Symptoms of hepatitis A.

Symptoms of hepatitis A infection

Approx. 50% of hepatitis A virus infections have no or only discrete symptoms and do not have any health consequences.

The other 50% of the sick get the symptoms of viral hepatitis described below, which can occur in all forms, but the fulminant form is extremely rare. The manifestation of the disease follows an approximately two-week prodromal stage (the patient has become infected, but the virus does not cause any symptoms).

Read more on the subject at: Hepatitis A

Symptoms in the course of the disease

When the disease begins, the patient initially complains of unspecific general symptoms such as tiredness, fatigue, headache, and muscle and joint problems. In addition, there is 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 enlarged liver (liver edema) and the associated tension in the organ capsule. In the case of the hepatitis A virus, a fever can sometimes occur because the cause is infectious.

This can lead to jaundice (jaundice) 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 jaundice develops: a yellowing of the skin and the white color of the eyes are the most noticeable and obvious symptoms of jaundice. An excruciating itching sensation due to bile salts deposited in the skin is particularly unpleasant for the patient. There is also a clay-like discoloration of the stool due to the lack of bile pigment in the stool and a dark coloration of the urine, since the kidneys now take over the excretion of the bile pigments. The lack of bile acids in the small intestine makes it harder to digest fats, which can lead to intolerance to high-fat meals and fatty stools (steatorrhea).

The patients are infectious about 2 weeks before and about 12 weeks after the onset of the disease (carriers of the disease). Some patients rarely experience a flare-up (relapse) of the disease during this healing period. 99% of HAV infections heal without consequences. The remaining cases can lead to fulminant liver failure or protracted cholestatic courses. A chronification of hepatitis A as with hepatitis B and C has never been described.


At the beginning of an infection with hepatitis A viruses, unspecific, flu-like symptoms often occur.
This can be accompanied by a fever, which can occur again and again as the disease progresses. In addition, the patients report a subjective feeling of illness with severe exhaustion, tiredness and exhaustion.

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Jaundice (Jaundice) is probably the most widely known symptom of hepatitis.
However, it often only occurs in the advanced stages of the disease after several weeks or months. The inflammation of the liver tissue disrupts the metabolism of bilirubin. The resulting bilirubin is metabolized into various intermediate products and can be deposited in the skin and in the mucous membranes.
With increasing concentration, this leads to yellowing of the skin and can also cause severe itching. The dermis of the eyes often turn yellow at first, and the skin only turns yellow when the bilirubin levels continue to rise. The skin in the head and neck area is typically affected before the skin in the area of ​​the chest, abdomen and extremities turns yellow.

Read more on this topic at: Therapy for jaundice

Loss of appetite

A common symptom in the early phase of the disease is the increasing loss of appetite.
This can occur just a few weeks after being infected with the virus. In part, the loss of appetite is also directed against certain foods.

Nausea and vomiting

Other symptoms that often occur in the early stages of the disease are nausea and vomiting.
The nausea often accompanies general tiredness, 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.

Changes in urine

The inflammation of the liver tissue disrupts the metabolism of bilirubin.
The bilirubin that accumulates every day can therefore not be excreted via the biliary tract and the intestine and accumulates in the blood. As a result, the water-soluble bilirubin is excreted through the kidneys. There it causes the urine to darken.

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Clay chair

At the same time, the disturbed bilirubin metabolism also leads to altered bowel movements.
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 color of the stool. However, if liver function is impaired due to the inflammation associated with hepatitis, bilirubin will not pass through the biliary tract in the intestine. As a result, the stool becomes discolored - one speaks of a clay chair.

Pain in the upper right abdomen

Another characteristic symptom of the presence of inflammation of the liver (hepatitis) represents pain in the right upper abdomen.
While the liver tissue itself is not supplied by sensitive nerve fibers, the liver capsule surrounding it contains numerous nerve fibers. Inflammation results in tension in the liver capsule and, in some cases, very strong, dull tenderness below the right costal arch.

also read: Pain in the right upper abdomen