Hepatitis A

Hepatitis A is caused by a virus called hepatovirus A. This virus invades the cells of your liver and causes inflammation, which affects how your liver functions. Hepatitis A is usually a short-term, or acute, infection. It runs its course in a matter of weeks or months, and it usually does not cause permanent liver damage, but it is highly contagious.

Young man carrying young woman on his backYoung man carrying young woman on his backHappy young couple eating out

Hepatitis A transmission

Hepatitis A is a highly contagious infectious disease. The virus itself can be found in the feces and blood of an infected person. It is usually spread by:

Having close person-to-person contact, such as:

Hepatitis A is also common in places like long-term care homes, daycare centers and group homes.

Consuming contaminated water or food:

Food and water can become contaminated by the Hepatitis A virus while it is being grown, harvested, processed or handled. This happens more commonly in lower-income countries with limited sanitation infrastructure. Sometimes, imported food can be contaminated and cause outbreaks. Normal food processing techniques are often not enough to kill hepatitis A.

Hepatitis A: symptoms and risk factors

Hepatitis A can be asymptomatic

Not everyone who gets Hepatitis A develops symptoms. Children, in particular, tend not to show symptoms, although they are still able to spread the virus.

If you do develop symptoms, they may include:

  • Dark urine and light-colored stools.
  • Diarrhea.
  • Fever.
  • Itchy skin.
  • Loss of appetite.
  • Stomach pain, or pain near the liver (usually a dull throb in the upper-right hand side).
  • Tiredness and weakness.
  • Upset stomach (nausea) or vomiting.
  • Yellowing of the skin and whites of the eyes (jaundice).

The incubation period

The incubation period of a virus is the time between exposure to the virus and the start of symptoms.

The incubation period for Hepatitis A ranges from 2-6 weeks. However, you can start spreading the virus two weeks after exposure, even if you never have symptoms. This delay is one of the reasons Hepatitis A is so contagious; people spread it before they know they’re sick. Symptoms usually resolve in less than 2 months.

Risk factors for hepatitis A

A risk factor is anything that increases your chances of developing a disease. Risk factors for hepatitis A include:

  • International travelers.
  • People who live in group homes, long-term care homes or similar group settings.
  • People who use injection drugs.
  • People who experience homelessness.
  • People who may come into contact with Hepatitis A at work, such as healthcare workers.

The following people are at increased risk for developing an acute hepatitis A infection:

  • People who have a pre-existing liver condition, like liver disease or liver cancer.
  • People who have another type of hepatitis, such as hepatitis B or C.
  • People with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). These conditions affect your immune system’s ability to fight off infection.

How is hepatitis A diagnosed?

If you think you have been exposed to hepatitis, you should call your doctor or your local health department right away.

Your doctor will start by asking you about your symptoms and your medical and travel history. They will then take a blood sample and check for the virus in a lab.

If you have pre-existing conditions that could put you at risk for a severe infection, your doctor may also run tests to check your liver function.

If you test positive for hepatitis A, you and your doctor will decide on next steps.

Hepatitis A treatment

There is no cure for hepatitis A, and there are no specific treatments for hepatitis A symptoms. Your body will fight and clear the infection on its own. In the meantime, you can make sure that you get enough rest, fluids and nutrients.

  • Avoid alcohol. Alcohol is a toxin and can further damage your liver.
  • Don’t take any over-the-counter medicines without checking with your doctor. Your liver helps process many medications, and taking certain medications while the liver is infected can cause damage. Avoid acetaminophen, paracetamol and medications that prevent vomiting.
  • Drink fluids. Your body needs to stay hydrated while fighting an infection, especially if you are vomiting. Drink lots of water. If you are feeling nauseous, try drinking milk or fruit juice.
  • Eat well. You may not have much of an appetite, but be sure to eat regularly and take in a variety of nutrients. Try to avoid fatty foods.
  • Rest. Hepatitis can make you feel tired and weak. Get a full night’s sleep, avoid vigorous activities and rest often until you get better.

Hospital treatment may be needed for people who have pre-existing conditions or who have developed a severe hepatitis A infection. You should call your doctor right away if:

  • Your symptoms get worse instead of better.
  • You show signs of dehydration, like decreased urination, very dark urine, dry or sticky mouth, and confusion.
  • You have swelling in your hands, arms, feet, ankles, belly or face.
  • You are bleeding from your nose, mouth or rectum.

If you have tested positive for hepatitis A

Take steps to avoid infecting others.

If you have tested positive for hepatitis A, there are several precautions you should take in your everyday life to avoid infecting others. These include:

  • Avoid any sexual activity while you are infected. Hepatitis A spreads easily through many types of sexual activities. Condoms and dental dams do not provide adequate protection against the spread.
  • Avoid going to work or public places until symptoms are gone.
  • Do not prepare food for others while you are infected.
  • Tell people you live with, take care of or have sex with to get tested and ask their doctor about getting vaccinated.
  • Wash your hands thoroughly. Scrub your hands with soap and warm water for at least 20 seconds after using the bathroom or changing a diaper. If possible, dry your hands with a disposable towel or a towel that won’t be used by others.

Hepatitis A prevention

Take steps to avoid infection

  • Get vaccinated. Make sure that you and your children are fully vaccinated against hepatitis A. Also consider getting vaccinated against hepatitis B, which is more serious.
  • Wash your hands often.  Always wash your hands after using the bathroom or changing diapers, and before preparing food or eating. Work up a good lather with soap and clean, running water. Scrub for at least 10 to 15 seconds, then rinse.
  • Cook food thoroughly. Food needs to reach temperatures of 185 °F to kill the hepatitis A virus.
  • Be safe while traveling abroad. Drink bottled water, peel the skins from fruits and vegetables and don’t eat raw or uncooked meat or fish.

Hepatitis A vaccine

Hepatitis A has several safe and effective vaccines available.

  • For children. The hepatitis A vaccine is usually given to children 12 months or older. It is given as a series of 2 shots, 6 months apart.
  • For adults. The vaccine is given in as a series of 2 shots over 6 months, You can also get a combined vaccine for both hepatitis A and hepatitis B. This vaccine is given as 3 shots over 6 months. You need all your shots to have long-term protection.

If you test positive for Hepatitis A within 2 weeks of exposure and are not vaccinated, your doctor may recommend that you get one shot of the hepatitis A vaccine.

Getting vaccinated after you are exposed is referred to as post-exposure prophylaxis (PEP), and it can help prevent you from developing the infection.

References

Center for Disease Control and Prevention (CDC). Hepatitis A (https://www.cdc.gov/hepatitis/hav/index.htm)

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Hepatitis A (https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-a)

MedlinePlus: National Library of Medicine. Hepatitis A (https://medlineplus.gov/hepatitisa.html)