Hep A Flashcards
Transmission is via…
Faecal-oral, either from person to person or through contaminated food or drink
Infection with hep A causes an _______ hepatitis
Acute
Notifiable infection?
Yes
Risk factors
Travel to high prevalence countries
oral-anal sexual contact (rimming)
IV drug use
Is testing for hep A part of routine sexual health screen in NZ?
No
Do you need to screen someone for hep A before vaccination?
No - no harm in vaccinating an already immune person, however some groups with a higher probability of prior infection may wish to avoid the expense of vaccination
Unfunded indications for screening before vaccination
MSM and others engaging in oral-anal sexual contact
People who inject drugs
People who have hepatitis B or C (superinfection with HAV leads to increased morbidity and mortality)
People travelling to high-risk countries
HAV testing is not funded in NZ, unless ___________
Acute infection is suspected
Routine testing for HAV immune status =
Total HAV antibody (Ab)
Differential testing for HAV IgG and IgM is limited to patients suspected of __________
Having acute HAV (jaundice and deranged liver function tests)
Interpretation of results - Total HAV Ab < 20 IU/mL
Susceptible
Offer vaccination if risk, and patient willing to pay
Interpretation of results - Total HAV Ab > 20 IU/mL and no suspicion of acute hepatitis
Previous infection or vaccination
Reassure the patient
No further action required
Suspicion of acute hepatitis and total HAV Ab > 20 IU/mL or positive HAV IgM +/- positive HAV IgG
Possible acute infection
Request liver function tests and HAV IgM if not already done
HAV IgM remains positive for __________ after acute infection
6 months or more
Management of acute hep A acute infection
Supportive care and monitoring
Advise avoiding food-handling and sexual contact (including oral-genital and oral-anal) until non-infectious
Notify public health
