of developing countries.

In addition, the described pathology is common in regions with a hot climate, so the tourists hit the road Asian countries, Egypt, Turkey and other "warm spots" should be cautious and carefully refers to the observance of the rules hygiene.

Kinds

Known forms of viral hepatitis A:

• icteric;
• worn with jaundice;
• anicteric.

Separately allocated subclinical (inapparent) form, which is diagnosed only on the basis of laboratory results.

Course of the disease may be acute, protracted, subacute and chronic (extremely rare). Acute hepatitis B infection in the severity of clinical manifestations can be easy, moderate and severe.

Causes

The causative agent of the disease is the hepatitis A virus, which belongs to the family of picornaviruses. It is very stable in the environment, it is stored in at 4 for several months^aboutOn and on for several years at -20^aboutFROM. Killed virus only after five minutes of boiling.

The source of infection is becoming a sick man, no matter what his form of the disease: icteric or anicteric. The most dangerous are patients at the end of the incubation period and for preicteric step. With the advent of jaundice virus in the blood can not be detected, and the risk of infection is reduced as much as possible.

The main ways of infection:

• nutritional (food);
• contact-household;
• water.

Some doctors are of the opinion that the virus can be transmitted by airborne droplets, but sufficient evidence of this view does not matter. Therefore hepatitis A is referred to as intestinal infections.

You can get hepatitis A in the use of:

• the food prepared for the infected person;
• fruits and vegetables, which are washed and contaminated unboiled water;
• Food cooked a person who does not comply with the rules of personal hygiene or caring for a sick child;
• raw seafood, which capture agent is produced in the infected with hepatitis A waters (not eliminated and waste water);
• as well as through homosexual contact with a sick person.

risk for infection with hepatitis A:

• households patient person with hepatitis A;
• people who have sexual contact with a patient;
• People, especially children, who live in areas with a high prevalence of hepatitis A;
• gay men;
• employees of kindergartens, institutions of public power and water supply;
• Children who attend preschool;
• drug addicts.

Symptoms of hepatitis A

The incubation period of the disease lasts 2-3 weeks on average, a maximum of 50 days and a minimum of 7.

Signs anicteric shapes and forms with the erased jaundice

In children, hepatitis A usually occurs without jaundice or with a defaced picture of jaundice.

Difficulty in diagnosis of these forms is that the temperature increase momentarily observed during the first 2-3 days, then it is reduced or (rarely) remains low grade.

The main and important features are enlarged liver and spleen (hepatosplenomegaly). The liver performs at 2-3 cm from under the costal margin during palpation of its sensitivity. In a minority of patients with palpable enlarged spleen.

Perhaps a transient darkening of the urine.

Most patients complain of:

• loss of appetite;
• nausea;
• weakness;
• dragging pain in the epigastric and right upper quadrant;
• joint pain;
• in the upper airways catarrhal phenomena are detected.

icteric form

If hepatitis A is acute, the clinically well diagnosed by his stage:

• preicteric;
• height of the disease (jaundice);
• of recovery (recovery).

Preicteric stage is typically less than 7 days in children is shorter up to 4-5 days for adults - 7-8 days.

Depending on whether the syndrome is prevalent in preicteric period distinguish its variants:

• asthenovegetative (weakness, fatigue, lethargy, malaise);
• dyspepsia (nausea, lack of appetite, possible vomiting, pain in the right upper quadrant);
• catarrh of respiratory tract infections (rhinitis, pain in the throat and redness of mucous, cough, increased temperature to 39-40 degrees);
• lozhnorevmatichesky (joint pain);
• mixed.

Icteric stage is characterized by yellowing of the skin and sclera, which first increases and then decreases. These manifestations detects either the sick or friends or relatives.

Signs of intoxication are not increased, you may experience itching. The patient continues to bother heaviness and aching in the upper quadrant, there is discoloration of feces and darkening of urine. The liver and spleen are enlarged.

In the period of recovery of the clinical symptoms of the disease gradually leveled. Appears appetite, the liver returns to its original size, brightens urine, stool color normal.

Diagnostics

The differential diagnosis of hepatitis A is necessary in preicteric stage: many of the symptoms are similar to SARS and acute gastroenteritis, or after the onset of jaundice: hepatitis A to distinguish from other hepatitis, Cholangitis, bile stasis and cholelithiasis.

For the diagnosis of the disease are important:

• medical history;
• clarify the epidemiological situation and the possibility of contact with patients with hepatitis A;
• confirmation of increase in liver and spleen;
• availability of complaints light feces and dark urine.

From laboratory methods used:

• activity determination AST and ALT, Aldolase, thymol;
• holding ELISA or PHA for detecting specific antibodies of immunoglobulin class M (ANTI-HAV IgM);
• general blood analysis (lymphocytes increase and monocytes at Reducing the number of leukocytes and ESR);
• biochemical blood tests (increase bilirubin, Reduction of the total protein);
• general urine analysis;
• study of blood clotting, in particular prothrombin index;
• liver ultrasound.

Treatment of hepatitis A

Treatment of hepatitis A is engaged in infectious disease physician. All patients were compulsorily hospitalized in the infectious department or the hospital.

* Learn more about the standard of care (2012.) In a hospital in children and adults.

Special medical treatment is usually given: required bed rest for the improvement of blood supply of the liver and other organs, calm and gentle diet.

Of food you want to exclude:

• animal fats;
• fried, spicy, salty and smoked products;
• limit the intake of vegetable fats;
• consumption of alcoholic beverages is prohibited.

In moderate and severe cases:

• used intravenous infusions (glucose solution reopoligljukin, Ringer's solution, gemodez) for detoxification;
• shows the intake of antioxidants (vitamins E, A, PP, C), metabolic and enzymatic preparations (Riboxinum, Essentiale-forte);
• recommended to take chelators (Polyphepanum, enterosgel) and rich alkaline water.

Read more about diet for hepatitis A >>>

Consequences and outlook

Viral hepatitis A rarely causes complications.

Some patients may increase the recovery period, in which case they receive a restorative treatment and multivitamins.

chronicity of the process is extremely rare. After this illness sometimes occur biliary tract diskenezii, cholecystitis. Rarely develop cholangitis and pancreatitis. Sometimes after hepatitis A manifests Gilbert's disease.

Weather favorable.