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Hepatitis ABy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/hepatitis-a/DS00397
Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. The hepatitis A virus is one of several types of hepatitis viruses that cause inflammation that affects your liver's ability to function.
You're most likely to contract hepatitis A from contaminated food or water or from close contact with someone who's already infected. Mild cases of hepatitis A don't require treatment, and most people who are infected recover completely with no permanent liver damage.
Practicing good hygiene — including washing your hands often — is one of the best ways to protect against hepatitis A. Effective vaccines are available for people who are most at risk.
Hepatitis A signs and symptoms typically don't appear until you've had the virus for a few weeks. Signs and symptoms of hepatitis A include:
- Nausea and vomiting
- Abdominal pain or discomfort, especially in the area of your liver on your right side beneath your lower ribs
- Loss of appetite
- Low-grade fever
- Dark urine
- Muscle pain
- Yellowing of the skin and eyes (jaundice)
Signs and symptoms of hepatitis A usually last less than two months, but may last as long as six months. Not everyone with hepatitis A develops signs or symptoms.
When to see a doctor
Make an appointment with your doctor if you have signs or symptoms that worry you.
If you've been exposed to hepatitis A, you may prevent infection by having a hepatitis A vaccine or immunoglobulin therapy within two weeks of exposure. Ask your doctor or your local health department about receiving the hepatitis A vaccine if:
- A restaurant where you recently ate reports a hepatitis A outbreak
- Someone close to you, such as someone you live with or someone who is your caregiver, is diagnosed with hepatitis A
- You recently had sexual contact with someone who has hepatitis A
- You recently shared needles for self-injected drugs with someone who has hepatitis A
Hepatitis A is caused by infection with the hepatitis A virus. The hepatitis virus is usually spread when a person ingests tiny amounts of contaminated fecal matter. The hepatitis A virus infects the liver cells and causes inflammation. The inflammation can impair liver function and cause other signs and symptoms of hepatitis A.
Hepatitis A virus can be transmitted several ways, such as:
- When someone with the virus handles the food you eat without first carefully washing his or her hands after using the toilet
- Drinking contaminated water
- Eating raw shellfish from water polluted with sewage
- Being in close contact with a person who's infected — even if that person has no signs or symptoms
- Having sex with someone who has the virus
You're at increased risk of hepatitis A if you:
- Travel or work in regions with high rates of hepatitis A
- Are a man who has sexual contact with other men
- Are HIV positive
- Use injected or noninjected illicit drugs
- Live with another person who has hepatitis A
- Receive clotting-factor concentrates for hemophilia or another medical condition
Continuing signs and symptoms of hepatitis A
A small number of people with hepatitis A will continue to experience signs and symptoms of infection for several weeks longer than usual. For these people, hepatitis A signs and symptoms may go away and then reappear over several weeks. Though the signs and symptoms occur over a longer period of time, this form of hepatitis A infection is not more serious than a hepatitis A infection that causes the usual signs and symptoms.
Acute liver failure
In rare cases, hepatitis A can cause acute liver failure, which is a loss of liver function that occurs suddenly. People with the highest risk of this complication include those with chronic liver diseases and older adults. Acute liver failure requires hospitalization for monitoring and treatment. In some cases, people with acute liver failure may require a liver transplant.
Preparing for your appointment
If someone close to you is diagnosed with hepatitis A, contact your doctor or your local health department to determine whether you may need the hepatitis A vaccine to prevent infection.
If you have signs and symptoms of hepatitis A, make an appointment with your family doctor or a general practitioner.
How to prepare
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared. For instance:
- Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Write down key personal information, including any major stresses or recent life changes.
- Make a list of all medications, as well as any vitamins or supplements, that you're taking.
- Consider taking a family member or friend along. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
Questions to ask
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For hepatitis A, some basic questions to ask your doctor include:
- Do I have hepatitis A?
- Can I pass hepatitis A to other people?
- What can I do to prevent spreading hepatitis A to my friends and family?
- Should people close to me receive the hepatitis A vaccine?
- Can I continue to work or go to school while I have hepatitis A?
- How long can I expect to experience signs and symptoms of hepatitis?
- What signs and symptoms signal that my hepatitis A is causing serious complications?
- How will I know when I can no longer pass hepatitis A to others?
- Are there any brochures or other printed material that I can take with me? What websites do you recommend?
- What will determine whether I should plan for a follow-up visit?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions that come to mind during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover other points you want to address. Your doctor may ask:
- When did you begin experiencing symptoms?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
Tests and diagnosis
Blood tests are used to detect the presence of hepatitis A in your body. A sample of blood is taken, usually from a vein in your arm, and sent to a laboratory for testing. Your doctor may also discuss your signs and symptoms as part of making a diagnosis.
Treatments and drugs
No specific treatment exists for hepatitis A. Your body will clear the hepatitis A virus on its own. In most cases of hepatitis A, the liver heals completely in a month or two with no lasting damage.
