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Hepatitis A

(Hep A)

 

Definition

Hepatitis A is an infection of the liver. It can be passed easily from contaminated food, water, or close contact with an infected person.

Hepatitis

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Causes    TOP

Hepatitis A is caused by a specific virus. It may be spread by:

  • Drinking water contaminated by raw sewage
  • Eating food contaminated by the hepatitis A virus, especially if it has not been properly cooked
  • Eating raw or partially cooked shellfish contaminated by raw sewage
  • Sexual contact with a partner infected with the hepatitis A virus, especially as oral-anal contact

Hepatitis A is present in stool of people with the infection. They can spread the infection if they do not wash their hands after using the bathroom and touch other objects or food.

 

Risk Factors    TOP

Factors that may increase the chances of hepatitis A:

  • Having close contact with an infected person—although the virus is generally not spread by casual contact
  • Using household items that were used by an infected person and not properly cleaned
  • Having oral-anal sexual contact with an infected person
  • Traveling to or spending long periods of time in a country where hepatitis A is common or where sanitation is poor
  • Working as a childcare worker, changing diapers or toilet training children
  • Being in daycare centers
  • Being institutionalized
  • Injecting drugs—especially if you share needles
  • Receiving plasma products, common in conditions like hemophilia
 

Symptoms    TOP

Hepatitis A does not always cause symptoms. Adults are more likely to have them than children.

When present, symptoms may include:

  • Fatigue
  • Loss of appetite
  • Fever
  • Nausea and vomiting
  • Abdominal pain or discomfort
  • Yellowing of the eyes and skin—jaundice
  • Darker colored urine
  • Light or chalky colored stools
  • Rash
 

Diagnosis    TOP

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

  • Blood test—to look for signs of hepatitis A
  • Liver function studies
 

Treatment    TOP

Hepatitis A usually goes away on its own within 2 months. There are no lasting effects in most people once the infection passes. Immunity to the virus occurs after recovery from the infection.

The goals of hepatitis A treatments are to:

  • Help you stay as comfortable as possible.
  • Prevent the infection from being passed to others.
  • Prevent stress on the liver while it's healing. Mainly done by avoiding certain substances like specific medications or alcohol.

In rare cases, the infection is very severe. If the liver is severly damaged, a liver transplant may be needed.

 

Prevention    TOP

To to help reduce the chances of hepatitis A:

  • Wash your hands often with soap and water.
  • Wash your hands before eating or preparing food.
  • Avoid using household utensils that a person with hepatitis A may touch. Make sure all household utensils are carefully cleaned.
  • Avoid sexual contact with a person with hepatitis A.
  • Avoid injected drug use. If you use drugs, do not share needles.
  • If you travel to a high-risk region:
    • Use bottled water for drinking, cooking, washing food, and brushing your teeth.
    • Do not use ice chips
    • Eat well-cooked food

Medical treatments that may help prevent infection:

  • Immune (Gamma) Globulin—Temporary protection from hepatitis A. It can last about 3-6 months. It must be given before exposure to the virus or within 2 weeks after exposure.
  • Hepatitis A vaccine—Highly effective in preventing infection. It provides full protection 4 weeks after the first injection. A second injection provides long-term protection. The vaccine should be considered for:
    • All children aged 12-23 months
    • Children aged 24 months or older who are at high risk and have not been previously vaccinated
    • People traveling to areas where hepatitis A is prevalent (Centers for Disease Control and Prevention's Traveler's Health website shows which areas have a high prevalence of hepatitis A)
    • Men who have sex with men
    • Injection drug users
    • People who are at risk because of their job, such as lab workers
    • People with chronic liver disease
    • People with blood-clotting disorders such as hemophilia
    • People who will have close contact with an adopted child from a medium- or high-risk area
    • People who desire immunity to hepatitis A

Check with your doctor to see if you should receive the vaccine.

RESOURCES:

Centers for Disease Control and Prevention
https://www.cdc.gov

American Liver Foundation
https://www.liverfoundation.org

CANADIAN RESOURCES

Canadian Institute for Health Information
https://www.cihi.ca

Canadian Liver Foundation
https://www.liver.ca

REFERENCES:

2015 Sexually transmitted diseases treatment guidelines. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/std/tg2015/default.htm. January 25, 2017. Accessed February 15, 2018.

Hepatitis A questions and answers for the public. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/hepatitis/hav/afaq.htm. Updated November 2, 2017. Accessed February 15, 2018.

Hepatitis A virus (HAV) infection. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114868/Hepatitis-A-virus-HAV-infection. Updated January 4, 2018. Accessed February 15, 2018.

Hepatitis A VIS. What you need to know. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hep-a.html. Accessed February 15, 2018.

Immunization schedules. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/vaccines/schedules/index.html. Updated February 6 2018. Accessed February 15, 2018

What I need to know about hepatitis A. National Institute of Digestive and Diabetes and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-a. Updated May 2017. Accessed February 15, 2018.

9/25/2009 DynaMed Plus Systematic Literature Surveillance. http://www.dynamed.com/topics/dmp~AN~T114868/Hepatitis-A-virus-HAV-infection: Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. MMWR Morb Mortal Wkly Rep. 2009;58(36):1006-1007.



Last reviewed February 2018 by EBSCO Medical Review Board David L. Horn, MD, FACP
Last Updated: 5/2/2014

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