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Hepatitis A

Overview
Diagnosis
Treatment
Prevention

Hepatitis A Overview

Hepatitis A is a liver disease caused by the hepatitis A virus. The virus is usually found in stool (bowel movement).

Hepatitis A infections generally clear up, without treatment, within two to five weeks.

Causes of hepatitis A

Hepatitis A is caused by the hepatitis A virus (HAV).

It is spread by:

Putting something in your mouth that has been contaminated with HAV
Eating food contaminated by HAV, especially if it has not been properly cooked
Drinking water contaminated by raw sewage
Eating raw or partially cooked shellfish contaminated by raw sewage
Having sexual contact (particularly anal sex) with a partner infected with HAV

HAV is generally not spread by casual contact, such as you would encounter in school, the office, or at a public event.

Risk factors of hepatitis A

A risk factor is something that increases your chance of getting a disease or condition.

While the virus can affect anyone in the United States, there are certain risk factors that increase your chances of getting hepatitis A, including:

Having close contact with an infected person
Using household items that were used by an infected person, but were not properly cleaned
Having sexual contact with multiple partners
Traveling to, or spending long periods in, a country where hepatitis A is common or where sanitation is poor
Injecting drugs, especially if you use shared needles
Swallowing contaminated water or ice made with contaminated water
Eating raw shellfish harvested from sewage-contaminated water
Eating fruits, vegetables, or other food that may have become contaminated during handling

People at risk include:

Child care workers who change diapers or toilet train children
Children in day care centers
Institutionalized patients
Hemophiliacs receiving plasma products

Diagnosing 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, but adults are more likely to have symptoms than children.

Symptoms of hepatitis A

Tiredness
Loss of appetite
Fever
Nausea
Abdominal pain or discomfort
Jaundice (yellowing of the eyes and skin)
Darker colored urine
Rash

A person can spread the hepatitis A virus (HAV) about one week before symptoms appear and during the first week of symptoms.

People 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 state with hepatitis A. Having had the disease produces lifelong immunity from future hepatitis A virus infection.

Testing for hepatitis A

To diagnose hepatitis A, your doctor will ask about your symptoms and medical history, and perform a physical exam.

Tests may include:

Blood tests — to look for hepatitis A antibodies (proteins that your body has made to fight the hepatitis A virus)
Liver function studies
Liver biopsy — removal of a sample of liver tissue to be examined (only in severe cases)

Hepatitis A Treatment

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 generally will go away, without treatment, within two to five weeks. However, about 15 percent of people who are infected by 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.

In rare cases, hepatitis A infection will be so severe that a liver transplant may be necessary.

Learn more about treatments at the UPMC Liver Cancer Center.

Hepatitis A Prevention

The hepatitis A virus (HAV) is usually found in stool (bowel movement).

Here are a few you ways you can protect yourself from infection.

Proper sanitary habits

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.
Carefully clean all household utensils after use by a person infected with HAV.
Avoid using household utensils that a person infected with hepatitis A may have touched.
Avoid sexual contact with a person infected with hepatitis A.
Avoid injected drug use, especially with shared needles.

Immune (gamma) globulin

Immune (gamma) globulin is a preparation containing antibodies that provides temporary protection from hepatitis A (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 two years of age, the vaccine is recommended for:

People who have chronic liver diseases or clotting factor disorders
Those who have close physical contact with people who live in areas with poor sanitary conditions
People traveling to countries where sanitary conditions are poor
Children who live in areas that have repeated hepatitis A epidemics
People who inject illicit drugs
Men who have sex with men

Notes about the hepatitis A vaccine

It's unclear how safe the vaccine is for women who are pregnant.
The vaccine should not be given to children under two years old.
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 by cooked foods if they are contaminated after cooking.

Adequate chlorination of water, as recommended in the United States, kills HAV.

Contact the UPMC Liver Cancer Center

To schedule an appointment, or for more information, call the UPMC Liver Cancer Center at 412-692-2001.