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3 Oct 2001

hepatitis a

One person I knew drained his entire pool because a friend with hepatitis A went for a swim.

Intro
Hepatitis A is a viral infection of your liver, and is commonly transmitted sexually among men who have sex with men, though anyone can get it. The good news is that there is a vaccine that prevents hepatitis A. If you're not vaccinated and you get the infection, you become immune to any future recurrence. Even so, you're still susceptible to other types of hepatitis, which are also infectious.

What is it?
Hepatitis A is a virus that infects your liver cells. The disease begins slowly and many times you don't even realize that you have it. In fact, you find out at some future date that you have antibodies to the virus, which indicates a prior infection. Hepatitis A is rarely fatal, but hospitalization may be required to control its symptoms. Unlike other types of hepatitis, type A does not become chronic. The illness generally runs its course in six to eight weeks and your liver fully recovers. You're usually contagious before you know you are ill.

Diagnosis
Doctors diagnose hepatitis A with a blood test that measures your liver function. Inflammation of the liver can destroy its cells, and liver enzymes spill into your blood. If your blood test reveals these enymes at an elevated level, you probably have hepatitis, and your doctors will then search for the cause. Hepatitis A is specifically diagnosed by checking your blood for antibodies to the virus or prensence of virus particles. When any of these are present, you have or have had the infection.

Symptoms
Feeling tired is the most common symptom (you may feel like you can't get out of bed), followed by loss of appetite, nausea and vomiting (that worsens as the day progresses) and loss of your desire for cigarettes. Jaundice (when your skin and eyes turn yellow) is also a very common symptom, as is darkening of your urine. You might also have a dull pain in your upper abdomen. In severe cases, you may have problems with bleeding and poor blood clotting (your liver manufactures substances crucial to blood clotting; liver damage hurts the process).

How is it acquired?
Hepatitis A passes between people via a "fecal/oral" route. And no, you don't have to eat shit: rimming an infected partner can give you the virus, as can kissing. You also risk infection when you take off that condom and forget to wash your fingers before they end up in your mouth. Eating raw shellfish from contaminated waters or food prepared by infected workers can also give you hepatitis A.

How to treat it?
There's no medication to treat hepatitis A once you have it. Often, treatment is commonly called "supportive": your nutrition level and liver function are carefully monitored by your doctor. You mustn't drink alcohol, no matter what type of hepatitis you have, until your liver completely heals. If you get nauseous, try to eat more in the morning, when nausea is usually less severe. You must get lots of rest. The more tender love and care (TLC) you receive from loved ones, the better you'll feel. Hospitalization is rare, and you may be given medication to decrease nausea.

Anyone with hepatitis A should be vaccinated against hepatitis B.


Myths dispelled
Here are some facts to clear up some common misconceptions.

Hepatitis A is not the same as hepatitis B or C. Nor is hepatitis A is the only form of infectious hepatitis.

Prevention
Hepatitis A is a completely preventable disease, and vaccination will prevent infection. The vaccines for Hepatitis A and B are different, and one won't protect you from the other! If you've previously had hepatitis A, you can't catch it again.

The hepatitis A vaccine is given in two doses spaced 6 to 12 months apart. Most people become immune within one month of the first injection. The vaccine is extremely safe, and the most common side effect is a sore arm. If you're exposed to hepatitis A and are not immune to it, you can get an immune globulin shot within two weeks of exposure to help keep you from becoming infected.

There's no need to barricade yourself from someone with hepatitis A. Just keep your dishes separate, abstain from having sex with the infected person, and thoroughly wash your hands after bodily contact and you should be fine. If you get vaccinated against hepatitis to begin with, then you won't have to worry!

Of particular concern to
Hepatitis A is endemic to some parts of the world, particularly non-industrialized nations.

Of particular concern to Sexually Active Men
Hepatitis A is a common STD for men who have sex with men. Even so, everyone should get vaccinated!

Of particular concern to Women
Though women are at much lower risk than gay men for hepatitis A, women with liver disease, blood clotting problems, or who travel to or live in places with high rates of hepatitis should get vaccinated.

Of particular concern to Ethnic
American Indians have high rates of hepatitis A. Cultures known to eat raw seafood have higher incidence of hepatitis A as well.

Incubation period
The incubation period is extremely variable, but it averages two to six weeks.

Sex Sexually Active
Refrain from sex with a partner who has hepatitis A until the infection is completely gone. Rimming is a common way for hepatitis A to pass between partners. Not washing your hands after touching a used condom can lead to a hepatitis A infection.

Prevalence
There are 125,000 to 200,000 hepatitis A infections and about 100 subsequent deaths each year in the United States. Thirty-three percent of Americans have evidence of a prior hepatitis A infection. Areas with high rates of hepatitis A include: South America, Africa, Greenland and Asia. The Soviet Union also has an increased prevalence of hepatitis A.

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