Reviewed By: Pramod Kerkar, MD, FFARCSI

HAV in High Endemicity Area

Hepatitis A virus (HAV) is one the most common cause of food-borne hepatitis disease in the world. The disease can lead to significant economic and social consequences in communities. It can take weeks or months for people recovering from the illness to return to work, school, or daily life. At present years, the prevalence rate of HAV is declined due to an increase of access to the clean water and the availability of hepatitis A vaccine. But, in developing countries and economically poor countries, HAV infection still exists and challenges to a public health issue. It ranges from 20 – 25 % of HAV infection occurs in developing countries (high endemicity) because of overcrowding and poor sanitation.

Can a Person Die from Hepatitis A?

Serious illness is rare with hepatitis A infection when compared to acute hepatitis caused by other viruses. Most people who get hepatitis A feel sick for several weeks, but they usually recover completely and do not have lasting liver damage. Some exceptional cases have shown the HAV infection leading to severe liver inflammation and liver failure. This is more common in older people who develop this infection because of poor immunity. An extremely small number of people die from severe hepatitis A infection.

HAV Infections are self-limited

Most acute HAV infections are self-limited which can resolve spontaneously with or without specific treatment. The severity of the symptoms may vary with age and concurrent comorbidities, particularly chronic viral hepatitis. But in HAV, only acute infection phase exist and no chronic infection is reported so far. Acute HAV infection is usually silent or subclinical in children and infected patients have symptoms including hepatitis, jaundice, and abdominal pain. The incubation period of acute HAV infection is not more than 30 days. Clean water, hygienic food, plenty of rest can effectively combat the disease. It can take months for people to feel better.

Recurrence of Symptoms

Some patients with hepatitis A have clinical relapses (a recurrence of symptoms of a disease) after an initial partial or complete resolution. This clinical relapse occurs because of continuous viral replication. It is usually milder than the initial illness, and subsequent recovery is the rule. Some patients develop extrahepatic manifestations, such as arthralgias, cutaneous vasculitis, cryoglobulinemia, Guillain–Barre´ syndrome, myelopathy, mononeuritis, or meningoencephalitis, with or without clinical evidence of hepatitis.

HAV in Low Endemicity Areas

In low endemicity, outbreaks of acute hepatitis A infection are common in men who have sex with men and injecting drug users. Subgenotypes IA and IB are often found in North and South Americas, Europe, China, and Japan. This happens because of travelers to countries where hepatitis A is common. Some scientific publications reported on HAV prevalence among HIV +ve patients. HAV in blood in HIV +ve patients with acute hepatitis A was prolonged compared to that in HIV -ve patients with acute hepatitis A. Men who have sex with men and injecting drug users were the main reason for the increase of HAV transmission to healthy individuals. Best statistical example is, HAV seroprevalence among HIV-positive individuals ranged from 15.1% in Taiwan to 96.3% in Iran.

Conclusion

HAV is a self-limiting disease which can resolve spontaneously with or without treatment. Adequate rest, good sanitation, balanced nutrition and clean water can improve the health condition of HAV infected patients for a month. Almost everyone recovers fully from hepatitis A with a lifelong immunity. Death occurs rarely in high endemicity areas because of age or poor immune system of the infected individuals which triggered fulminant hepatitis. The incidence of HAV in low endemicity areas is because of men who have sex with men and injecting illicit drugs.

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: July 11, 2018

This article does not provide medical advice. See disclaimer

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