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Hepatitis A is inflammation (irritation and swelling) of the liver from the hepatitis A virus.
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Viral hepatitis; Infectious hepatitis
Causes, incidence, and risk factors
The hepatitis A virus is found mostly in the stools and blood of an infected person about 15 - 45 days before symptoms occur and during the first week of illness.
You can catch hepatitis A if:
About 3,600 cases of hepatitis A are reported each year. Because not everyone has symptoms with hepatitis A infection, many more people are infected than are diagnosed or reported.
Risk factors include:
Other common hepatitis virus infections include hepatitis B and hepatitis C. Hepatitis A is the least serious and mildest of these diseases. The other hepatitis infections may become chronic illnesses, but hepatitis A does not become chronic.
Symptoms will usually show up 2 - 6 weeks after being exposed to the hepatitis A virus. They are usually mild, but may last for up to several months, especially in adults.
Signs and tests
The doctor will perform a physical examination and may discover that you have an enlarged and tender liver.
Blood tests may show:
There is no specific treatment for hepatitis A. Rest is recommended when the symptoms are most severe. People with acute hepatitis should avoid alcohol and any substances that are toxic to the liver, including acetaminophen (Tylenol).
Fatty foods may cause vomiting, because substances from the liver are needed to digest fats. Fatty foods are best avoided during the acute phase.
The virus does not remain in the body after the infection has gone away.
Over 85% of people with hepatitis A recover within 3 months. Nearly all patients get better within 6 months.
There is a low risk of death, usually among the elderly and persons with chronic liver disease.
There are usually no complications. One in a thousand cases becomes fulminant hepatitis, which can be life threatening.
Calling your health care provider
Call for an appointment with your health care provider if you have symptoms of hepatitis.
The following tips can help reduce your risk of spreading or catching the virus:
The virus may spread more rapidly through day care centers and other places where people are in close contact. Thorough hand washing before and after each diaper change, before serving food, and after using the restroom may help prevent such outbreaks.
If you have recently been exposed to hepatitis A and have not had hepatitis A before or have not received the hepatitis A vaccine series, ask your doctor or nurse about receiving either immune globulin or the hepatitis A vaccine. Common reasons why you may need to receive one or both of these include:
Vaccines that protect against hepatitis A infection are available. The vaccine begins to protect 4 weeks after receiving the first dose. The 6- to 12-month booster is required for long-term protection.
Travelers should take the following precautions:
Advisory Committee for Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). Recommended immunization schedules for children, adolescents, and adults -- United States, 2010 (accessed November 9, 2010).
Advisory Committee for Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC) Update: Prevention of hepatitis A after exposure to hepatitis A virus and in international travelers. Updated recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2007;56:1080-1084.
Hoofnagle JH. Acute viral hepatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 151.
Sjogren MH, Cheatham JG. Hepatitis A. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 77.
Victor JC, Monto AS, Surdina TY, Suleimenova SZ, Vaughan G, Nainan OV, Favorov MO, Margolis HS, Bell BP. Hepatitis A vaccine versus immune globulin for postexposure prophylaxis. N Engl J Med. 2007;357:1685-1694.
Reviewed by:David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California.
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