| Hepatitis A
What is hepatitis A and how do you get it?
Hepatitis is a term used to describe liver inflammation caused by
any of a variety of agents, including viruses, drugs, bacteria,
etc. There are several kinds of viral hepatitis; each type is labeled
by a letter, Hepatitis A, B, C, D, E or G. Hepatitis A, B and C
are the most common. The different kinds of viral hepatitis are
spread in different ways and have different symptoms.
Hepatitis A virus (HAV) is spread by direct or indirect contact
with fecal material (shit). Exposure to Hepatitis A is common amongst
children, travelers in developing countries, and is extremely common
amongst gay men, particularly in New York City. You can get Hepatitis
A by eating contaminated raw or undercooked shellfish, eating food
or drinking water polluted with feces, and through sexual activity,
particularly oral-anal contact (rimming). There is no known danger
of transmitting Hepatitis A through pregnancy.
What are the symptoms of hepatitis A?
Usually, when children get Hepatitis A, they have no symptoms. In
adults, symptoms will appear after a four- to six-week incubation
period. Symptoms can include diarrhea, nausea, vomiting, fever,
achiness, fatigue and loss of appetite. A blood test will reveal
that liver function tests are abnormally high. Abdominal pain or
tenderness is often experienced. Jaundice will often occur, causing
a temporary yellowing of the skin and eyes, a darkening of the urine
and lightening of the stool. Symptoms usually end after two weeks,
but continued rest is very important to avoid a relapse.
Once you have had Hepatitis A, it is very unusual to for it to
reoccur. It is good to have your doctor test you to make sure you
have developed antibodies for Hepatitis A. This means that you cannot
usually get it again. However, you can become infected with another
type of hepatitis virus.
Can hepatitis A be prevented?
You can protect yourself against Hepatitis A. Ways to do this include:
1) Using proper hygiene (including washing hands after going to
the bathroom and before eating or cooking); 2) Avoiding impure water
and raw and other possibly contaminated foods in areas where the
disease is endemic (common in the population); and 3) Using a latex
condom for anal sex or rimming and by avoiding other oral contact
with fecal material that may have gotten on your skin or your partners
skin during sex.
If you are living with someone who has Hepatitis A, the use of
separate dishes, glasses and utensils is not necessary as long as
everything is washed with hot water.
Can hepatitis A be treated?
Although there is no treatment for Hepatitis A, discomfort may be
relieved to some extent by rest and proper nutrition. Bed rest is
recommended until liver function tests return to normal. Some doctors
recommend a high-protein, low-fat diet. It is important to avoid
dehydration by drinking plenty of fluids if you have diarrhea or
vomiting. As a general rule all drugs should be avoided during an
episode of Hepatitis A (especially narcotics, painkillers and tranquilizers)
unless specifically prescribed by your doctor.
If you think that you may have recently been exposed to Hepatitis
A, talk to your doctor about getting an immune globulin (also called
gamma globulin) injection. This substance is an antibody-rich blood
extract taken from exposed individuals having high levels of Hepatitis
A antibodies. The shots can prevent or reduce symptoms when given
within two to six weeks after exposure.
Immune globulin is also 75% effective in providing immunity against
Hepatitis A when given before exposure to the virus, such as before
travel to countries where hepatitis is common. The protection lasts
for five months.
These injections should work, causing no added difficulties in
people with HIV/AIDS.
Although shortages of immune globulin have been reported, there
is enough for people who have been exposed to Hepatitis A. If your
doctor has difficulty obtaining immune globulin, he or she can contact
the CDCs Division of Hepatitis at 404/639-2709 for information.
Hepatitis A Vaccine
There are two approved vaccines that protect against Hepatitis A,
HAVRIX by SmithKline Beecham and VAQTA by Merck. Both vaccines have
been found to be 99% to 100% effective. Both vaccines consist of
two injections given six months to one year apart. The vaccines
offer protection for at least seventeen years. The Hepatitis A vaccine
has very few severe side effects, the most common including redness
and pain at the injection site, fever, and malaise. There are no
reports of the vaccine working differently in HIV-positive people
but more study needs to be done in this area.
Although the cost of the Hepatitis A vaccine varies by clinic,
you should be able to get the vaccine at low cost by contacting
your local health department or non-profit community clinic.
The Hepatitis A vaccine is highly recommended for gay men, travelers
to countries where HAV is common, people with HIV/AIDS, injection
drug users, day care workers, American Indians and Eskimos. Ask
your doctor if the Hepatitis A vaccine is right for you.
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