From the Guidelines
There is no specific antiviral treatment for Hepatitis A, as the infection is usually self-limiting and resolves on its own within a few weeks to months. Treatment focuses on supportive care, including:
- Adequate rest
- Proper nutrition
- Maintaining hydration Patients should avoid alcohol completely during recovery to prevent additional liver damage. Over-the-counter medications like acetaminophen (Tylenol) may be used for symptom relief, but should be taken cautiously and at reduced doses since the liver processes these medications. Severe cases might require hospitalization for IV fluids and monitoring. Most people recover completely from Hepatitis A without long-term liver damage, with symptoms typically improving within 2-8 weeks. The body develops antibodies during infection that provide lifelong immunity against future Hepatitis A infections. For prevention, hepatitis A vaccine is highly effective and recommended for high-risk individuals and travelers to endemic areas. Additionally, immune globulin (IG) can be administered intramuscularly before exposure to HAV, or within 2 weeks after exposure, and is greater than 85% effective in preventing hepatitis A 1. Good hygiene practices, including thorough handwashing after using the bathroom and before handling food, are essential to prevent transmission.
From the Research
Hepatitis A Treatment
The treatment for Hepatitis A (Hep A) is primarily focused on supportive care, as most cases are self-limited. Key aspects of treatment include:
- Bedrest if the patient is very symptomatic 2
- A high-calorie diet 2
- Avoidance of hepatotoxic medications 2
- Abstinence from alcohol 2 In severe cases, hospitalization may be necessary for:
- Intravenous rehydration if the patient is unable to maintain adequate oral intake due to nausea and vomiting 2
- Monitoring and management of fulminant hepatic failure 2, 3
Fulminant Hepatic Failure
Fulminant hepatic failure due to Hepatitis A is uncommon, but can be life-threatening. Monitoring for fulminant hepatic failure includes:
- Coagulation factor assays, such as prothrombin time and factor V levels 3
- Diagnosis is established with the onset of encephalopathy 3 In some cases, emergency liver transplantation may be necessary, particularly in older patients or those with severe symptoms 3
Prevention and Prophylaxis
Prevention and prophylaxis of Hepatitis A infection can be achieved through:
- Immune globulin administration, which provides approximately 90% efficacy in preventing Hepatitis A 4
- Hepatitis A vaccine, which offers long-term protection and may be a reasonable alternative to immune globulin for postexposure prophylaxis 5, 6 A study comparing Hepatitis A vaccine and immune globulin for postexposure prophylaxis found that both provided good protection, although the vaccine may have slightly lower efficacy 6