Hepatitis A

Question 1

Hepatitis A definition

Answer 1

• liver infection caused by Hep A
• Hep A is an RNA virus transmitted by the faecal-oral route

Question 2

Hepatitis A risk factors

Answer 2

• travel to endemic areas
• consumption of contaminated food
• MSM
• IV drug users
• childcare centres

Question 3

Hepatitis A pathophysiology

Answer 3

• virus replicates in hepatocytes
• causes cellular damage, may be mediated by Th1

Question 4

Hepatitis A signs and symptoms

Answer 4

• onset 2-4 weeks
• prodromal illness - fever, nausea and vomiting, bowel changes, flu symptoms - before jaundice
• hepatomegaly and RUQ pain
• clay coloured stool

Question 5

Hepatitis A investigations

Answer 5

• LFTs (AST, ALT, bilirubin)
• U&Es
• prothrombin
• IgM anti-HAV
• consider PCR

Question 6

Hepatitis A management

Answer 6

• if confirmed - supportive symptomatic care (paracetamol, metoclopramide, chlorpheniramine)
• avoid alcohol and stop work/school until not infectious
• good hygiene to reduce spread
• vaccinate if high risk (travel to endemic areas, chronic liver disease, haemophilia, IVDU and MSM)