What Is Hepatitis A?

Hepatitis A is a viral infection that affects the liver. The virus spreads through close contact with someone else who has hepatitis A or through consuming hepatitis A-contaminated food or water. Symptoms of the infection can range from mild to severe, including fatigue, fever, loss of appetite, nausea, dark brown urine, and yellowing of the skin and eyes (jaundice).

According to the World Health Organization, about 1.5 million cases of hepatitis A occur worldwide each year. Treatment usually involves rest, avoiding alcohol, and certain medications. Most people with hepatitis A recover within a few weeks, but in some cases, the infection can last months and lead to severe complications, such as liver failure.

The hepatitis A vaccine is highly effective in preventing infection and is recommended for children, travelers to high-risk countries, and people with certain risk factors. 

Symptoms 

Hepatitis A does not always cause symptoms, especially in young children. In adults and older children, symptoms usually appear within two to seven weeks after exposure to the virus. Most people with hepatitis A have mild symptoms, but older adults and people with certain health conditions (e.g., pre-existing liver disease) may experience more severe, longer-lasting symptoms. 

Hepatitis A symptoms can include:

• Abdominal pain 
• Clay, gray-colored, or light-colored stools
• Dark brown urine 
• Diarrhea 
• Fatigue
• Joint pain 
• Loss of appetite 
• Low-grade fever
• Nausea 
• Vomiting 
• Yellowish skin or eyes (jaundice) 

What Causes Hepatitis A?

Hepatitis A is caused by the hepatitis A virus (HAV). The virus is highly contagious and is found in the blood and stool of people who have the infection. HAV can spread by:

• Having close personal contact with a person who has hepatitis A, including sexual contact (e.g., oral, anal, or vaginal sex), taking care of an ill person, or using drugs with and sharing drug paraphernalia with a person who has the infection
• Eating food handled or prepared by an infected person who did not wash their hands after using the bathroom
• Drinking water contaminated with the virus or eating foods rinsed with contaminated water

The hepatitis A virus can survive on surfaces for months and spreads quickly in communities with poor sanitation or hygiene. While less common in the United States, hepatitis A outbreaks have also occurred from people eating contaminated imported food products. 

Risk Factors

Anyone can get hepatitis A, but certain factors increase your risk, such as:

• International travel to developing countries 
• Living in crowded, unsanitary conditions 
• Providing care for a person with hepatitis A 
• Using certain drugs or substances
• Being a man who has sex with men 
• Experiencing homelessness 
  

Diagnosis

To diagnose hepatitis A, your healthcare provider will ask about your symptoms, review your medical history, perform a physical examination, and order blood tests to confirm the diagnosis.

During the physical exam, your healthcare provider will look for signs of hepatitis A, such as fever, jaundice, and abdominal pain. They will ask about your medical history and risk factors, such as recent travel to areas with high rates of hepatitis. 

A blood test can detect the presence of antibodies to the hepatitis A virus. The test looks for specific antibodies that tell your healthcare provider whether you have a current hepatitis A infection, whether you have had one in the past, have been vaccinated, or how much damage there is to the liver from the virus.

Treatment

Unfortunately, there is no cure for hepatitis A, so treatment focuses on managing symptoms and supporting the body’s natural healing process. Treatment for hepatitis A may include:

• Rest and hydration: Getting plenty of rest and staying well-hydrated can help the body fight off the infection and alleviate symptoms such as fatigue and nausea. Avoid alcohol drinking alcohol until symptoms decrease.
• Medications: Over-the-counter pain relievers such as acetaminophen may help relieve symptoms like fever and body aches. Talk to your healthcare provider before taking any medicines because some OTC drugs (e.g., ibuprofen or acetaminophen) can damage the liver in large doses. Your healthcare provider may recommend taking smaller doses to protect your liver while you manage the symptoms of the infection.
• Hospitalization: If you develop severe symptoms, you may need to spend some time in the hospital for intravenous fluids, nutrition support, and management of complications (e.g., liver failure).

How to Prevent Hepatitis A

The most effective way to prevent hepatitis A is to get vaccinated with the hepatitis A vaccine. The vaccine is given in two doses, generally six to 12 months apart. Children 12 months or older, people with liver disease or HIV, and those with certain risk factors (e.g., travel outside the United States for leisure or work) should especially get vaccinated to protect themselves against the virus.

Other preventative measures that can help lower your risk of contracting hepatitis A include:

• Washing your hands frequently with soap and water for at least 20 seconds after using the bathroom, before preparing or handling food, and after changing diapers
• Rinsing fruits and vegetables before eating 
• Avoiding eating raw or undercooked shellfish
• Boiling water to cook and drinking or using bottled water when washing produce and brushing your teeth while traveling to other countries

Complications 

Most of the time, the body’s immune system can fight a hepatitis A infection without problems. In people with liver disease and adults aged 50 and older, hepatitis A can sometimes cause liver damage and lead to liver failure.

Other rare complications of hepatitis A include:

• Cholestasis: Jaundice (yellowish skin and eyes) lasting three months or longer occurs in less than 5% of people with hepatitis A infection. 
• Relapsing hepatitis: Sometimes, a hepatitis A infection initially resolves but returns later (relapses) within six months following the initial infection. Relapses typically last less than three weeks but may persist for up to 12 months. 
• Autoimmune hepatitis: Rarely, hepatitis A can trigger autoimmune hepatitis, in which the body’s immune system attacks the liver, causing chronic inflammation and damage. 

Living With Hepatitis A  

Living with a hepatitis A diagnosis can be challenging, especially if you’re battling fatigue or nausea. The good news is most people recover from their symptoms fully within several weeks with no liver damage.

To promote healing, try taking time off from work or school to give your body a chance to rest, drink plenty of water, and eat a nutritious diet with plenty of fruits, vegetables, and lean protein. Avoid alcohol and other harmful substances to prevent harming your liver and give your body a chance to heal. If you notice symptoms are worsening, talk to your healthcare provider about what you can do to better manage your condition.