Hepatitis A treatment usually focuses on coping with signs and symptoms of hepatitis A infection. For instance:
- Expect to have less energy. Many people with hepatitis A infection feel tired and have less energy for their daily tasks. Rest when you need to. You may feel tired and sick for a few months.
- Find ways to cope with nausea. Nausea can make it difficult to eat. Find ways to make food more appealing. Eat small snacks throughout the day, rather than three large meals. If you're having trouble eating enough calories, avoid low-calorie foods and choose high-calorie foods. For instance, drink fruit juice or milk, rather than water.
- Give your liver a rest. Your liver may have difficulty processing medications and alcohol if you have hepatitis A. Review your medications, including over-the-counter drugs, with your doctor. Your doctor may recommend stopping or changing some of your medications. Stop drinking alcohol while you have signs or symptoms of hepatitis A infection.
Lifestyle and home remedies
If you have hepatitis A, you can take steps to reduce the risk that you may pass the virus to others. Take steps to:
- Avoid sexual activity. Avoid all sexual activity if you have hepatitis A, since many kinds of sexual activity can expose your partner to infection. Condoms don't offer adequate protection.
- Wash your hands thoroughly after using the toilet. Scrub vigorously for at least 20 seconds and rinse well. Dry your hands with a disposable towel.
- Don't prepare food for others while you're actively infected. You can easily pass this highly contagious infection to other people.
No complementary or alternative medicine treatments have proved helpful in preventing or treating hepatitis A infection.
One herb that continues to attract attention for its touted liver-health properties is milk thistle. Proponents of milk thistle recommend the herb to treat jaundice and other liver disorders. People take milk thistle as a capsule, extract or infusion.
Small studies of milk thistle treatment for liver disease have shown mixed results. Many of the studies have been poorly designed, making it difficult for researchers to draw conclusions about the usefulness of milk thistle.
If you're interested in trying milk thistle, discuss the benefits and risks with your doctor.
Coping and support
If you've been diagnosed with hepatitis A, you may be afraid of what it means for your health and worried that you might pass the virus to others. To help you cope, consider trying to:
- Learn about hepatitis A. Finding out more about hepatitis A can help ease your fears. For most people, hepatitis A goes away on its own and doesn't cause other health problems, unlike other forms of viral hepatitis. Ask your doctor about good sources of information to learn more about hepatitis A. The Centers for Disease Control and Prevention is a good place to start.
- Take care of yourself. Help your body recover from hepatitis A by making healthy choices every day. For instance, choose a healthy diet full of fruits and vegetables. Try to exercise most days of the week. Get enough sleep so that you wake feeling rested.
- Let others know it's OK to be near you. You can't spread the hepatitis A virus by sneezing, coughing, hugging or sitting next to someone. If your friends or family are afraid of becoming infected with hepatitis A, let them know you'll do everything you can to protect them. For instance, you'll use your own hand towel after washing your hands and thoroughly wash your own dishes. But they don't have to fear being near you.
Consider the hepatitis A vaccine
The hepatitis A vaccine can prevent infection with the virus. The hepatitis A vaccine is typically given in two doses — initial vaccination followed by a booster shot six months later. The Centers for Disease Control and Prevention recommends the following individuals receive a hepatitis A vaccine:
- All children at age 1, or older children who didn't receive the vaccine at age 1
- Laboratory workers who may come in contact with hepatitis A
- Men who have sex with men
- People planning travel to areas of the world with high rates of hepatitis A
- People who use illicit drugs, including both injected and noninjected drugs
- People who receive clotting-factor concentrates as part of their medical treatment
- People with chronic liver disease
If you're concerned about your risk of hepatitis A, ask your doctor about whether the vaccine is right for you.
Follow safety precautions when traveling
If you're traveling in regions where hepatitis A outbreaks occur, you can help prevent infection by peeling and washing all your fresh fruits and vegetables yourself and by avoiding raw or undercooked meat and fish. Drink bottled water and also use it when brushing your teeth. Ask for your beverages to be served without ice. If bottled water isn't available, boil tap water before drinking it.
Practice good hygiene
Thoroughly wash your hands often to help protect yourself from infection. Wash after using the toilet, before preparing food or eating, and after changing a baby's diaper. Also, don't share towels, eating utensils or toothbrushes.
- Sjogren MH, et al. Hepatitis A. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed July 25, 2011.
- Hepatitis A FAQs for the public. Centers for Disease Control and Prevention. http://www.cdc.gov/hepatitis/A/aFAQ.htm. Accessed July 25, 2011.
- What I need to know about hepatitis A. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/hepa_ez/index.aspx. Accessed July 25, 2011.
- Hepatitis nutrition therapy. Nutrition Care Manual. American Dietetic Association. http://nutritioncaremanual.org/index.cfm. Accessed Aug. 3, 2011.
- Milk thistle. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/milkthistle/ataglance.htm. Accessed July 25, 2011.