Hepatitis A

What is hepatitis A?

Hepatitis A is a viral infection of the liver. The liver gets inflamed. It may also be swollen and tender.

How does it occur?

Hepatitis A is caused by the hepatitis A virus. Someone who is infected may pass hepatitis A to others by not washing his or her hands, especially after using the bathroom. The infection can also be spread by anal-oral sex. You might also get the virus from:

• contact with the bowel movements of an infected person
• food handled by an infected person
• water that has sewage in it or shellfish taken from the contaminated water.

You have a higher risk for infection if

• You travel to places where hepatitis A is common.
• You use illegal drugs.
• You are a man who has sex with men.

What are the symptoms?

Symptoms usually appear 2 to 6 weeks after you are infected with the virus. Sometimes hepatitis A is so mild that there are no symptoms.

If you have symptoms, the illness usually begins with these flulike symptoms:

• loss of appetite
• fever
• general aching
• tiredness.

Smokers may lose their taste for cigarettes.

After several days you may also have these symptoms:

• nausea and vomiting
• dark urine
• yellowish skin and eyes (jaundice)
• pain just below the ribs on your right side, especially if you press on that part of your belly
• bowel movements that are whitish or light yellow and may be looser than normal.

How is it diagnosed?

Your healthcare provider will ask about your medical history and symptoms. Your provider will look at your skin and eyes for signs of hepatitis. Your provider will check your belly to see if the liver is bigger than it should be or hurts when it is touched.

You will have blood tests. If blood tests show that your liver is not working normally, your provider will do tests to find out if a virus is causing the problems. Tests that find a virus will also determine the type of virus. (Several types of viruses can cause hepatitis.)

How is it treated?

The usual treatment is rest. Your healthcare provider will recommend that you avoid alcohol for at least 6 months.

Usually it is not necessary to stay at the hospital. If you become too dehydrated from nausea and vomiting, you may need to go to the hospital to get intravenous (IV) fluids.

Because this is a virus, antibiotics are not helpful.

How long will the effects last?

Recovery from hepatitis A usually takes 4 to 8 weeks. Tiredness is the most persistent symptom. The disease rarely has lasting effects, such as permanent liver damage.

How can I take care of myself?

• Follow your provider's instructions for taking medicine for your symptoms. You need to avoid taking medicines that can damage the liver more (for example, acetaminophen). Ask your provider which medicines you can safely take for your symptoms, such as itching and nausea.
• Follow your provider's advice for how much rest you need and when you can go back to your normal activities, including work or school. As your symptoms get better, you may slowly start being more active. It is best to avoid too much physical exertion until your provider says it’s OK.
• Eat small, high-protein, high-calorie meals, even when you feel nauseated. Sipping soft drinks or juices and sucking on hard candy may help you feel less nauseated.
• Don’t drink alcohol until your healthcare provider says it is safe.

What can be done to help prevent hepatitis A?

Hepatitis A can be spread only by people with active infections. It is usually contagious for 2 to 3 weeks before symptoms appear and for 2 to 3 weeks afterward. During this time, others can pick up the virus by touching anything contaminated with bowel movements of the infected person.

You can get shots that prevent hepatitis A. Two shots are given 6 to 18 months apart. Healthcare providers usually recommend that you get the shots if:

• You travel to or work in a country that has high rates of hepatitis A.
• You live in an area that has outbreaks of hepatitis A.
• You are a man who has sex with other men.
• You inject illegal drugs.
• You have HIV.
• You have chronic liver disease.
• You receive clotting factor concentrates because you have a clotting disorder, such as hemophilia.

If you are planning travel to an area where hepatitis A is common, you should have the first shot at least 1 month before you start your travels. Check with your healthcare provider about when you should have a second shot. Two shots of this vaccine can protect against hepatitis A for many years.

Hepatitis A vaccine is available as a combination vaccine with hepatitis B. Ask your healthcare provider if this is recommended for you.

If you have been exposed to hepatitis A, you may be treated with the hepatitis A vaccine or you may be given a shot of immune (gamma) globulin. It is best to get the shot right after you have been exposed to contaminated food or have had contact with an infected person. Immune globulin may not always prevent hepatitis A, but it may make it milder. The protection begins almost right away but it lasts for just 2 to 4 months. Whether you are given the vaccine or the immune globulin will depend on your age and your health.

If you have an active hepatitis A infection, be especially careful to always wash your hands thoroughly after using the restroom. This will help prevent spread of the disease to others.

If someone in your household has hepatitis, take the following precautions:

• Ask your healthcare provider if you need to get a hepatitis or gamma globulin shot.
• Wear disposable gloves if you must have contact with the sick person's bowel movements, body fluids, clothing, towels, or bed linens.
• Wash the infected person's clothing and bed linens separately from other laundry. Use very hot water and a strong detergent.
• Clean contaminated toilets and other bathroom surfaces with a disinfectant. Wear gloves when you clean. If possible, it's safest to have the infected person use a different bathroom from everyone else in the household.

For more information, call or write:

American Liver Foundation
Phone: 800-GOLIVER (465-4837)
Web site: http://www.liverfoundation.org