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Viral Hepatitis A and E

Viral Hepatitis A and E

Viral hepatitis refers to infections caused by viruses that affect the liver. Viral hepatitis includes five distinct diseases caused by five different viruses. The different viruses are called by a letter name:

What is Hepatitis A?

Hepatitis A accounts for 20 to 25 percent of hepatitis cases in developed countries. Hepatitis A is usually transmitted through the fecal-oral route, meaning a person somehow ingests contaminated feces from an infected person. If an infected person did not wash his or her hands properly after using the bathroom, the disease may spread from the persons hands.

Other causes include eating shellfish harvested from contaminated water. Developing countries experience hepatitis A epidemics caused by drinking water contaminated with raw sewage.

Prognosis for hepatitis A patients is excellent and recovery is complete. The disease does not become chronic, and there are no long-term health implications.

What is Hepatitis E?

Hepatitis E, also called enteric hepatitis (enteric means related to the intestines), is similar to hepatitis A. It is also transmitted through the fecal-oral route. It is generally not fatal, though it is more serious in women during pregnancy and can cause fetal complications. Most patients with hepatitis E recover completely.

Hepatitis A and E Symptoms

Hepatitis A and hepatitis E present with similar symptoms. The diseases may develop without any signs or symptoms, or symptoms may be nonspecific. If you experience any of the symptoms below for more than two weeks, make an appointment with a gastroenterologist.

There are three phases of hepatitis A and E, and symptoms may differ depending on the stage.
Early in the disease, called the prodromal phase , symptoms may include:

  • Fever

  • Joint pain or arthritis

  • Rash

  • Edema (swelling)

Symptoms of the next phase, the preicteric phase , include:

  • Fatigue

  • Myalgia (muscle pain)

  • Anorexia

  • Nausea and/or vomiting

  • Fever

  • Cough

  • Abdominal pain and/or diarrhea

  • Dark urine and light stool color

During the icteric phase :

  • Jaundice (yellowing of the skin and whites of the eyes) develops

  • Other symptoms may subside

  • Anorexia, nausea and vomiting may worsen

  • Irritated skin lesions may develop

Hepatitis A and E Diagnosis at Johns Hopkins

The diagnosis phase of hepatitis A and E includes:

History and Physical Examination

A diagnosis begins with comprehensive physical exam during which you describe your symptoms and medical history. Perhaps more than other diseases, the diagnosis of hepatitis A and E is largely dependent on medical history. Your doctor will pay close attention to your particular risk factors and physical exam.

You will be asked about:

  • Recent travels

  • Exposure to water or shellfish that may have been contaminated by sewage

  • Sexual activity

  • Intravenous drug use

  • Medications

Blood Tests

A blood test will reveal certain antibodies in your blood, called anti-HAV IgM. These antibodies indicate whether you were infected with hepatitis A; the peak levels occur early in the infection and persist for about four to six months. Your doctor can diagnose hepatitis E by testing your stool for certain antibodies.

Labs will also look for:

  • The presence (or elevated levels of) certain enzymes in your blood

  • High levels of bilirubin

  • Low white blood cell count

Hepatitis A & E Treatment at Johns Hopkins

Hepatitis A and E usually resolve after a period of four to eight weeks of illness. They do not cause chronic hepatitis, and usually, no special treatment is necessary. Learn more about hepatitis A and E treatment at Johns Hopkins.

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