Hepatitis A

In this section:

• What is hepatitis A?
• How common is hepatitis A?
• Who is more likely to get hepatitis A?
• What are the complications of hepatitis A?
• What are the symptoms of hepatitis A?
• What causes hepatitis A?
• How do doctors diagnose hepatitis A?
• How do doctors treat hepatitis A?
• How can I protect myself from hepatitis A infection?
• How can I prevent spreading hepatitis A to others?
• What should I eat and drink if I have hepatitis A?

What is hepatitis A?

Hepatitis A is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis A virus typically spreads through contact with food or water that has been contaminated by an infected person’s stool.

Hepatitis A is an acute or short-term infection, which means people usually get better without treatment after a few weeks. In rare cases, hepatitis A can be severe and lead to liver failure and the need for an emergency liver transplant to survive. Hepatitis A does not lead to long-term complications, such as cirrhosis, because the infection only lasts a short time.

You can take steps to protect yourself from hepatitis A, including getting the hepatitis A vaccine. If you have hepatitis A, you can take steps to prevent spreading hepatitis A to others.

How common is hepatitis A?

In the United States, hepatitis A has become relatively uncommon. After the hepatitis A vaccine became available in 1995, the rate of hepatitis A infections declined by 95 percent in the United States. The number of reported cases of hepatitis A fell to 1,239 in 2014, the lowest yearly number of cases reported since the disease could be tracked.¹ However, the number of reported cases increased to 3,366 in 2017, almost 3 times higher, mostly due to outbreaks among people who use drugs and people experiencing homelessness.¹ Early reports suggest that the numbers of cases and outbreaks of hepatitis A increased further during 2018 and continue at these higher rates in 2019.²

Hepatitis A is more common in developing countries where sanitation is poor and access to clean water is limited. Hepatitis A is more common in parts of Africa, Asia, Central and South America, and Eastern Europe than it is in the United States.

Who is more likely to get hepatitis A?

People more likely to get hepatitis A are those who

• travel to developing countries
• have sex with an infected person
• are men who have sex with men
• use illegal drugs, including drugs that are not injected
• experience unstable housing or homelessness
• live with or care for someone who has hepatitis A
• live with or care for a child recently adopted from a country where hepatitis A is common

What are the complications of hepatitis A?

People typically recover from hepatitis A without complications. In rare cases, hepatitis A may lead to liver failure. Liver failure due to hepatitis A is more common in adults older than age 50 and in people who have another liver disease.³

What are the symptoms of hepatitis A?

Some people have symptoms 2 to 7 weeks after they come in contact with the virus.³ People with hepatitis A typically get better without treatment after a few weeks. In some cases, symptoms can last up to 6 months. These symptoms may include

• dark yellow urine
• diarrhea
• feeling tired
• fever
• gray- or clay-colored stools
• joint pain
• loss of appetite
• nausea
• pain in the abdomen
• vomiting
• yellowish eyes and skin, called jaundice

Some people infected with hepatitis A have no symptoms, including many children younger than age 6.³ Older children and adults are more likely to have symptoms.

What causes hepatitis A?

The hepatitis A virus causes this type of hepatitis and spreads through contact with an infected person’s stool. Contact can occur by

• eating food made by an infected person who did not wash his or her hands after using the bathroom
• drinking untreated water or eating food washed in untreated water
• placing a finger or an object in your mouth that came into contact with an infected person’s stool
• having close personal contact with an infected person, such as through sex or caring for someone who is ill

You cannot get hepatitis A from

• being coughed on or sneezed on by an infected person
• sitting next to an infected person
• hugging an infected person

A baby cannot get hepatitis A from breast milk.⁴

How do doctors diagnose hepatitis A?

Doctors diagnose hepatitis A based on symptoms and a blood test. A health care professional will take a blood sample from you and send the sample to a lab. A blood test will detect antibodies to the hepatitis A virus called immunoglobulin M (IgM) antibodies and show whether you have acute hepatitis A. If the blood test finds antibodies to the hepatitis A virus that are not IgM antibodies, then you are immune to hepatitis A, due to either past hepatitis A infection or hepatitis A vaccination.

How do doctors treat hepatitis A?

Treatment includes resting, drinking plenty of liquids, and eating healthy foods to help relieve symptoms. Your doctor may also suggest medicines to help relieve symptoms.

Talk with your doctor before taking any prescription or over-the-counter medicines, vitamins or other dietary supplements, or complementary or alternative medicines—any of these could damage your liver. You should avoid alcohol until your doctor tells you that you have completely recovered from hepatitis A.

See your doctor regularly to make sure your body has fully recovered. If you have symptoms for longer than 6 months, see your doctor again.

How can I protect myself from hepatitis A infection?

You can protect yourself from hepatitis A by getting the hepatitis A vaccine. If you have not had the vaccine, you can take steps to reduce your chance of infection.

If you have had hepatitis A in the past, you cannot get hepatitis A again. You can still get other types of viral hepatitis though.

Hepatitis A vaccine

All children should receive the hepatitis A vaccine between 12 and 23 months of age. People who are more likely to be infected and people with chronic liver disease should also receive the vaccine.

Doctors give the hepatitis A vaccine in two shots. You should get the second shot 6 to 12 months after the first shot. You need to get both shots to be fully protected against the virus.

If you are traveling to a developing country where hepatitis A is common and you haven’t received the hepatitis A vaccine, talk with your doctor about how to prevent getting hepatitis A. If possible, try to get both shots of the hepatitis A vaccine before you go. If you don’t have time to get both shots, get the first shot as soon as you can. Most people gain some protection within 2 weeks of the first shot.

Reduce your chance of infection

You can reduce your chance of getting hepatitis A by washing your hands thoroughly with soap and warm water for 15 to 30 seconds

• after using the toilet
• after changing diapers
• before and after handling or preparing food

When traveling in a developing country, drink bottled water. Use bottled water to brush your teeth, make ice cubes, and wash fruits and vegetables.

Prevent infection after contact with the virus

If you think you have come in contact with the hepatitis A virus, see your doctor right away. A dose of the hepatitis A vaccine or a medicine called hepatitis A immune globulin may protect you from getting the infection. Your doctor may recommend a vaccine dose or medicine if

• you live with, have had sex with, or have had close contact with someone who has hepatitis A
• you shared illegal drugs with someone who had hepatitis A
• you ate food or drank water possibly containing the hepatitis A virus

You must get the vaccine dose or medicine shortly after coming into contact with the virus to prevent infection.

How can I prevent spreading hepatitis A to others?

If you have hepatitis A, you can reduce your chance of spreading the infection by washing your hands with warm, soapy water after using the toilet and before fixing or eating food. While you are sick, avoid close contact with others, and don’t prepare food or serve food to others. Also, tell your doctor, dentist, and other health care professionals that you have hepatitis A.

Talk with a blood donation center before you donate blood. If you had hepatitis A when you were younger than 11, you may be able to donate blood. If you had hepatitis A when you were age 11 or older, you should not donate blood.

You are most contagious—able to spread the virus to others—during the 2 weeks before you have symptoms. You may be contagious for up to 3 weeks after you develop symptoms. Children are often contagious longer than adults.⁵

What should I eat and drink if I have hepatitis A?

If you have hepatitis A, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

References