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).
Dr. Palmer is an internationally renowned hepatologist who has been practicing medicine since 1985. Prior to 2012, she maintained perhaps the largest medical practice devoted to liver disease in the United States. Dr. Palmer is Clinical Professor of Medicine at New York University Medical Center. Dr. Palmer graduated from Columbia University with a B.A. and was trained in hepatology (as well as medical school) at the Mount Sinai School of Medicine in New York City.
Dr. Palmer is Board Certified in Gastroenterology and in Internal Medicine.
She has authored numerous scientific publications in the field of hepatology in such peer-reviewed journals as Hepatology, Gastroenterology, Seminars of Liver Disease, Transplantation and Archives of Internal Medicine.
She is frequently called upon by the media for her opinion on various topics related to liver disease. Dr. Palmer has appeared many times on television as a liver disease expert and has been quoted in such publications as TIME magazine, Cosmopolitan magazine, Prevention magazine, the Los Angeles Times, and Newsday. She also has appeared in numerous videos and CD-Roms aimed at educating doctors and the public about hepatitis C and other liver diseases, such as primary biliary cirrhosis. Dr. Palmer lectures to the medical and general public on liver disease-related topics on a regular basis.
Dr. Palmer has performed numerous clinical trials on various experimental medications for the treatment of hepatitis.
Dr. Palmer is currently available for lecturing, investor and hedge-fund consultations, consultations to industry, and media interviews and appearances-- including television. For such matters, she can be contacted through hepatitismedia@gmail.com.