What is hepatitis A?
Hepatitis A is a viral infection that affects your liver. It causes liver inflammation (hepatitis) and symptoms of mild-to-severe illness. This is an acute infection that lasts for up to two months.
How serious is hepatitis A?
Hepatitis A doesn’t cause chronic liver disease or lasting liver damage like other hepatitis viruses can. But during infection, hepatitis A rarely can cause acute liver failure, which is life-threatening.
What is the difference between hepatitis A, B and C?
Hepatitis A, hepatitis B and hepatitis C are all different viruses that cause liver inflammation (hepatitis). They differ in how they’re spread, how they’re treated, how they can affect you and for how long.
Hepatitis A is the most contagious of the three. It’s also the most likely to cause noticeable symptoms during infection. However, it’s a temporary infection that goes away by itself, without treatment.
How common is hepatitis A infection?
Worldwide, hepatitis A is common where sanitation is poor and where food and water are frequently contaminated. The virus is highly contagious and can live for months in the environment without a host. It also spreads through person-to-person contact, leading to large outbreaks in individual communities.
In the U.S., infection is less common, thanks to sanitation and the hepatitis A vaccine. However, rates remain high among people experiencing homelessness and those who use intravenous drugs. Around 10,000 cases are reported each year. Experts estimate the true rate of infection is closer to 20,000.
Symptoms and Causes
What are the symptoms of hepatitis A infection?
Symptoms in adults and children over six include:
- Stomach pain, especially in the upper right quadrant.
- Loss of appetite.
- Nausea and vomiting.
- Weakness and fatigue.
- Jaundice (yellowing of your skin and eyes).
- Joint pain.
- Itchy skin.
- Light-colored poop and dark-colored pee.
Younger children may not show signs or symptoms of infection. About 10% develop jaundice.
When do symptoms develop?
Symptoms appear between two to five weeks after contracting the virus. This is the incubation period when the virus is busy replicating in your body. When the virus has replicated enough to register as a threat, your immune system launches an attack against it. This is where the symptoms come from.
How long do symptoms last?
The symptoms last as long as it takes for your immune system to defeat the virus. It takes at least a few weeks. Most people recover in less than two months, but a small number of people have symptoms for up to six months. Sometimes, symptoms appear to be gone but then return for another round (relapse).
Are you contagious even if you don’t have symptoms?
Yes. You may be contagious for up to two weeks before symptoms develop, and up to three weeks afterward. Some people, including most children, never develop symptoms, but they can still spread the virus. Even after the peak contagious period, the virus may survive on surfaces in your environment.
How do you get hepatitis A?
Hepatitis A transmission commonly occurs through food poisoning. It can also occur through close personal contact with a person who is infected. The virus lives in the blood and poop of people who’ve been infected. Transmission occurs when it enters the body of an uninfected person, often by mouth.
Trace amounts of poop containing the virus can contaminate food at any stage of production, from harvesting to storage to cooking or preparation. Freezing doesn’t kill the virus, and it can live in temperatures of up to 185 degrees Fahrenheit (85 degrees Celsius). It can survive for months outside of a body.
Without rigorous handwashing, a person who’s infected can easily contaminate their environment or food with trace amounts of poop. They can also transfer it to you through physical contact. A person who’s infected and uses needles can spread the virus by sharing them or not disposing of them safely.
Is hepatitis A an STD (sexually transmitted disease)?
It can be transmitted through oral-anal sex, or through kissing if the infected person is bleeding. It’s easy to have a minor bleed from a cracked lip, mouth sore or bleeding gums without being aware of it. Statistically, men who have sex with men are more likely than average to be infected with hepatitis A.
Who is most at risk of hepatitis A infection?
You’re more at risk of infection when your local community is more extensively infected. That may be the case if you live in a community with lower levels of sanitation, or if the social groups or places you spend time in are more widely infected. People with weaker immune systems are also more at risk.
Communities more at risk include:
- Lower-income countries and communities with poor sanitation.
- Children living in infected communities.
- People experiencing homelessness.
- People who inject drugs.
- People living with HIV.
- People living with, caring for or having sex with a person who’s infected.
What are the possible complications of hepatitis A infection?
Complications are rare, but people with weakened immune systems are more at risk of having a severe reaction to hepatitis A infection. The most serious risk is acute liver failure. That means that your liver reacts by suddenly shutting down. This requires emergency care, and in some cases, a liver transplant.
