Hepatitis A

What is hepatitis A?

Hepatitis A is a viral infection that can inflame and temporarily damage the liver. Unlike other forms of hepatitis, hepatitis A rarely causes severe illness and does not lead to a persistent infection. Spread of the virus most often occurs from ingestion of contaminated food or water. It also can be passed during sexual practices that involve the anus. In rare cases, hepatitis A can be spread by contact with the blood of a person who has the infection, for instance, when intravenous drug users share needles.

Many people have been exposed to hepatitis A. Symptoms can be very mild. So, you may not even be aware that you had the infection.

Americans most likely to get hepatitis A include:

• people who eat shellfish taken from waters where raw sewage drains
• children and caregivers in daycare centers who are exposed to the stool of an infected child
• international travelers.

Symptoms of hepatitis A

If the infection is mild, there may not be any symptoms, especially in a child. When symptoms appear, they can include:

• tiredness
• loss of appetite
• fever
• nausea
• tenderness in the stomach area
• dark, tea-colored urine
• yellowing of the eyes and skin (jaundice).

Diagnosing hepatitis A

Your doctor may ask whether you have eaten shellfish recently or traveled to a foreign country with poor sanitation. He or she will ask about your personal hygiene habits and whether you have been near someone who has hepatitis A.

Your doctor will examine you to check for swelling and tenderness near your liver and for a yellowish color to your skin and the whites of your eyes. You will need to have blood tests to confirm the diagnosis.

Expected duration of hepatitis A

Hepatitis A usually lasts two to eight weeks, although some people can be ill for as long as six months. The infection is likely to last longer and be more severe in people who are older or are in poor health.

Preventing hepatitis A

You can reduce your risk of getting hepatitis A by following these basic guidelines:

• Wash your hands thoroughly with soap after handling food, after using the bathroom, and before eating.
• Buy shellfish only at reputable food stores or restaurants.
• If you catch your own shellfish, make sure that it comes from waters inspected regularly by health authorities.
• If you are traveling to a developing country, avoid drinking water or eating food that may be contaminated, and get vaccinated for hepatitis A before your trip.
• Avoid injecting illegal drugs. Outbreaks of hepatitis A have been seen among intravenous drug users.

A vaccine to prevent hepatitis A is available for all adults and older children. It should be routinely given to:

• all children 1 year (12 through 23 months) of age
• anyone 1 year of age and older traveling to or working in countries with high or intermediate prevalence of hepatitis A (most of the developing countries)
• men who have sex with men
• people with persistent liver disease, such as chronic hepatitis
• people with HIV infection
• people who require blood transfusions or products derived from donated blood (such as clotting factors for bleeding disorders)
• research workers who handle the hepatitis A virus in the laboratory.

Children who are not vaccinated by 2 years of age can be vaccinated at later visits. For travelers, the vaccine series should be started at least one month before traveling to provide the best protection.

If you have been exposed to someone with hepatitis A, your doctor may give you the hepatitis vaccine or an injection of hepatitis A immune globulin to help prevent you from getting symptoms of the illness. Sometimes both are given. You should contact your doctor as soon as you become aware of the exposure. After two weeks post exposure, the immune globulin shot is not effective.

Treating hepatitis A

There are no drugs to treat hepatitis A. Doctors generally recommend getting bed rest, eating well-balanced meals, drinking plenty of fluids and avoiding alcoholic beverages. It is also essential to avoid medications that can be toxic to your liver, such as acetaminophen (Tylenol).

When to call a professional

Call your doctor if you suspect that you have been exposed to someone with hepatitis A or if you are showing symptoms of the illness. If you are planning to travel to a foreign country, ask your doctor whether you should be vaccinated against hepatitis A before your trip.

Prognosis

Nearly everyone who gets hepatitis A will recover completely within a few weeks to months. A very small number of people can get severe disease. In very rare cases (less than one-tenth of 1% of patients), the disease can cause liver failure, which can result in death if a liver transplant cannot be arranged.

In people who already had liver disease or other types of hepatitis, such as hepatitis B and hepatitis C, the risk of severe disease from hepatitis A is much higher.

Additional info

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