Helyn Jane A. Domingo

BsPharmacy-31

Hepatitis AIt is an acute liver disease caused by

the hepatitis A virus(HAV).

lasting from a few weeks to several months

The most famous sign of Hepatitis is Jaundice

It does not lead to chronic infection. 2

Nature of HAV virusHAV is a 27 – 30 nm

spherical particle with cubic symmetry

Contain linear single stranded RNA genome with size of 7.5 kb.

Only one serotype3

HAV characteristicsHAV are stable to treatment with 20% ether

acid

The virus are destroyed by: autoclaving at 1210c

Treatment with chlorine 1 ppm

Heating food > 850c

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EpidemiologyA major communicable disease in the

developing world.

Well cooked food and sanitary water supply will protect the individual living.

Community hygiene is important in schools, hostels and jails, as overcrowding and poor sanitation favor the spread.

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SYMPTOMSFatigue

Fever

Sore muscles

Headache

Nausea

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SYMPTOMSPain on the right side of the body

Yellowing of the skin and eyes

Dark urine

Diarrhea

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Close personal contact

Contaminated food or water

Blood exposure

Hepatitis A Virus Transmission

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PathogenesisHAV invade into human body by mouth and

cause viremia.

After one week, the HAV reach liver cells replicate within.

Then enter intestine with bile and appear in feces.

After HAV replicating and discharging, liver cells damage begin

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DIAGNOSISDoctors usually need a blood test to diagnose

hepatitis A

though, they can also use a combination of signs, symptoms and known exposure to someone who has hepatitis A.

When the hepatitis A virus infects a liver, the body's immune system begins producing special antibodies called HAV IgM

The body also produces another type of antibody, HAV IgG, which appears much later in the infection.

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MANAGEMENTHepatitis A is a self-limited infection

and does not cause chronic disease. This means that the body's immune system will clear itself of the infection, usually in a couple of weeks. Medical care is usually limited to education about the disease and relieving discomfort from symptoms. However, in rare cases, complications might develop from hepatitis A infection and will require further medical care.

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Clinical ManifestationsIncubation period 2 – 6 weeks

May be asymptomatic

Overt illness in 5%

Present as two stages: 1 Preicteric 2 Icteric

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TreatmentNo specific antiviral drug is available

Treatment is symptomatic

Specific passive prophylaxis by pooled normal human immunoglobulin given before exposure or in early incubation period can prevent or attenuate clinical illness.

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Complications: -Fulminant hepatitis-Cholestatic hepatitis

-Relapsing hepatitis

Chronic sequel: None

Clinical Complications

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Vaccination for HAVHepatitis A vaccination is recommended for all

children starting at age 1 year, travellers to certain countries, and others at risk.

A safe and effective formalin inactivated alum conjugated vaccine containing HAV grown in human diploid cell culture is available

A full course containing two intramuscular injections of the vaccine

Protection starts after 4 weeks after injection and lasts for 10 – 20 years

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Many cases occur in community-wide outbreaks no risk factor identified for most cases highest attack rates in 5-14 year olds children serve as reservoir of infection

Persons at increased risk of infectiontravelershomosexual meninjecting drug users

Vaccination Strategies

Epidemiologic Considerations

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Pre-exposuretravelers to intermediate and high

HAV-endemic regions

Post-exposure (within 14 days)Routinehousehold and other intimate contacts

institutions

common source exposure

Hepatitis A Prevention – Immune Globulin

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Preventing Hepatitis A

Hygiene

Sanitation

Hepatitis A vaccine

Immune globulin

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