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Hepatitis A

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What is hepatitis A?

Hepatitis A is an inflammation of the liver caused by the hepatitis A virus (HAV). The virus spreads through contaminated food or water and through direct contact with an infected person. Common symptoms of a hepatitis A infection can include fatigue, fever, loss of appetite, nausea and vomiting, dark urine and jaundice.

Hepatitis A can be prevented with vaccination and by taking care to avoid contact with infected people. Hepatitis A does occur in developed countries, but is more common in developing countries. Travelers from the US or other developed nations can be at risk if not vaccinated.

Causes

Hepatitis A is caused by the hepatitis A virus (HAV). It leads to inflammation and damage to the liver and digestive system. The virus moves between people via the fecal-oral route - meaning that you catch it when you accidentally come in contact with an infected person's stools (feces). This can occur in the following situations:

Risk factors

People at particular risk of infection include:

  • Sexual partners of people with hepatitis A. There is a higher risk in men who have sex with men;
  • People sharing a household with a person with hepatitis A;
  • People who live in, or have travelled to, countries where sanitation is poor and hepatitis A is common, and;
  • Childcare and healthcare workers.

Poor sanitation can transmit hepatitis A. 

Signs and symptoms

Many people who have been infected with hepatitis A are not aware of it. About 30% of infected adults and up to 90% of infected children show no signs or symptoms at all. [1 ] Symptoms are generally worse in older children and adults. Young children can have hepatitis A and pass it on without experiencing any symptoms. If symptoms do appear, they typically do so after an incubation period of 2-6 weeks.

Symptoms of hepatitis A may include:

Symptoms normally clear up within a few weeks, but the virus can persist for 2 to 3 months.

Methods for diagnosis

Since the symptoms of hepatitis A are very similar to those of the more serious types of hepatitis (hepatitis B and hepatitis C), it is important to diagnose it correctly. Your doctor may suspect a hepatitis A infection based on your symptoms and your recent medical history. Hepatitis A can then be diagnosed by blood tests. These tests can measure liver function and detect the presence of virus particles and antibodies, which the body's immune system produces in response to the virus.

The hepatitis A virus can often be hard to detect soon after infection has occurred. It may take several weeks before the presence of virus particles, or the body's immune reaction to them, are reliably picked up by blood tests.

Types of treatment

There is no specific treatment for hepatitis A; treatment focuses on supporting your body's immune system as it handles the infection and easing the burden on your liver. Treatment measures include:

Medication

Hepatitis A treatment does not require medication. However, if the symptoms affect your quality of life, your doctor may prescribe medications to relieve pain or ease nausea, as long as they do not harm your liver.

Potential complications

The hepatitis A virus normally goes away by itself after a couple of months, with the symptoms usually only lasting a few weeks. The body develops immunity to the virus and you are unlikely to catch it again. In rare cases, the symptoms may persist for up to six months.

Relapse

In about 10% of cases, hepatitis A will not be completely cleared from the body and symptoms will flare up again after several weeks. [2] This is known as a relapse.

Cholestasis

Cholestasis is an uncommon complication of hepatitis A that affects mostly older people. It is caused by blockage of the small ducts in the liver, which leads to bile accumulating in the liver. It can last for months and is characterized by jaundice, high fever, itching, weight loss and diarrhea with pale stools. Cholestasis normally goes away on its own.

Liver failure

Very rarely, a hepatitis A infection can lead to liver failure, a serious condition in which the liver sustains significant damage and cannot operate normally. If that occurs, a liver transplant may be required. This complication is more common in older people who either have other liver problems or have a weak immune system.

Prognosis

Unlike other types of hepatitis, hepatitis A does not develop into a chronic condition. The acute phase of the disease typically goes away on its own after a few weeks.

Prevention

Vaccination

The best protection is a vaccine against hepatitis A. In many countries, children are now vaccinated against hepatitis A at an early age. Vaccinations are available for unvaccinated adults and older children who intend to travel to areas where hepatitis A is common.

