Posible long term effects.

[DRV]

Recentley I had hepetitus A.My liver funtion test were:AlT 5036 and AST 6416.When I was cleared to go back to work my ALT was 352 and AST 98. I am having troubles finding any information on this subject.I was one of 660 people infected from a recent outbreak of hpetitus A.Three people died, one received a liver transplant.The only comments I have found are that most people recover in three weeks only a few suffer long term effects.                              I would like to know what to look out for possible long term effects.One person I know developed severe muscle spasms.     Do you recomend any aditional test?                                Also considering my AST and ALT level How sick was I ? Was I near as sick as those whom died or recieved transplants?               Should I be concearned about long term effects?                        Who is an expert on this subject?

[Kevin Pho, MD]

Hepatitis A infection usually results in an acute, self-limited illness and only rarely leads to hepatic failure. Hepatic failure occurs more commonly in patients with underlying liver disease, particularly chronic hepatitis C virus infection.

Approximately 85 percent of individuals who are infected with hepatitis A have full clinical and biochemical recovery within three months, and nearly all have complete recovery by six months.  

Serum aminotransferase (i.e. AST/ALT) concentrations decrease more rapidly than the serum bilirubin; the latter normalizes in more than 85 percent of individuals by three months.

Fatalities due to hepatitis A are more common with advancing age and, as noted above, in patients with chronic hepatitis C. Reported case fatality rates are 0.1 percent in infants and children, 0.4 percent between the ages of 15 and 39, and 1.1 percent in those over age 40

Marked elevation of ALT/AST (usually over 1000) are common.  I would contine with periodic liver enzyme tests.  As stated above almost all patients have full recovery within 6 months.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

Bibliography:
Cheney.  Overview of hepatitis A virus infection.  UptoDate, 2004.