What Is Hepatitis A? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Hepatitis is an inflammation of the liver, an organ with several important functions.

Your liver converts dietary nutrients into useful substances and breaks down toxins and chemicals.

Hepatitis A is a type of hepatitis caused by the hepatitis A virus (HAV). It’s generally acquired through consuming contaminated food or water, but it can also be spread from person to person and is highly contagious. (1)

Numerous other types of viral and nonviral hepatitis also exist, including hepatitis B, hepatitis C, alcohol-related hepatitis, and nonalcoholic steatohepatitis, which is caused by a buildup of fat in the liver.

It usually takes a few weeks after becoming infected with hepatitis A to exhibit symptoms, and people also can have the infection and not ever have symptoms. (2)

Often, children who are infected do not develop noticeable symptoms. (3)

For those who do develop symptoms, they can include the following: (2)

• Fatigue
• Sudden nausea and vomiting
• Pain in the abdomen, especially on the upper-right side beneath the lower ribs (by the liver)
• Clay-colored bowel movements
• Loss of appetite
• Low-grade fever
• Joint pain
• Dark-colored urine
• Yellowish tint to the skin and whites of the eyes, indicating jaundice
• Intense itching

Learn More About Signs and Symptoms of Hepatitis A

The hepatitis A virus is passed between people through the “fecal-oral route,” which can occur: (2)

• When an infected person touches objects or food after going to the bathroom and failing to wash his hands properly
• When someone doesn’t wash properly after handling diapers or cleaning up the stool of an infected person
• During sex with an infected person, particularly if it involves direct or indirect anal-oral contact, or anal sex in which sanitary measures aren’t taken afterward

An infected person does not have to have symptoms to spread the virus. (1)

Many U.S. states have reported hepatitis A outbreaks in recent years among people who use illegal drugs and people who are homeless or have unstable housing. In these outbreaks, the virus is spread primarily person-to-person.

You can also get hepatitis A by ingesting food or water contaminated with feces containing HAV. (1)

Common sources of HAV transmission include fruits, vegetables, shellfish, ice, and water. (1)

This mode of transmission is far less common in the United States and other developed countries, which have better sanitation measures in place, such as treating the water supply with chlorine or chloramine. (3)

You cannot get HAV through casual contact with an infected person, such as through hugging or even being coughed or sneezed on. (3)

Babies are not believed to get HAV from breast milk. (4)

You are at an increased risk for hepatitis A if you: (1)

• Live in or travel to a developing country where hepatitis A is common
• Live with someone who has hepatitis A
• Have oral-anal sexual contact with someone who is infected
• Are a man who has sex with men
• Use illegal drugs, including those that aren’t injected
• Have hemophilia or other disorders that affect blood clotting
• Work in the healthcare, food, or sewage industries

Hepatitis A is diagnosed based on a blood test that detects antibodies produced by the body in response to infection with the hepatitis A virus. (5)

Prognosis of Hepatitis A

The outlook for someone with HAV is excellent. Close to 85 percent of people with hepatitis A recover within three months, and nearly everyone recovers within six months.

HAV isn’t a chronic disease and there are no long-term health consequences. (6)

For the majority of people, symptoms of hepatitis A last less than two months. In about 10 to 15 percent of people, the symptoms of HAV can last up to six months. (1)

People are most contagious soon after they get the infection, one to two weeks before symptoms appear. Healthy adults are no longer contagious two weeks after the illness begins, while children and people who have weak immune systems can remain contagious for up to six months. (7)

After a person has HAV and recovers, the majority of people will never get the infection again; they are immune for life. (8)

There is no special treatment or medication needed to cure HAV. The body gets rid of the virus on its own. (9)

When you’re sick with the infection, rest is important. Nausea can make eating difficult; small snacks and plenty of fluids are recommended. (9)

Medication Options

There are no medications that are needed or recommended to cure hepatitis A. (9)

If a person has been exposed to the hepatitis A virus, a single shot of the hepatitis A vaccine can help prevent infection. (1)

In some cases, an exposed person might also be given immune globulin, which is a substance that contains antibodies and comes from human blood plasma. (1)

Complementary and Integrative Approaches and Therapies

Because hepatitis A resolves on its own, there haven’t been any substantial studies on complementary therapies to help treat it.

