Hepatitis A: symptoms, causes and treatment of HAV

By Cristiano Antonino On May 1, 2023

Hepatitis A is an infection of the liver caused by the hepatitis A virus, HAV. It is a very contagious disease that develops when a person unwittingly comes into contact with the pathogen, in most cases by eating contaminated food or drink

The disease does not always manifest itself, but when it does it can cause fatigue, nausea, stomach ache and jaundice.

The best way to prevent it is through the vaccine.

Hepatitis A, what it is

Hepatitis is an inflammatory and infectious process in the liver, characterised by more or less extensive destruction of liver cells.

There are various forms of the disease, caused by different factors, both viral and nonviral.

Among the viral forms, there is also hepatitis A, which, as its name implies, is caused by the hepatitis A virus, also called HAV.

The disease is present worldwide: in some areas it is epidemic (especially in poor countries with poor hygienic conditions), i.e. it affects a large number of people, while in others it occurs sporadically.

The HAV virus can survive outside the body for months.

Hepatitis A symptoms

Hepatitis A does not always manifest itself: in some cases, it is silent and therefore shows no signs of its presence, especially in children (adults are more likely to have symptoms than children).

Or it manifests itself so mildly that the person does not notice anything.

If symptoms do develop, they usually appear two to three weeks after infection and last on average one to two weeks, although some people may become ill up to six months later and in some cases the illness may drag on for two months.

Manifestations, when present, may include

yellow skin and/or eyes (jaundice);
lack of appetite;
malaise;
upset stomach;
nausea and/or vomiting;
stomach pain;
fever;
dark urine and/or light-coloured stools
diarrhoea;
joint pain;
feeling of tiredness;
itching.

This hepatitis rarely causes complications.

These occur mainly in people who have other liver diseases and are older than 65 years of age.

The most serious danger is liver failure, which can sometimes be very serious.

Hepatitis A: can it be cured?

Unlike other forms of hepatitis, such as C and B, hepatitis A only manifests itself in an acute form and never becomes chronic: those affected always recover.

Only in rare cases do serious consequences ensue.

Once cured of the disease, one can never get sick again because specific antibodies develop, which protect against the disease for life.

Can a person spread the HAV virus even if they have no symptoms? Unfortunately, yes: hepatitis A is very contagious and people, especially children, can spread the infection even if they have no symptoms.

Incidentally, one should be aware that an infected individual can transmit the hepatitis A virus to others up to two weeks before the onset of symptoms.

Transmission of hepatitis A

The hepatitis A virus is found in the faeces and blood of infected persons.

Virus transmission can occur mainly via two routes

– by the faeco-oral route, i.e. through the consumption of contaminated raw or undercooked food and water: contamination of food by this virus can occur at any time, during the growing, harvesting, processing, handling and preparation of food. The products most at risk from this point of view are seafood and shellfish reared in water contaminated by sewage containing the virus. Not even fruit and vegetables, however, are immune. Cooking is the only effective measure to eliminate or inactivate the HAV virus from fresh produce. Contamination of food and water occurs most often in countries where hepatitis A is endemic;

-person-to-person contact: this form of hepatitis can be transmitted by close, personal contact with an infected person, e.g. through certain types of sexual contact (such as oral-anal sex), caring for someone who is ill, caring for newborns. The virus is present in faeces from 7-10 days before the onset of symptoms and up to a week afterwards. If you come into contact with the faeces of an infected person, therefore, you can become ill yourself. It should be noted that the virus also remains in the blood, albeit for a few days. The disease can therefore also be transmitted through contact with infected blood, even during sexual intercourse.

Risk factors

Certain groups of people are at a higher risk of infection and serious illness if they contract the HAV virus.

These are:

international travellers;
homosexual men, who have sex with people of the same gender;
people who use drugs;
workers with an occupational risk of exposure;
individuals who are homeless and live in poor sanitary conditions;
individuals with chronic liver diseases, including hepatitis B and hepatitis C;
people with HIV.

How to detect hepatitis A

If you have any doubt that you have been exposed to the HAV virus, you should contact your doctor or your Asst as soon as possible.

In this way, you can receive precise and targeted advice on what to do, also depending on your health condition and age.

A doctor can determine the presence of hepatitis A simply by analysing any symptoms presented by the person and prescribing a blood test for antibodies against the virus that causes hepatitis A.

Hepatitis A cure

The disease usually lasts one to two weeks.

Only in a minority of cases does it last longer (even several months).

In any case, to treat the symptoms of hepatitis when present, doctors usually recommend resting as much as possible, so as not to accentuate malaise and fatigue.

Yes also to eating a healthy and light diet, low in heavy and fatty foods and alcohol, so as not to further burden the liver, and to introduce plenty of fluids.

If symptoms are severe, hospitalisation may be necessary to follow specific treatment.

The vaccine for hepatitis A

The best way to prevent this hepatitis is to have the specific vaccination.

It is important to know that there is a vaccine that protects against this disease, consisting of inactivated (killed) viruses.

To obtain maximum benefit from the drug, more than one injection is required.

Generally, the two doses are given at least 6-12 months apart.

Protection develops as early as 14-21 days after the first dose.

The second dose prolongs the effectiveness, providing long-lasting protection (up to 10-20 years).

There is also a combined vaccine against hepatitis A and hepatitis B on the market, which is used in individuals who are susceptible to both viruses.

Prevention rules

To prevent this form of hepatitis, it is essential to observe basic hygiene rules, especially when preparing food.

Here are a few tips.

Wash your hands thoroughly after using the bathroom and changing nappies and before preparing and eating food. Handling food by infected people who have not washed their hands carefully is one of the most risky behaviours.

Do not eat raw fish and seafood unless you are sure of their origin.

Wash fruit and vegetables thoroughly before consumption.

Beware of well water.

Heating food and liquids to temperatures of 85 °C for at least one minute can kill the virus. Exposure to freezing temperatures, on the other hand, does not kill the virus.

When travelling in poor countries, with poor sanitation or endemic for hepatitis A, it is even more important to eat only cooked vegetables and fish, drink only bottled water and do not consume ice (unless you know the origin of the water with which it was made).

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