The diagnostic gold standard for hepatitis A is the detection of anti-hepatitis A virus [HAV] IgM antibodies and the determination of total anti-HAV by enzyme immunoassay. However, detection of HAV RNA can be useful in the diagnosis of patients without specific antibodies for hepatitis A and for the monitoring of infection. Studies using real-time PCR have demonstrated that HAV RNA can be detected not only in feces, but also in serum and saliva samples earlier than detection of antibodies, and that viremia may be present for a much longer period than the convalescent phase of hepatitis A. Alternative samples have been proposed for diagnosis, epidemiological studies, investigation of outbreaks and selection of persons receptive to vaccination. Understanding the events of clinical course that take place during the hepatitis A infection may lead to more effective diagnosis.
The various human hepatitis viruses cause very similar symptoms. Therefore, neither the individual nor the healthcare provider can tell by symptoms or signs if a given individual is suffering from hepatitis A unless laboratory tests are performed.
Fortunately, blood tests are widely available to accurately diagnose hepatitis A, including tests for antibodies, or the affected person’s immune response to hepatitis A proteins. This immune response is conclusively demonstrated by the presence of Immunoglobulin M [IgM] antibodies, indicating acute disease, and immunoglobulin G [IgG], indicating a past infection or vaccination. The IgG antibodies are present for life, indicating immunity.
HAV RNA is present in blood and feces soon after infection [while an individual is asymptomatic], until 1 to 2 weeks after the onset of symptoms. Longer shedding in feces can occur in children and those infected with HIV. HAV is also shed in saliva and urine, but no assays are available to detect this.
Blood tests are used to look for signs of the hepatitis A virus in your body. A sample of blood is taken, usually from a vein in your arm. It's sent to a laboratory for testing.
Treatment
No specific treatment exists for hepatitis A. Your body will clear the hepatitis A virus on its own. In most cases of hepatitis A, the liver heals within six months with no lasting damage.
Hepatitis A treatment usually focuses on keeping comfortable and controlling symptoms. You may need to:
- Rest. Many people with hepatitis A feel tired and sick and have less energy.
- Get adequate food and liquid. Eat a balanced healthy diet. Nausea can make it difficult to eat. Try snacking throughout the day rather than eating full meals. To get enough calories, eat more high-calorie foods. For instance, drink fruit juice or milk rather than water. Drinking plenty of fluids is important to prevent dehydration, especially if vomiting or diarrhea occurs.
- Avoid alcohol and use medications with care. Your liver may have difficulty processing medications and alcohol. If you have hepatitis, don't drink alcohol. It can cause liver damage. Talk to your health care provider about all the medications you take, including medications available without a prescription.
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