A highly contagious liver infection caused by the hepatitis A virus.Hepatitis A is preventable by vaccine. It spreads from contaminated food or water or contact with someone who is infected.

• Anorexia, nausea, vomiting influenza like syndrome.
• Fever, soft enlarged tender liver, jaundice.
• Abnormal liver function tests with elevation of
SGOT, SGPT and LDH.
• Liver biopsy is characteristic.

Investigation:- HBsAg ,LFT ,USG ABDOMEN AND PELVIS,CBC

Treatment:-

-Bed rest at the initial stage of the disease with gra- dual return to normal activity in convalescence.
-Plenty of oral Glucose or IV Glucose 10 per cent if oral intake is hampered due to nausea/vomiting.
-A palatable diet with less fat. If patient shows any
signs of impending coma, protein should be
withheld.
-Plenty of vitamin B-Complex and vitamin ‘K’.
-Liv-52 can be given empirically at the dose of 2 tab tds for 1 to 2 months.

-If jaundice is progressive, Corticotropin or Prednisolone. Prednisolone is given for 20 days at the dose of 2 tab (5 mg tab) tds for 5 days, 1 tab tds × 5 days, 1 tab bd × 5 days and 1 tab od × 5 days.
-Phenobarbitone if restlessness occurs.
-1 per cent Phenol with Calamine lotion or Cholestyramine 4 gm daily to reduce itching. Neomycin/Paramomycin only when precoma occurs. Serum hepatitis is transmitted by infected blood or blood products. Its incubation period is long (6 weeks to 6 months) and its onset is more insidious. The clinical picture is similar to that of infectious hepatitis. The blood of the patient is positive for Australia antigen.

Prophylaxis-

Hepatitis A—Human normal immunoglobulin 0.002 ml/kg IM soon after exposure.
Hepatitis B—Vaccine Engerix B given IM in deltoid muscle. Same dose for all ages in 3 doses. Second dose 1 month after first dose and third dose 6 months after 1st dose.

DRUG TO AVOID IN LIVER DEMAGE:-

-ciprofloxacin

-Erythromycin

-Rifampicin

-Metformin

-ACE inhibitors like Enalapri

-Anticoagulant

-Antidepressants

-Antipsychotics

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