It is important to note that the vaccine does not protect against other types of hepatitis.

The best protection against hepatitis A is a vaccination. 

Passive immunization

A different kind of hepatitis A vaccine can be given just before or just after exposure to hepatitis A. Known as passive immunization, this vaccine consists of antibodies against the hepatitis A virus. It is effective only for a few weeks.

Avoiding exposure

Since hepatitis A spreads through contaminated water and food, a good way of avoiding infection is practicing good food-handling measures and avoiding eating uncooked food from dubious sources.

References

  1. Shetty N. Tang J.W. and Andrews J. (2009) Infectious disease: Pathogenesis Prevention and Case Studies (1st edition). Chichester UK: Wiley-Blackwell.
  2. Matheny S.C. and Kingery J.E. (2012). Hepatitis A. American Family Physician 86:1027–1034.
  3. Nandini Shetty Julian W Tang Julie Andrews. (2009). Infectious Disease: Pathogenesis Prevention and Case Studies (1st ed.). Wiley-Blackwell. Accessed from link here
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9 Most frequently asked questions (FAQs)

What is hepatitis A?
Hepatitis A is an inflammation of the liver caused by the hepatitis A virus.
What are the signs of hepatitis A?
A hepatitis A infection can often pass undetected, since many people who contract the virus exhibit no signs and symptoms. Signs of hepatitis A include fatigue, loss of appetite, nausea and vomiting, dark urine, muscle and joint pains, jaundice, fever, liver pain and pale stools.
How is hepatitis A transmitted?
The hepatitis A virus spreads via the oral-fecal route, often through food and water that is contaminated with human bodily waste.
What happens after I am infected?
Hepatitis A is normally not a serious condition and goes away naturally after a few weeks.
Who gets hepatitis A?
Anyone can be infected by hepatitis A. Groups at particular risk include sexual partners of hepatitis A carriers, people sharing a household with hepatitis A carriers, intravenous drug users and people who live in, or have travelled to, countries where sanitation is not good and hepatitis A is common.
How is hepatitis A diagnosed?
Your doctor will usually diagnose hepatitis A by performing a blood test.
How is hepatitis A treated?
Hepatitis A usually does not require treatment. Bed rest, hydration and good nutrition can help your body recover from the infection.
Are there complications of hepatitis A?
Complications of hepatitis A are rare. In some people the infection can relapse. In rare cases, infection with hepatitis A in combination with other liver conditions or a weakened immune system can produce liver failure, a serious condition.
Can I prevent hepatitis A infection?
A vaccine for hepatitis A is available. The risk of contracting hepatitis A can be reduced by taking care to avoid contact with infected people.

Related topics

Hepatitis

Hepatitis is an inflammation of the liver, which has numerous causes. In many cases, hepatitis goes away by itself after a few weeks. In other cases hepatitis can be a long-term condition.

Hepatitis B

Hepatitis B is a viral inflammation of the liver which can be spread through sexual and blood-to-blood contact. While most people get better, some people may develop liver failure or even liver cancer in the future, however treatment options are available.

Diarrhea

Diarrhea is a common digestive complaint that involves frequent, urgent, and watery bowel movements. Although most cases clear up at home without much treatment, be aware that diarrhea can lead to severe dehydration, especially in children and the elderly.

Hepatitis C

Hepatitis C is an infection of the liver caused by the hepatitis C virus entering the blood. It’s mainly passed on through contact with the blood of an infected person and tends to be a long-term condition. No vaccine is available for hepatitis C.

About this article

Title: Hepatitis A

Author: Dr Idan Ben-Barak PhD, MSc, BSc (Med)

First Published: 21 Sep 2014

Last reviewed: 17 Jan 2022

Category: Information on Hepatitis A

Average rating: 4.2 out of 5 (1556 votes)

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