Hepatitis a virus

RNA enterovirus from the group of picornaviruses; HAV is resistant to temperature In cold conditions it can survive indefinitely. In seawater the virus remains infectious for 3 months. Normal soaps cannot inactivate the virus!

Transmission of the virus occurs faecal-orally, i.e. either through the ingestion of food contaminated by faeces or through close personal contact. Most infections in the industrialized countries affect holidaymakers returning home!

Transmission of the hepatitis A virus through blood or blood products is extremely rare, as viruses in the blood only occur in a freshly infected person.

Direct detection:

• PCR: detection of viral RNA in stool, EDTA blood or serum
• Virus excretion especially during the incubation period! Pathogen detection in stool and serum during the course of the disease with highly sensitive PCR technology for a long time possible.

Serology: 1-2ml serum

Microbiological diagnostics (direct detection)

• PCR: detection of viral RNA in stool, EDTA blood or serum
• ELISA: AG detection in faeces (less important)
• Culture: difficult, not routine

Serological detection of AK:

• Anti-HAV IgM: proves fresh infection. Detection from the onset of the first symptoms, detectable for 3-6 months.
• Anti-HAV IgG: also detectable at the onset of the first symptoms. Persists for life! Later, the antibody (from a concentration of 20IU/l) ensures immunity.

The virus occurs worldwide, but is particularly common in developing countries due to poor hygiene conditions. In this country, the proportion of people who have no protection (natural immunity) against hepatitis A acquired through previous infection is increasing. In Germany after the Second World War, almost 90% of children and young people had already been infected with the hepatitis A virus. Today only about 5% of children and adolescents acquire natural immunity. However, a vaccination offers protection against the disease. Incubation period (ICZ): 2-6 weeks

Supplementary laboratory parameters: liver enzymes (GPT>GOT) ↑, Bilirubin↑, AP, GGT increased only initially and decreased in the case of cholestasis, serum ants ↑, gamma-Globuline↑, liver synthesis parameters (CHE, albumin, quick value) only in the case of fulminant course.

Immunization options: Indicative vaccination for medical staff, homosexual men and promiscuous heterosexuals, sewerage and sewage workers, patients with hemophilia and chronic liver failure. liver diseases.

1. Neumeister B (2018) Hepatitis viruses. In: Neumeister B et al. (Eds) Clinical guide to laboratory diagnostics. Elsevier GmbH S. 652-653