MRCEM Notes

Hepatitis A

Hepatitis A is typically a benign, self-limiting disease, with a serious outcome being very rare.

Overview
  • incubation period: 2-4 weeks
  • RNA picornavirus
  • transmission is by faecal-oral spread, often in institutions
  • doesn't cause chronic disease

Features
  • flu-like prodrome
  • jaundice, hepatosplenomegaly

Complications
  • complications are rare and there is no increased risk of hepatocellular cancer

Immunisation
  • an effective vaccine is available
  • after the initial dose a booster dose should be given 6-12 months later

Who should be vaccinated? (Based on the Green book guidelines)
  • people travelling to or going to reside in areas of high or intermediate prevalence, if aged > 1 year old
  • people with chronic liver disease
  • patients with haemophilia
  • men who have sex with men
  • injecting drug users
  • individuals at occupational risk: laboratory worker; staff of large residential institutions; sewage workers; people who work with primates
  • people infected with HIV
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