People more at risk of acute liver failure include:
- Older adults.
- People with HIV.
- People taking immunosuppressants.
- People with preexisting chronic liver disease.
Diagnosis and Tests
How is hepatitis A diagnosed?
A healthcare provider will begin by physically examining you and asking about your symptoms. You may or may not have evident physical signs of hepatitis, such as:
- Enlarged liver.
- Enlarged spleen.
But they won’t know for sure, or what type of hepatitis it is until they do a blood test. They’ll draw a small sample of your blood and test it for specific substances.
Liver function tests will show elevated liver enzymes and other factors that indicate liver disease. A hepatitis panel will test your blood for specific antibodies. The antibodies they find will tell them which virus you have.
Management and Treatment
What treatment is available for hepatitis A?
There’s no specific treatment for hepatitis A infection, except to rest and take care of yourself. Healthcare providers recommend that you:
- Stay hydrated. Broths are great for both hydration and nutrition, especially when you’re feeling nauseated. Smoothies are another way to add healthy calories with hydration.
- Stay in bed, at least until your fever and jaundice have subsided. After that, you may return to work or school if it’s been at least one week since your symptoms started.
- Avoid substances that stress your liver. Take a break from alcohol, smoking, drugs and medications if possible. Check with your healthcare provider before taking herbs.
- Keep in touch. They’ll want to check on you periodically to make sure your condition is improving. If you have severe symptoms, they might want to monitor you more closely.
In some cases, your healthcare provider may recommend specific medications to relieve your symptoms or to replace other routine medications. It’s important to only take medications approved by your healthcare provider. Some medications, including herbs and supplements, may harm your liver.
Is there a prophylactic treatment for hepatitis A?
Yes. If you think you may have been exposed to hepatitis A, contact your healthcare provider. You can help prevent the infection from taking hold by getting vaccinated within two weeks of exposure. It takes two-to-three doses to be fully vaccinated, but one dose soon after exposure may prevent infection.
In some cases, healthcare providers also recommend an injection of immune globulin. This is a substance made from human blood that contains antibodies to the virus. They usually suggest it as an alternative to the vaccine if the vaccine is contraindicated (shouldn’t be used) for you based on your preexisting conditions.
How can I prevent hepatitis A infection?
Vaccination is the easiest form of prevention. Healthcare providers recommend routine vaccination for children over 12 months old and for anyone with regular or occupational exposure to hepatitis A. They recommend elective vaccination for anyone planning to travel to or adopt from a developing country.
If you can’t get vaccinated before travel, be cautious of what you eat and drink. Stick to bottled water and well-cooked food. Locals, who are often infected in childhood, may already be immune to the virus even though you aren’t. So, food and water that appears safe for the locals may not be safe for you.
Whether at home or abroad, good hygiene helps prevent many diseases, including hepatitis A. That means frequent hand-washing, screening your sex partners for STDs and not sharing needles. If you think you may have been exposed to the virus, ask a healthcare provider about prophylactic treatment (treatment to stop the virus from developing after you’ve been exposed to it).
If you’ve been diagnosed with active hepatitis A, you can help prevent it from spreading to others by practicing careful hygiene during your infection. Disinfect your home with bleach-based cleaning agents. Inform your close contacts of your infection, and avoid sex and preparing or serving food to others.
Outlook / Prognosis
Is hepatitis A curable?
Hepatitis A is a self-limited disease. It doesn’t require a cure. Your body will eventually clear the virus without treatment. But this can take a while, and you may feel unwell for some time. Keep in touch with your healthcare provider about your symptoms. They can offer relief and hospital care if necessary.
When should I consult a healthcare provider?
Consult a healthcare provider if:
- You think you’ve been exposed to hepatitis A.
- You’re interested in being vaccinated against hepatitis A.
- You’ve had symptoms for more than two months, or your symptoms have relapsed.
- You have severe symptoms that don’t seem to be improving.
A note from Cleveland Clinic
Hepatitis A is a highly contagious virus. Even in places with sanitary sewage disposal and food handling practices, outbreaks can occur. Although the infection is rarely life-threatening, it can make you ill for several weeks to months. It’s worth avoiding if you can, especially for the more vulnerable among us.
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