Hepatitis A

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 a high risk of infection.

Symptoms of hepatitis A

The symptoms of hepatitis A develop, on average, around four weeks after becoming infected, although not everyone will experience them.

Symptoms can include:

• feeling tired and generally unwell
• joint and muscle pain
• a high temperature (fever)
• loss of appetite
• feeling or being sick
• pain in the upper-right part of your tummy
• yellowing of the skin and eyes (jaundice)
• dark urine and pale stools
• itchy skin

The symptoms will usually pass within a couple of months.

Read more about symptoms of hepatitis A.

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 don't 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 (see below)

Although hepatitis A isn't usually serious, it's important to get a proper diagnosis to rule out more serious conditions with similar symptoms, such as hepatitis C or cirrhosis (scarring of the liver).

It may also be necessary to test your friends, family and any sexual partners, in case you've 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 hasn't 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 who has the infection (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 two weeks before their symptoms appear until about a week after the symptoms first develop.

Read more about the causes of hepatitis A.

Vaccination against hepatitis A

Vaccination against hepatitis A isn't 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 levels of sanitation and food hygiene are expected to be poor
• people with any type of long-term (chronic) 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, staff of institutions where levels of 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.

Read more about the hepatitis A vaccine.

Treatments for hepatitis A

There's currently no cure for hepatitis A, but it will normally pass 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've recovered
• maintain a cool, well-ventilated environment, wear loose clothing, and avoid hot baths or showers to reduce any itching
• eat smaller, lighter 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 measures, such as washing your hands with soap and water regularly 

Speak to your GP if your symptoms are particularly troublesome or haven't started to improve within a couple of months. They can prescribe medications to help with itchiness, nausea or vomiting, if necessary.

Read more about treating hepatitis A.

Outlook for hepatitis A

For most people, hepatitis A will pass within two months and there will be no long-term effects. Once it passes, you normally develop life-long immunity against the virus.

For around 1 in every 7 people with the infection, the symptoms may come and go for up to 6 months before eventually passing.

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 those with pre-existing liver problems and elderly people.

If liver failure does occur, a liver transplant is usually needed to treat it.