[kimy]

When we received our son's blood tests back they said that he had tested positive for having Hep A in the past but not to worry about it that he is fine now and shouldn't have any affects from it.
I have searched the web but find very little info. about Hep A. I know this can affect the liver should I get him tested any futher ? Should I do a blood test every year or what?
I trust my Dr. but it just worries me .
I know their are Dr' s out there-- What do you think??
thanks,
Kim

[PamelaC]

I am jumping over from the Russia board. Our daughter tested positive for Hep A in Russia, then tested neg. here. The doctor told us not to worry about, because they can test pos. if they had contaminated food or water before testing. Our doctor was a specialist at a children's hospital. She did not say we would need to retest, but they did give her the Hep A vaccine.

Pam

[sak9645]

I think you may be confusing Hep. A and Hep. B.

Hepatitis A is not a particularly serious illness in people with normal immune systems. It is a common food- and water-borne disease.

You mainly get it in countries like Mexico, China, and Guatemala, where the tap water system is antiquated and may be contaminated with sewage, where crops may be fertilized with untreated human waste, and where strict food safety requirements in restaurants may be absent. All of these factors make it likely that you will consume food or water in which there are microscopic amounts of infected human stool.

But you can also get it in the U.S. if you eat food prepared by an infected person who doesn't wash his/her hands after using the toilet, if you aren't scrupulous about hygiene when changing an infected child's diaper, etc. A child can get it by mouthing toys handled by a day care classmate who has Hep. A and has recently touched his/her diaper area.

Hepatitis A in adults usually results in fever, fatigue, diarrhea, nausea, loss of appetite, abdominal pain, and yellowing of the whites of the eyes and the skin. Children may or may not have any symptoms. The symptoms in adults generally last a few weeks to a few months. A child is unlikely to be this sick.

Treatment for Hep. A mainly addresses the symptoms, rather than the disease itself. So you might receive a medication that relieves diarrhea or nausea, although doctors don't like to give a lot of drugs that can strain the already sick liver. Usually, you just have to wait for all symptoms of the illness to end, and avoid alcoholic beverages, which may strain the liver.

Once a person is over Hep. A, he/she can't get it again, and there are no long-term effects. Liver damage is not usually involved unless the person has some other conditions that harm the liver. Once a person is over Hep. A, he/she cannot transmit the disease to others.

Travelers generally get immunized against Hep. A because it is so common. Most other people don't bother to get immunized.

So if it is true that your child had Hep. A, it's no big deal. He probably had symptoms resembling a "tummy virus", got over them quickly, and is now fine. You don't need to do any testing, and he won't need the Hep. A shots if you ever travel overseas with him in the future.

However, be absolutely sure that your child's report says that he had Hep. A and not Hep. B. Hepatitis B is a very different illness and can have longer term implications.

Hepatitis B is transmitted in blood and bodily fluids, much like HIV, so it is much harder to "catch" than Hep. A. In this country, adults often get it through having sex with strangers or through sharing needles in illegal drug use. However, in many countries (like China), it is endemic in the population, and plenty of people who don't use drugs or have risky sexual encounters are carriers. Any adult female carrier can transmit the disease to her baby during the birth process, and 90% of all babies infected by their mothers will become chronic carriers.

An acute case of Hepatitis B will cause symptoms similar to Hepatitis A. In most people (over 90% of adults), once the acute phase is over, there are no long term consequences. In others, however, the disease becomes chronic. The person can infect others, for the rest of his/her life. And the person may experience liver damage and the possibility that he/she will get cirrhosis of the liver or liver cancer in middle age.

At this time, there are no sure cures for chronic Hep. B. There are currently five antiviral drugs for adults and two for children that are approved and considered effective in reducing the likelihood of liver damage. They act by slowing down the virus's rate of reproduction.

As a result, Hep. B must be taken seriously by adoptive parents. Most adoption agencies have kids tested for Hep. B before referral. Unfortunately, if a child is tested in infancy, he/she COULD have a false positive, simply because the test is reading maternal antibodies. Such a child, who probably won't get adopted, unfortunately, probably doesn't have Hep. B at all. But many parents won't take the risk and will decline any infant who tests positive, even if it could turn out to be a false positive.

With older children and adults, you can tell by good testing whether: a) he/she has never been exposed to the disease; b) he/she has had an acute episode of Hep. B but has not become a carrier; or c) he/she is a chronic carrier. If a child is a carrier, more tests should be done to see whether there is liver damage, but those tests may be unavailable in some foreign countries.

Unfortunately, in some foreign countries, Hep. B testing isn't foolproof because of inadequately trained technicians, poor storage of reagents and specimens, poor quality testing materials, or testing materials that have passed their expiration dates. As a result, even a child who is referred as negative could turn out to be Hep. B positive.

Most people who adopt children who are Hep. B chronic carriers have no major problems. They will have to have their children seen regularly by a liver specialist, just to be sure that liver damage isn't occurring, but no treatment will be needed in most cases.

They will have to make sure that they (the parents) are immunized against Hep. B, so they don't accidentally get it when cleaning up after a nosebleed, etc. They will probably want to ensure that any caregivers, such as nannies or babysitters, are immunized or at least instructed about precautions.

Today, many states require day care providers to be immunized, and also require children to be immunized before admission to day care or to school. So the risk of infecting caregivers and children in these settings is low in those states. Still, the parent will have to determine what he/she should disclose to schools and child care settings.

The parent may or may not want to disclose a child's Hep. B to every possible playmate. However, parents will have to make some decisions about disclosure, especially in an area where many parents choose not to immunize their children.

The parent will have to educate his/her child, as he/she grows, with regard to things like not sharing toothbrushes, combs, etc. that could possibly pass blood from one person to another. The child will also need to know how to clean up after an injury and such.

As the child reaches an age when sexual activity may occur, he/she will need to be informed about the fact that Hep. B can be transmitted sexually, and how to prevent transmission. A girl will need to understand that she can transmit the disease to a baby when giving birth.

If the child develops serious liver problems, medical treatment may be needed, and this treatment may be costly, although some children can be enrolled in clinical trials that provide treatment at low or no cost. As a result, parents contemplating adoption of a child with Hep. B should be aware of the provisions of their insurance.

Again, this refers ONLY to Hep. B. Hep. A does NOT have long term effects. So if your medical report says Hep. A, then you are almost certainly fine.

Sharon

[kimy]

Thanks Sharon.
The form does say Hep A so I'll sleep easily now.
Kim

[sak9645]

Please understand that I'm not a doctor, though I did get my Master's degree at a respected school of public health.

I think you can verify everything I've said by going to the website of the U.S. Centers for Disease Control (CDC). It has some fairly extensive discussions of Hep. A and Hep. B.

Sharon