Hepatitis A is a liver disease caused by the hepatitis A virus. The complications of this infection can range from mild to severe, with symptoms like diarrhea and fatigue to liver failure in the most severe cases. However, most Hepatitis A infections clear up on their own without treatment within a matter of weeks.
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What Is Hepatitis A?
Hepatitis A is a viral infection, often referred to as HAV. This virus is most often spread when human feces get into drinking water or food, and humans are the only natural host of HAV. The effects of hepatitis A can vary but often include abdominal pain, fever, and or nausea.
People can have no symptoms and still be infected with and spread the virus. HAV has an incubation period ranging from 15 to 50 days, and symptoms can last up to two months. In some cases, these symptoms may continue or return for up to six months.
Luckily, your body will create immunity after contracting and recovering from this virus, so you cannot get HAV again.
How common is hepatitis A?
Hepatitis A is most often found in places where access to clean water is limited. It is rather uncommon in the U.S., affecting fewer than 3,000 Americans in 2022. A vaccine for hepatitis A was introduced in 1995, resulting in a 95% decline in cases from 1996 to 2011.
Access to the vaccine and clean water in the U.S. makes hepatitis A a rare condition, but worldwide, there are still many places where it is common.
What causes hepatitis A?
Hepatitis A is caused by the hepatitis A virus (HAV).
It is spread by:
- Drinking water contaminated by raw sewage.
- Eating food contaminated by HAV, especially if it has not been properly cooked.
- Eating raw or partially cooked shellfish contaminated by raw sewage
- Having sexual contact (particularly anal sex) with a partner infected with HAV.
- Putting something in your mouth that has been contaminated with HAV.
HAV is generally not spread through casual contact, such as that encountered in school, in the office, or at a public event.
Hepatitis A risk factors
Hepatitis A can spread from exposure to fecal matter. Exposure can occur without your knowledge through contaminated food or drinking water. People who work in careers that expose them to fecal matter may be at higher risk of contracting HAV.
While the virus can affect anyone in the United States, there are certain risk factors that increase your chances of getting hepatitis A, including:
- Eating fruits, vegetables, or other foods that have become contaminated during handling.
- Eating raw shellfish harvested from sewage-contaminated water.
- Having close contact with an HAV-infected person.
- Having sexual contact with multiple partners.
- Injecting drugs, especially if you use shared needles.
- Swallowing contaminated water or ice made with contaminated water.
- Traveling to, or spending long periods in, a country where hepatitis A is common or sanitation is poor.
- Using household items that were used by an infected person, but were not properly cleaned.
People at risk include:
Child care workers who change diapers or toilet train children.
Children in day care centers.
Hemophiliacs receiving plasma products.
Institutionalized patients.
Complications of hepatitis A
Left undiagnosed, hepatitis A can resolve itself in about two to five weeks. In some cases, however, it may have relapsing effects for up to nine months. That is why you should see your doctor to receive a proper diagnosis.
How can I prevent hepatitis A?
In 1995, a vaccine for hepatitis A was introduced, resulting in a 95% drop in cases across the United States. Getting vaccinated is the best first step in prevention, although it is not suitable for children under 2 years old.
Other means of prevention include:
Proper sanitary habits
- Avoid injected drug use, especially with shared needles.
- Avoid sexual contact with a person infected with hepatitis A.
- Avoid using household utensils that a person infected with hepatitis A may have touched.
- Carefully clean all household utensils after use by a person infected with HAV.
- Wash your hands with soap and water before eating or preparing food.
- Wash your hands with soap and water after using the bathroom or changing a diaper.
Immune (gamma) globulin
Immune (gamma) globulin is a preparation containing antibodies that provides temporary protection from hepatitis A for about one to three months.
You must receive it before exposure to the virus, or within two weeks after exposure to HAV.
Hepatitis A vaccine
This vaccine is made from inactive hepatitis A virus, and is highly effective in preventing infection.
It provides protection from infection for:
- Four weeks following the first injection.
- Up to 20 years following a second injection.
Licensed for those over 2 years of age, the vaccine is recommended for:
- Children who live in areas that have repeated hepatitis A epidemics
- Men who have sex with men.
- People with chronic liver diseases or clotting factor disorders.
- People in close physical contact with others who live in poor sanitary conditions.
- People traveling to countries with poor sanitary conditions.
- People who inject illicit drugs.
Notes of caution about the hepatitis A vaccine
- The safety of the vaccine is unclear for pregnant people.
- The vaccine should not be given to children under 2 years of age.
- Check with your doctor to see if you should receive the vaccine, and if so, how many injections you should have.
Can the hepatitis A virus be killed?
The virus is killed by heating to 185°F (85°C) for one minute. However, the disease can still be spread through cooked foods if they are contaminated after cooking.
Adequate chlorination of drinking water, as recommended in the United States, kills HAV.
What Are the Signs and Symptoms of Hepatitis A?
Some cases of hepatitis A are asymptomatic (show no symptoms).
When there are symptoms, they include:
- Abdominal pain or discomfort.
- Darker colored urine.
- Fever.
- Jaundice (yellowing of the eyes and skin).
- Loss of appetite.
- Nausea.
- Rash.
- Tiredness.
A person can spread the hepatitis A virus (HAV) about one week before symptoms appear and during the first week of symptoms.
People who are asymptomatic (with no symptoms) can still spread the virus. This often happens with young children who unknowingly spread HAV to older children and adults.
Unlike hepatitis B and hepatitis C, hepatitis A causes no long-term liver damage and usually does not cause death.
There is no chronic carrier status with hepatitis A. Having had the disease produces lifelong immunity from future hepatitis A virus infections.
When should I see a doctor about my hepatitis A symptoms?
If you suspect you have the symptoms of hepatitis A, you should see your doctor as soon as you can. Most cases resolve on their own with rest and time. More severe cases may require more intervention.
How Do You Diagnose Hepatitis A?
Three out of every four adults who get hepatitis A have symptoms that usually develop over a period of several days.
Hepatitis A does not always cause symptoms; however, adults are more likely to experience symptoms than children.
Doctors will look to see how your case of hepatitis A has affected your liver.
What to expect during your visit
You can expect the doctor to take your medical history, ask you about your symptoms, and perform a physical examination.
They may also order tests, including:
- Blood tests — To look for hepatitis A antibodies — proteins that your body has made to fight the hepatitis A virus.
- Liver Biopsy — removal of a sample of liver tissue to be examined (only in severe cases).
Hepatitis A prognosis
Outside of very rare cases where hepatitis A can lead to liver failure, this condition will resolve itself with time and make you immune to further infections of hepatitis A.
How Do You Treat Hepatitis A?
There are no specific treatments for hepatitis A.
The goals of hepatitis A treatment are to:
- Keep you as comfortable as possible.
- Prevent the infection from being passed to others.
- Prevent more liver damage by helping you avoid substances (medications, alcohol) that might stress the liver while it's healing.
The disease typically goes away on its own within two to five weeks. However, about 15% of people who are infected with hepatitis A will have relapsing symptoms for up to nine months.
In almost all cases, once you recover, there are no aftereffects, and you are immune to the virus from then on.
In rare cases, hepatitis A infection will be so severe that a liver transplant may be necessary.
