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Hepatitis A

(Hep A)


Hepatitis A is an infection of the liver. It is caused by a virus.


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Hepatitis A is caused by a virus. It can be found in stool of people with the infection. The virus can pass to the hands after using the bathroom. The virus can then spread from the hands to other objects or food. Washing hands after using the bathroom will remove the virus from the hands and stop the spread of virus.

The virus may also be spread through:

  • Drinking water that has had contact with raw sewage
  • Food that has the virus, more likely when food is not cooked well
  • Raw or partly cooked shellfish that has had contact with raw sewage
  • Sexual contact with someone with the virus, especially with oral-anal contact

Risk Factors

Things that may increase the chances of hepatitis A:

  • Having close contact with an infected person—often not spread by casual contact
  • Using household items that were used by an infected person and not cleaned
  • Oral-anal sexual contact with an infected person
  • Travel to or time spent in a country where hepatitis A is common or where sanitation is poor
  • Close personal contact, with an adopted child, in first 60 days since arrival from country with high rates of hepatitis A
  • Being homeless
  • Recent stay in jail or prison
  • Work in a lab that works with hepatitis A virus
  • Work as a childcare worker who changes diapers or does toilet training
  • Being in daycare centers
  • Being in an institution
  • Use of illicit drugs
  • Treatment with plasma products, common for issues like hemophilia


Hepatitis A does not always cause symptoms. When present, symptoms may include:

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


The doctor will ask about your symptoms and past health. A physical exam will be done. The doctor may suspect hepatitis based on symptoms. A blood tests will confirm hepatitis A. The blood tests can also show how well the liver is working.


Hepatitis A often goes away on its own within 2 months. There are no lasting effects in most people once the infection passes. Those who have the virus and recover will be protected from future infection.

The goals of treatment is to:

  • Lower discomfort.
  • Prevent spread to others.
  • Avoid medicine like acetaminophen (Tylenol) or alcohol that can stress the liver.

Some infections can be severe but this is very rare. A liver transplant may be needed for these infections.


To help lower the chances of hepatitis A:

  • Wash your hands often with soap and water.
  • Wash your hands before eating or making food.
  • Avoid using household utensils that a person with hepatitis A may have used. Make sure all utensils are cleaned well.
  • Avoid sexual contact with a person with hepatitis A until they are cured.
  • 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. Use it for cooking, washing food, and brushing your teeth.
    • Do not use ice chips.
    • Eat well-cooked food.

Some may have a higher risk of infection. A doctor may suggest:

  • Immune (Gamma) Globulin—can protect from hepatitis A for about 3 to 6 months. It must be given before contact with the virus or within 2 weeks of contact.
  • Hepatitis A vaccine —creates full protection 4 weeks after the first shot. A second shot will improve long-term protection. Encouraged for:
    • All children aged 12 to 23 months
    • Children aged 24 months or older who are at high risk and have not had vaccine yet
    • All persons at higher risk
    • People with chronic liver disease such as hepatitis C
    • People who want protection from hepatitis A

Centers for Disease Control and Prevention

American Liver Foundation


Canadian Institute for Health Information

Canadian Liver Foundation


Hepatitis A virus (HAV) infection. EBSCO DynaMed website. Available at: Updated August 8, 2019. Accessed October 31, 2019.

Hepatitis A VIS. What you need to know. Centers for Disease Control and Prevention website. Available at: Updated September 20, 2016. Accessed October 31, 2019.

Immunization schedules. Centers for Disease Control and Prevention website. Available at: Updated February 6 2018. Accessed October 31, 2019.

What I need to know about hepatitis A. National Institute of Digestive and Diabetes and Kidney Diseases website. Available at: Updated September 2019. Accessed October 31, 2019.

9/25/2009 DynaMed Systematic Literature Surveillance. 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 October 2019 by EBSCO Medical Review Board David L. Horn, MD, FACP