Medication Summary
No specific treatment for hepatitis A virus (HAV) exists. Accordingly, treatment is supportive rather than directly curative. Agents used include analgesics, antiemetics, vaccines, and immunoglobulins. Prevention (either before or after exposure to HAV) is important.
Long-term studies indicate that seropositivity conferred by hepatitis A vaccine lasts at least ten years in children under the age of 2 years, although titers are somewhat lower in those children whose mothers were hepatitive A-positive by serology, presumably through interference with the vaccine. The significance of these lower titers is uncertain. [18]
Vaccines
Class Summary
Vaccination is indicated for primary immunization to prevent hepatitis A. It is also used for postexposure prophylaxis, either alone or in conjunction with immune globulin (IG).
Hepatitis A vaccine inactivated (Havrix, Vaqta)
For active immunization against disease caused by hepatitis A virus (HAV). Complete primary immunization at least 2 wk prior to expected exposure to HAV. Primary immunization series consists of 2 doses.
Analgesic Agents
Class Summary
Pain control is essential to quality patient care. Acetaminophen is useful for pain and/or fever.
Acetaminophen (Tylenol, Children's Nortemp, FeverAll)
Acetaminophen reduces fever by acting directly on hypothalamic heat-regulating centers, thereby increasing dissipation of body heat via vasodilation and sweating. It relieves mild to moderate pain.
Antiemetics
Class Summary
Antiemetic agents are used to treat nausea and vomiting.
Metoclopramide (Reglan, Metozolv)
Antiemetic agents are used to treat nausea and vomiting.
Immune Globulins
Class Summary
These are purified preparations of gamma globulin. They are derived from large pools of human plasma and are composed of 4 subclasses of antibodies, approximating the distribution of human serum. They are used for postexposure prophylaxis or when inadequate time is available for immunization to be effective before potential exposure.
Immune globulin IM (Gamunex, Octagam, Gammaplex)
Immune globulin IM neutralizes circulating virus. It is effective for pre-exposure protection and for post-exposure protection when administered within 14 days of exposure. It should be used in place of vaccination in those children too young (< 1 y) for vaccination when the child is traveling to an endemic area.
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Incidence of acute hepatitis A virus in the United States from 1982-2006. (Image from "Surveillance for Acute Viral Hepatitis --- United States, 2006." MMWR March 21, 2008. 57(SS02);1-24)
