Hepatitis A is a liver infection caused by a virus that's spread in the poo of an infected person.
It's uncommon in the UK, but certain groups are at increased risk. This includes travellers to parts of the world with poor levels of sanitation, men who have sex with men, and people who inject drugs.
Hepatitis A can be unpleasant, but it's not usually serious and most people make a full recovery within a couple of months.
Some people, particularly young children, may not have any symptoms.
But hepatitis A can occasionally last for many months and, in rare cases, it can be life threatening if it causes the liver to stop working properly (liver failure).
A hepatitis A vaccine is available for people at high risk of infection.
Symptoms of hepatitis A
The symptoms of hepatitis A develop, on average, around 4 weeks after becoming infected, although not everyone will get them.
Symptoms can include:
- feeling tired and generally unwell
- joint and muscle pain
- a raised temperature
- loss of appetite
- feeling or being sick
- pain in the upper right part of your tummy
- yellowing of the skin and eyes (jaundice)
- dark pee and pale poo
- itchy skin
The symptoms will usually pass within a couple of months.
When to get medical advice
See your GP for advice if:
- you have symptoms of hepatitis A – a blood test can usually confirm whether you have the infection
- you might have been exposed to the hepatitis A virus recently but you do not have any symptoms – treatment given early on may be able to stop the infection developing
- you think you might need the hepatitis A vaccine – your GP can advise you about whether you should have the vaccine
Although hepatitis A is not usually serious, it's important to see your GP so they can rule out more serious conditions with similar symptoms, such as hepatitis C or scarring of ther liver (cirrhosis).
It may also be necessary to test your friends, family and any sexual partners in case you have spread the infection to them.
How you can get hepatitis A
Hepatitis A is most widespread in parts of the world where standards of sanitation and food hygiene are generally poor, such as parts of Africa, the Indian subcontinent, the Far East, the Middle East, and Central and South America.
You can get the infection from:
- eating food prepared by someone with the infection who has not washed their hands properly or washed them in water contaminated with sewage
- drinking contaminated water, including ice cubes
- eating raw or undercooked shellfish from contaminated water
- close contact with someone who has hepatitis A
- less commonly, having sex with someone with hepatitis A (this is particularly a risk for men who have sex with men) or injecting drugs using contaminated equipment
Someone with hepatitis A is most infectious from around 2 weeks before symptoms appear until about a week after symptoms first develop.
Vaccination against hepatitis A
Vaccination against hepatitis A is not routinely offered in the UK because the risk of infection is low for most people.
It's only recommended for people at an increased risk, including:
- close contacts of someone with hepatitis A
- people planning to travel to or live in parts of the world where hepatitis A is widespread, particularly if sanitation and food hygiene are expected to be poor
- people with any type of long-term liver disease
- men who have sex with other men
- people who inject illegal drugs
- people who may be exposed to hepatitis A through their job – this includes sewage workers, people who work for organisations where personal hygiene may be poor, such as a homeless shelter, and people working with monkeys, apes and gorillas
The hepatitis A vaccine is usually available for free on the NHS for anyone who needs it.
Treatments for hepatitis A
There's currently no cure for hepatitis A. But it usually gets better on its own within a couple of months. You can usually look after yourself at home.
While you're ill, it's a good idea to:
- get plenty of rest
- take painkillers, such as paracetamol or ibuprofen, for any aches and pains – ask your GP for advice about this, as you may need to take lower doses than normal or avoid certain medications until you have recovered
- maintain a cool, well-ventilated environment, wear loose clothing and avoid hot baths or showers to reduce any itching
- eat small, light meals to help reduce nausea and vomiting
- avoid alcohol to reduce the strain on your liver
- stay off work or school and avoid having sex until at least a week after your jaundice or other symptoms started
- practise good hygiene, such as washing your hands with soap and water regularly
Speak to your GP if your symptoms are particularly troublesome or have not started to improve within a couple of months.
They can prescribe medications to help with itchiness, nausea or vomiting, if necessary.
For most people, hepatitis A gets better within 2 months and there are no long-term effects.
Once it passes, you normally develop life-long immunity against the virus.
In around 1 in every 7 people with the infection, the symptoms may come and go for up to 6 months before eventually disappearing.
Life-threatening complications such as liver failure are rare, affecting less than 1 in every 250 people with hepatitis A.
People most at risk include the elderly and those with pre-existing liver problems.
If you have hepatitis A and liver failure, you'll usually need a liver transplant.