Management of hepatitis A virus hepatitis

Hepatitis A is a notifiable disease (1)

There is no specific treatment and therapy should be supportive

• adequate rest and balanced nutrition
• hepatotoxins such as alcohol and acetaminophen should be avoided
• no specific anti-viral treatment for hepatitis A is available (2).

Prevention is the most appropriate measure against the disease:

• clear and accurate written information should be given to patients and family regarding the importance of good hygiene
  • thorough hand washing after going to the toilet or before handling food
  • proper disposal of sanitary waste (2)
• food handling and unprotected sexual intercourse should be avoided until patients become non infectious
• screening for preexisting hepatitis A exposure and vaccination if appropriate (1)

The following patient should be admitted to the hospital immediately:

• severe attack with vomiting
• dehydration
• signs of hepatic decompensation - change in conscious level or personality, prothrombin time of 5 seconds or more (1)

In case of a suspected outbreak or if the source is a food handler, local CCDC/public health department should be informed over the phone (1).

The infected person (source) should stay away from work, school or nursery until 7 days after the onset of jaundice (if there is no history of jaundice then 7 days after symptom onset) (3)

Reference:

• 1. British Association for Sexual Health and HIV (BASHH) 2008. United Kingdom national guideline on the management of the viral hepatitides A, B & C 2008
• 2. Brundage SC, Fitzpatrick AN. Hepatitis A. Am Fam Physician. 2006;73(12):2162-8
• 3. Health Protection Agency (HPA) 2009. Guidance for the prevention and control of hepatitis A infection