Hepatitis A

Hepatitis A is a type of viral liver infection uncommon in England but widespread in other parts of the world, such as Africa and India.

Initial symptoms of hepatitis A are similar to flu and include:

• mild fever – usually no higher than 39.5ºC (103.1ºF)
• joint and muscle pain
• feeling and being sick
• diarrhoea

This may then be followed by symptoms related to the liver becoming infected, such as:

• jaundice – yellowing of the skin and eyes
• passing very dark urine and pale stools
• itchy skin
• a swollen and tender liver

Symptoms usually clear up within two months, although occasionally last up to six months. Older adults tend to have more severe symptoms.

In most cases the liver will make a full recovery.

Read more about symptoms of hepatitis A.

Treating hepatitis A

There is no cure for hepatitis A, so treatment involves making a person feel as comfortable as possible until the infection clears up.

This involves:

• getting plenty of rest
• using painkillers to relieve pain – always make sure you never exceed the recommended dose as this could further damage your liver
• taking steps to help reduce itching
• taking a type of medication called an antiemetic to help with the symptoms of nausea and vomiting
• allowing your liver to rest – for example, avoiding alcohol and certain medications

Read more about treating hepatitis A.

What causes hepatitis A?

Hepatitis A is caused by the hepatitis A virus.

The virus is most commonly spread through the "faecal-oral" route. This is when you put something in your mouth that has been contaminated by the stools of someone with hepatitis A.

Eating foods such as shellfish contaminated by raw sewage can also lead to you becoming infected, as can drinking contaminated water.

Less commonly, hepatitis A can be spread through:

• sharing a needle with an infected person to inject drugs
• during sex (particularly anal sex)

The condition can also spread through close personal contact in closed environments, such as student halls, boarding schools and army barracks.

Read more about the causes of hepatitis A.

Who is affected?

Hepatitis A is widespread in parts of the world that are poor, overcrowded and have limited access to sanitation and clean water.

Regions where hepatitis A is most common include:

• sub-Saharan and north Africa
• the Indian subcontinent (particularly Bangladesh, India, Nepal and Pakistan)
• some parts of the Far East (excluding Japan)
• the Middle East
• South and Central America

Hepatitis A is much less common in high-income countries. There were only 367 reported cases of hepatitis A infection in England and Wales during 2010. It is unclear how many of these infections were actually caught abroad.

Hepatitis A is most common in young children, but often goes undetected as it tends not to cause any symptoms in this age group.

Other groups with an increased risk of catching hepatitis A include:

• men who have sex with men
• people who regularly inject drugs
• sewage workers
• people who travel to or work in less developed countries

Vaccination may be recommended for high-risk groups.

Vaccination

As hepatitis A is rare in England, children are not routinely vaccinated against it.

Vaccination is normally only recommended if you are travelling to certain parts of the world or you are at a high risk of infection.

Read more about the hepatitis A vaccine and who should have it.

Preventing the spread of infection

An infection of hepatitis A can often be prevented if vaccination and immunoglobulin are provided within two weeks of being exposed to the virus.

If you are diagnosed with hepatitis A, it is important that anyone you could have infected is tested for the condition.

Testing may be recommended for:

• people who live with you
• people you have recently prepared food for
• any person you have had sex with

It is also important to practise good hygiene, such as washing your hands after going to the toilet and before preparing food. Extra precautions include not sharing towels, eating utensils or toothbrushes.

Read more about hygiene and how to prepare food safely.

Complications

In most people the infection will pass without causing any long-term problems. Once the infection passes, you normally develop life-long immunity against the virus.

However, around 15% of people experience a relapse of symptoms a few months after the original infection, and this can happen more than once.

Serious complications tend to only occur in people with pre-existing liver disease, or elderly people, with the most serious being liver failure (where the liver loses most or all of its functions).

Once liver failure has occurred, it is usually possible to sustain life for several years using medication. However, a liver transplant is currently the only option for curing liver failure.

Read more about the complications of hepatitis A.