Hepatitis A Basics: Entire Lesson

The term "hepatitis" means inflammation (or swelling) of the liver. When the liver is inflamed, it can have a harder time doing some of its jobs. (See Understanding the Liver.) A hepatitis virus is one that lives in liver cells and causes inflammation. Different hepatitis viruses have been given different names, such as A, B, and C.

Hepatitis A is caused by the hepatitis A virus. Most people infected with the virus get well within six months. However, hepatitis A can be serious for older people and people who already have liver disease. Death is possible, although very rare. Learn how to prevent hepatitis A infection, especially if you already have any other type of liver disease.

The hepatitis A virus is usually spread by putting something in your mouth that is contaminated by the stool of another person with hepatitis A. It is usually spread through

• household contact with an infected person
• sexual contact with an infected person
• eating or drinking contaminated food or water
• sharing eating utensils that are contaminated
• touching contaminated surfaces and then placing your hands near or in the mouth

Anyone can acquire hepatitis A under the conditions described in the previous section. However, rates of infection are particularly high among certain groups, and people in these groups can be considered at high risk. These include the following:

• Men who have sex with men
• People who use illicit drugs
• People, especially children, living in or traveling to areas that have high rates of hepatitis A, particularly Africa, Asia, and Latin America

Some people with hepatitis A do not have any symptoms. If you do have symptoms, they may include the following:

• Yellowing of the skin or eyes (called jaundice)
• Feeling very tired
• Stomach pain
• Not feeling very hungry
• Dark urine
• Nausea
• Diarrhea
• Low-grade fever

Your doctor can tell you if you have hepatitis A by talking to you about your symptoms and taking a sample of your blood. A blood test for a specific antibody called an IgM antibody can tell if you are infected with hepatitis A.

Get vaccinated

The best way to prevent hepatitis A is to get vaccinated. The vaccine is very effective and can keep you from ever getting hepatitis A. You will not get hepatitis A from the vaccine.

Ask your VA medical care provider about vaccination if:

• you are in one of the high risk groups listed in "Who is at risk for hepatitis A?"
• you have any other type of chronic liver disease

More on the hepatitis A vaccine

Practice good personal hygiene

Because so many cases of hepatitis A are due to close contact with an infected person, you should always practice good personal hygiene, especially by washing your hands.

Be careful in high-risk situation

• Boil water or drink bottled water in areas where there is a risk for hepatitis A contamination.
• Eat cooked foods and fruits that you can peel and avoid eating vegetables or fruits that could have been washed with contaminated water, such as lettuce.
• Avoid eating raw or steamed shellfish, such as oysters, that live in contaminated waters.
• Use condoms correctly and every time you have sex. (See Tips for Using Condoms, on the VA HIV/AIDS website.)

There are no special treatments for hepatitis A. Most people with hepatitis A recover without treatment within a few months by getting a lot of rest and drinking plenty of fluids.

You may need the vaccine against hepatitis A if you

• have a chronic liver disease such as hepatitis C
• use illegal drugs
• are a man who has sex with other men
• work in a setting that puts you at risk for hepatitis A infection
• receive blood products such as clotting factors
• live in areas or in communities where there are high rates of hepatitis A infection
• travel or work in countries with high rates of hepatitis A infection (these tend to be developing countries with very poor sanitary and hygienic conditions, such as certain parts of Africa, Asia, and Central and South America)

You should not get the hepatitis A vaccine or you should wait, if you

• had a serious allergic reaction to a previous hepatitis A vaccine
• are ill at the time the shot is scheduled
  (If you are just mildly ill, ask your doctor or nurse if it is okay for you to receive the vaccine.)

Speak with your VA health care provider to see if you should be vaccinated against hepatitis A.

A vaccine is a shot of inactive virus that stimulates your natural immune system. After the hepatitis A vaccine is given, your body makes antibodies which will protect you against that virus. These antibodies are then stored in the body for several years and will fight off the infection if you are exposed to the hepatitis A virus.

For both adults and children, the vaccine is given in two shots, usually in the muscle of the upper arm. The first shot should be followed by a second shot six months to a year later. You may get the hepatitis A vaccine at the same time you receive other kinds of vaccines. It is not recommended that children under two years old get the hepatitis A vaccine.

If you are vaccinated and develop antibodies, you will be protected against hepatitis A for at least 20 years. If you are unsure if you were vaccinated, ask your doctor to check to see if you have antibodies in your body to protect you against the virus.

The hepatitis A vaccine is made from inactive virus and is quite safe. In general, there are very few side effects. The most common side effect is soreness at or around the injection site, and other side effects include mild headache, loss of appetite among children, and feeling tired. These side effects usually begin three to five days after the vaccination and may last one to two days.

However, like any medicine, the vaccine may cause serious problems, such as an allergic reaction, which may appear within a few minutes or hours after the shot. This occurs very rarely, but if you believe you are having a reaction to the vaccine, you should call your doctor or nurse right away. Some warning signs of a serious allergic reaction include the following:

• High fever
• Behavior changes
• Difficulty breathing
• Hoarse voice or wheezing
• Hives
• Pale skin
• Weakness or dizziness
• A fast heart beat

You will NOT get hepatitis A from the vaccine, and receiving the vaccine is much safer than getting the disease itself. Pregnant women have received the hepatitis A vaccine with no risk to the baby.

• Hepatitis Risk Assessment
  5-minute assessment developed by the federal Centers for Disease Control and Prevention that gives you a personalized report of your hepatitis risk
• Hepatitis C: An Introductory Guide for Patients
  A primer on hepatitis C, including information on the liver's functions, laboratory tests, and treatment
• The ABCs of Hepatitis
  Two-page guide to the symptoms, treatment, and prevention of hepatitis A, B, and C
• Glossary
  Definitions of terms commonly used with hepatitis C and related conditions.
• American Liver Foundation
  A national nonprofit organization dedicated to the prevention, treatment, and cure of hepatitis and other liver diseases through research, education, and advocacy. Web site features a database directory of hepatitis clinical trials, lay-oriented facts sheets, and links to additional resources.
• Centers for Disease Control and Prevention: Viral Hepatitis
  Information on all types of viral hepatitis from the CDC's National Center for Infectious Diseases. Site features related CDC guidelines and recommendations as well as training materials, slide sets, fact sheets, and key CDC hepatitis documents.
  • The ABCs of Viral Hepatitis
    1-page fact sheet on hepatitis A, B, and C.
• NATAP: Hepatitis
  Recogizing that coinfection with viral hepatitis among people with HIV is a growing problem, the National AIDS Treatment Advocacy Project (NATAP) has developed an extensive amount of information on hepatitis, both in the context of HIV coinfection and as a separate illness. NATAP provides coverage of key conferences, maintains a selection of hepatitis articles, and features an ask-the-expert forum on hepatitis C.