Learn More About Treatment for Hepatitis A: Medication, Vaccination, and Home Remedies

Prevention of Hepatitis A

Although the infection rate of hepatitis A is lower in the United States than in many low- and middle-income countries, it is still present. (3) But there are ways to reduce the risk of catching the infection.

The best way to prevent hepatitis A is to get a hepatitis A vaccine. If a person gets the entire series (two or three doses are required), it can provide long-term protection against the infection. (1)

Tips on reducing the risk of spreading or catching HAV include the following: (12)

• Wash your hands thoroughly after using the restroom or whenever coming into contact with another person’s blood, stools, or other bodily fluids.
• If you work at a place where people routinely come into close contact, such as a day care center or long-term care facility, wash your hands often, especially before handling or serving food.

People who are traveling to an area where the water may be unsafe need to use extra precautions:

• Avoid raw shellfish.
• Be cautious about eating raw salads or raw fruit or vegetables that have been sliced or cut. They may have been washed in contaminated water. It is safer to peel all fruits and vegetables yourself if you wish to eat them raw.
• Use only bottled water that is sealed for drinking or brushing teeth, or use water that has been boiled for at least a full minute or has been chemically treated. (13)
• If food is heated, it should be hot to the touch and consumed right away.

Hepatitis A can be transmitted through any sexual activity with an infected person and is not limited to fecal-oral contact. Getting the HAV vaccine is the best way to avoid catching or spreading the infection. (1)

While most cases of hepatitis A clear up on their own, in rare cases, HAV can lead to complications.

Liver Failure

Hepatitis A infection can lead to acute liver failure, especially in older people and people who have other liver diseases or risk factors for liver disease. (8)

In liver failure, the liver is losing or has lost the ability to perform its usual functions, which include helping to fight infection, cleaning the blood, aiding in food digestion, and storing energy. Liver failure is life-threatening and requires urgent medical care. (14)

Guillain-Barre syndrome (GBS)

Guillain-Barré syndrome is a rare but life-threatening disease where the immune system attacks the peripheral nervous system. In very rare cases, hepatitis A can cause GBS. (15)

Pancreatitis

Researchers have noted an association between hepatitis A infection and acute pancreatitis, although it is rare. (16) In acute pancreatitis, the pancreas becomes inflamed, causing such symptoms as sharp pain in the abdomen, fever, vomiting, elevated heart rate, and a swollen abdomen. Acute pancreatitis is a medical emergency, and anyone with symptoms should seek help immediately.

In 2019, there were an estimated 159 million acute HAV infections throughout the world, resulting in 39,000 deaths and 2.3 million disability-adjusted life years, according to the Global Burden of Disease database. (17)

In the United States specifically, there were 12,474 hepatitis A cases reported in 2018, according to the Centers for Disease Control and Prevention. However, experts believe there are many instances where people don’t get diagnosed or tested for the infection, and so the actual number of Americans with HAV is thought to be closer to 24,900. (1)

The number of hepatitis A cases has gone up in the past few years. More person-to-person outbreaks have been reported in groups of people who are unhoused or using IV drugs and among men who have sex with men. (1)

The best way to prevent hepatitis A is through vaccination. Research suggests that Black Americans born in the United States and Asians and Hispanics born outside but living in the United States are less likely to have been vaccinated for hepatitis A compared with white people. (18)

Hepatitis E, also known as enteric hepatitis, has many similarities to hepatitis A. It is also a type of viral hepatitis that is transmitted through the fecal-oral route, and it has similar symptoms to HAV, including sometimes causing no symptoms at all.

A hepatitis E diagnosis is made by testing the blood or a stool sample. Most people who get it make a complete recovery. (6)

A number of organizations can provide more information about hepatitis A, including updates on local outbreaks.

Centers for Disease Control and Prevention (CDC)

The government agency provides information for both healthcare providers and the public, including a list of questions and answers about hepatitis A.

World Health Organization (WHO)

This organization focuses on improving health around the world. It provides guidance, resources, and recommendations about diseases, including hepatitis A.

Additional reporting by Becky Upham.