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Saturday, February 23, 2013

Hepatitis A Virus: Properties, Transmission, Pathogenesis, Sign and Symptoms, Lab Diagnosis, Treatment, Prevention and Control of Hepatitis A Virus Infection

Hepatitis A virus: (infectious hepatitis):
Structure of Hepatitis A virus

Properties:


1.    It is a member of picorna group of enterovirus

2.    Single stranded RNA virus with one serotype

3.    Non-enveloped, Icosahedral nucleocapsid

4.    Replicate in the cytoplasm, inactivated by heat

5.    HAV is highly infectious and spread by the faeco-oral route




Some facts about Hepatitis A virus


NOTE: Infected individuals also may be asymptomatic, excrete the virus in faeces for about 2-3 weeks before the onset of symptoms and then for a further 2 weeks or so.




Transmission of Hepatitis A virus:
  • Faeco-oral route. e.g. poor sanitation, overcrowding, poor personal hygiene
  • Contaminated food and drink





Commonly spread by eating or drinking something (or putting something in your mouth such as utensil) that has been contaminated by the stool of a person with hepatitis A.


Pathogenesis of Hepatitis A Virus:

1.    Through contaminated food and drink the virus enters the body

2.    Replicates in the GIT
3.    Enters the blood
4.    Spreads to the liver
5.    Hepatocellular injury
6. Hepatitis A

Clinical Features / Signs and Symptoms of Hepatitis A Virus infection:


Jaundice
  • Jaundice (condition causing yellow eyes and skin, dark urine
  • Abdominal pain
  • Loss of appetite
  • Nausea
  • Fever
  • Diarrhea
  • Bile is removed from blood stream and excreted in urine, giving it a dark amber colour
  • Clay-coloured feces
  • Fatigue


Lab. Diagnosis of Hepatitis A Virus:

1.    Detection of Anti-HAV (IgM)

2.    A four-fold rise in IgG Ab titer

Treatment of Hepatitis A:


No specific treatment is given. Supportive treatment is given to manage the sign and symptoms.

Patients are given the following advice:

1. Take adequate rest
2. Drink plenty of water
3. Avoid fatty food and alcohol
4. Have a well-balanced diet

85% patients recover within 3 months and almost all recover within 6 months.

Prevention of Hepatitis A Virus:

Maintain good personal hygiene

A. Control of reservoir by:


1.    Notification

2.    Complete bed rest



3.    Disinfection of facecs and fomites

B. Control of transmission of Hepatitis A Virus:


1.    Hand washing before eating and after toilet

2.    Sanitary disposal of excreta

3.    Purification of community water supply

C. Control of susceptible population:


Human Ig is indicated to induce passive immunity in:

1.    Susceptible person travelling to highly endemic area

2.    Close personal contact of patients with HAV

3.    To control the outbreak in institutes. Dose 0.02 ml/ Kg BW


D. Vaccine:

Vaccination
Available but yet under development

Read about Hepatitis.

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