@Article{Waszak2026,
journal="Family Medicine \& Primary Care Review",
issn="1734-3402",
volume="28",
number="2",
year="2026",
title="Hepatitis A in primary care practice",
abstract=" Hepatitis A is an acute viral liver infection caused by the hepatitis A virus (HAV), transmitted primarily via the fecal-oral route, with occasional sexual or parenteral transmission. While incidence in Poland and Europe remains low, sporadic outbreaks continue to occur, reinforcing the need for vigilance in primary care. Clinical presentation ranges from asymptomatic to symptomatic infection, with children more often experiencing asymptomatic or mild disease, while adults more commonly develop symptomatic illness, including fatigue, anorexia, nausea, vomiting, abdominal discomfort, and cholestatic features such as jaundice and pruritus. Laboratory evaluation typically reveals elevated aminotransferases, bilirubin, and, in some cases, alkaline phosphatase. Diagnosis relies on serological confirmation, with anti-HAV IgM indicating acute infection and IgG reflecting past infection or vaccination. Management is largely supportive, focusing on hydration, nutritional maintenance, and monitoring for complications. Symptomatic therapies include antiemetics (ondansetron or metoclopramide) against vomiting, acetaminophen against fever and malaise, and cholestyramine or rifampicin against cholestatic pruritus. Refractory cases may benefit from opioid antagonists or selective serotonin reuptake inhibitors. Family physicians play a critical role in patient education, emphasizing hand hygiene, food safety, and sexual hygiene, as well as in postexposure prophylaxis using hepatitis A vaccine or immune globulin. Vaccination remains the most effective preventive measure, with high immunogenicity and long-term protection, significantly reducing disease incidence and complications. Special attention is warranted for high-risk populations, including young children, travelers, immunocompromised individuals, and those with chronic liver disease. Early recognition, monitoring, and preventive strategies in primary care are essential to mitigate transmission, prevent severe disease, and reduce impact on public health. ",
author="Waszak, Zuzanna
and Baran, Jakub Marek
and Grusiecki, Damian
and Jarzębska, Joanna
and Śmigielska, Maja",
pages="209--214",
doi="10.5114/fmpcr.2026.161520",
url="http://dx.doi.org/10.5114/fmpcr.2026.161520"
}