Symptoms of Hepatitis A infection
Approximately 50% of hepatitis A virus infections occur with no or only discreet symptoms and leave no health consequences. The other 50% of the patients get the symptoms of a viral hepatitis described in the following, which can occur in all forms, but the fulminant form is extremely rare. The manifestation of the disease follows a prodromal stage lasting about two weeks (the patient is infected, but the virus does not cause any symptoms).
Symptoms in the course of the disease
When the disease begins, the patient first complains of unspecific general symptoms such as fatigue, exhaustion, headaches, muscle and joint pain. This is accompanied by loss of appetite, nausea, vomiting and weight loss. Symptoms such as a feeling of pressure in the right upper abdomen can be caused by an enlargement of the liver (hepatic edema) and the associated tension in the organ capsules.
Hepatitis A virus can sometimes cause fever due to an infectious cause. This can be followed by jaundice (icterus) and its accompanying symptoms. The billirubin (bile pigment) can no longer be excreted into the bile ducts by the affected liver cells (hepatocytes).
A typical symptom complex of the icterus develops: a yellowing of the skin and the white color of the eyes are the most conspicuous and obvious symptoms of the icterus. A tormenting itching, due to deposited bile salts in the skin, is particularly unpleasant for the patient. In addition, there is a loamy discoloration of the stool, due to the absence of bile dye in the stool and a darkening of the urine, as the kidney now takes over the excretion of the bile dyes.
Due to the absence of bile acids in the small intestine, fats can be digested more poorly, resulting in intolerance to fatty meals and fatty stools (steatorrhea). Patients are infectious (carrier of the disease) about 2 weeks before and about 12 weeks after the onset of the disease. Rarely, some patients experience a recurrence of the disease during this healing period.
99% of HAV infections heal without consequences. In the remaining cases, liver failure or protracted cholestatic processes can occur. Chronification of hepatitis A as in hepatitis B and C has never been described before.
At the beginning of an infection with hepatitis A viruses, an unspecific, flu-like symptomatology often occurs. This can be accompanied by fever, which can also occur repeatedly in the further course of the disease. In addition, patients report a subjective feeling of illness with severe exhaustion, tiredness and fatigue.
This topic might also be of interest to you: Vaccination against hepatitis ego (icterus) is probably the best-known symptom of hepatitis. However, it often occurs only in the advanced stages of the disease after several weeks or months. The inflammation of the liver tissue disrupts the metabolism of bilirubin.
The bilirubin produced is therefore metabolized into various intermediate products and can be deposited in the skin and mucous membranes. This leads to a yellowing of the skin with increasing concentration and can be accompanied by severe itching. Often, the leather skin of the eyes first turns yellow and only when bilirubin levels continue to rise does the skin turn yellow.
Characteristically, the skin in the head and neck area is affected first, before the skin in the chest, abdomen and extremities also turns yellow. A frequently occurring symptom in the early phase of the disease is the increasing loss of appetite. This can occur just a few weeks after infection with the virus.
Sometimes the loss of appetite is also directed against certain foods. Other symptoms that frequently occur in the early phase of the disease are nausea and vomiting. The nausea is often accompanied by general fatigue, loss of appetite and fever.
In rare cases, the nausea and vomiting are also directed against certain foods. These are often meat and very fatty products. Due to the inflammation of the liver tissue, the metabolism of bilirubin is disturbed.
The bilirubin produced daily cannot therefore be excreted via the bile ducts and intestines and accumulates in the blood.Subsequently, the water-soluble bilirubin is excreted via the kidneys. There it leads to a darkening of the urine. At the same time, the disturbed bilirubin metabolism also leads to an altered bowel movement.
Normally, the bilirubin metabolized in the liver reaches the intestine via the bile ducts, where it is broken down into further bilirubin derivatives. These are responsible for the characteristic coloration of the stool. However, if the liver function is restricted due to the inflammation caused by hepatitis, the bilirubin does not reach the intestine via the bile ducts.
As a result, the stool becomes discolored – one speaks of a clay stool. Another characteristic symptom of hepatitis is pain in the right upper abdomen. While the liver tissue itself is not supplied by sensitive nerve fibers, the surrounding liver capsule contains numerous nerve fibers. In the course of an inflammation, this leads to tension in the liver capsule and sometimes to a very strong, dull pain under the right costal arch.
