TREATMENT OF HEPATITIS A
There are no specific medications used to treat hepatitis A. Treatment decisions are usually based on the symptoms experienced by the patient. Bed rest and decreased physical activity are not necessarily required. Each person should, on her own, determine a comfortable level of activity based on how she feels. If a person feels well, she may go to work. If she feels fatigued, a decreased level of activity or a midday nap is in order. It is always recommended that a person with hepatitis A consume plenty of fluids so as to avoid dehydration. This is especially important if diarrhea is one of the symptoms. All alcohol should be avoided during this time, as alcohol may provoke a relapse of the disease. All non-essential medications, both prescription and over-the-counter are best avoided.
Some people with cholestatic hepatitis experience a significant decrease in symptoms when a short course of corticosteroids- such as prednisone ( see my book), is used. Furthermore, ursodeoxycholic acid ( see my book) has occasionally been shown to hasten the resolution of LFT abnormalities in these patients. Further studies need to be conducted before these medications can be routinely advised for people with cholestatic heaptitis.
People who have fulminant hepatitis A need to be immediately admitted to the intensive care unit of a hospital for close management. These people have a high incidence of a poor outcome. Thus, patients who are not improving should be considered for liver transplantation. In the absence of a transplant, the risk of death for a person with fulminant hepatitis is approximately 30 percent. Patients with fulminant hepatitis A who undergo transplantation generally do very well, with approximately an 80 percent chance of surviving. Transplantation will be discussed in Chapter 22 of my book.
THE LONG-TERM PROGNOSIS FOR THOSE WITH HEPATITIS A
People with hepatitis A do not suffer any long-term consequences from the infection and are not chronically infectious to others. Within six months of contracting hepatitis A, symptoms, signs, and hepatitis A- related LFT abnormalities to totally resolve. Chronic liver disease does not occur. Therefore, contracting HAV does not put one at risk for cirrhosis and/or liver cancer.
Approximately 0.2 percent of people infected with HAV develop fulminant hepatitis A. Each year approximately 100 people either die or require a liver transplant as a result of liver failure due to HAV. Older people and people with underlying liver disease are more likely to develop this complication and are more likely to have a poor outcome from fulminant hepatitis A.All contents of this article are Copyright © Melissa Palmer, MD
Melissa Palmer, MD is the author of " Dr. Melissa Palmer's Guide of Hepatitis and Liver Disease". (Published 2004. Penguin Putnam).
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