Hepatitis A virus (HAV) infection usually is mild and self-limited, and infection confers lifelong immunity against the virus. Overall mortality is approximately 0.02%. In general, children younger than 5 years and adults older than 50 years have the highest case-fatality rates. Older patients are at greater risk for severe. Three rare complications are relapsing hepatitis, cholestatic hepatitis, and fulminant hepatitis failure (FHF).

HEV infection is usually mild and self-limited. The case-fatality rate reaches 15-20% in pregnant women. HEV infection does not result in chronic disease.

Video:
https://www.youtube.com/watch?v=y6XfSQ_zQgQ                                                                                      

Commonly, hepatitis A and E are asymptomatic in young adult age from 15 to 40 years old. In children, they are usually no obvious symptoms with only mild illness without jaundice which cause it to be undiagnosed. 

Hepatitis E are rarely develop into severe and progressed to fulminant stage, except when it occur during pregnancy. It will cause acute liver failure, fatal loss and mortality. in 20-25% pregnant women can die if they get hepatitis E in their third trimester. Beside, chronic hepatitis E also may occur in immunosuppressed person such as organ transplant recipient. 

Fecal- oral route
Ingestion of contaminated water or food. This occurs when the uninfected person ingested the water or food that has been contaminated with small and undetected faeces of infected person.
 

Certain sex practices
it usually occurs due to sex between women and women, men and men. This also can occur when the infected person has sexual activity with uninfected person.
 

Direct contact with infected people
can occur through dirty hand of infected person prepares for their family members
 

Poor personal hygiene
Do not wash hand and hair, usually occur in child care center as usually children do not properly do hand washing.
 

Blood exposure rare
it can be amplified in neonatal intensive care units
 
 

Fecal- oral route Ingestion of under-cooked or uncooked meat and consumption of contaminated water 

Poor sanitation- due to improper handling of sewage which cause virus 

Transfusion of infected blood products

Vertical transmission from pregnant mother to infants

The physicians are more likely to ask about the patients' history of travels, sexual activities, exposure to contaminated shellfish and water or any intake of medications.

2) Level of serum transaminase:

Alanine transaminase (ALT) and aspartate transainase (AST) will show increased amount due to hepatocytes injuries.

3) Serum albumin:
Individuals with hepatitis will show low level of serum albumin as the liver function to synthesize albumin is affected.

4) Serum bilirubin:
There will be a significant increase of bilirubin level in individuals with hepatitis because the liver fails to excrete bilirubin from the body due to cell injuries.

5) Serological tests:

6) Stool examination:
There may be presence of RNA virus in the feces of the infected individuals.

 

Video:
https://www.youtube.com/watch?v=vqvSG9hqGUs

Video: 
https://www.youtube.com/watch?v=Neqvdwi5fHc

Video: https://youtu.be/l4m3f2KCxLM

Bile plugs brown pigmentation – in canaliculi and hepatocytes – indicate cholestasis, this due to cessation of the contractile activity of the paricanalicular actin microfilament web.

Lobular inflammation – with interphase and ductular reaction. 

Pregnant woman are a highlighted to be at high risk group. Hepatitis E can affect both unborn child and possibly their themselves. 

Hepatitis E may also be much dangerous in people who have a history of liver disease or chronic liver disease. People who performed a liver transplant and take immunosuppressant drugs may also be at a higher risk of complications.

For further information regarding complication of hepatitis A:
https://about-hepatitis.com/hepatitis-complications

TRUTH:  People who have hepatitis A get lifelong protection against hepatitis A only but they are still at risk of infection with other forms of hepatitis. There is vaccine available for Hepatitis A and Hepatitis B but others not.

TRUTH: Nutrition is most important in improving the liver function and limiting food may cause protein malnutrition during prolonged disease.

TRUTH: No, the infection not fatal. In fact, in India about 20 – 40 million infected persons who are living healthy lives, the majority could live till old age.

TRUTH:  By the times jaundice appears the patients not shedding virus in stool and becomes non- infectious. Epidemics of hepatitis E usually results from contamination of a water source with sewage.

TRUTH: Vaccines only available against hepatitis A and b 

TRUTH: By the age of 10 years, more than 95% of children are already positive for Hepatitis A indicate poor sanitation and hygiene in the country.  Hepatitis E is the most common cause of acute viral hepatitis in adults in India. Unhygienic street food is one of the causes of Hepatitis E.