Hepatitis A virus
Pronunciation[edit | edit source]
HEH-puh-TY-tis ... VY-rus
Summary[edit | edit source]
- Hepatitis A virus is a virus that causes a serious liver disease.
- It is usually spread by contact with an infected person’s stool by eating food he or she has handled after not washing hands, but it can be spread in other ways.
- Symptoms of infection include jaundice, dark urine, and fever and other flu-like symptoms.
Definition[edit | edit source]
- Hepatitis means inflammation of the liver.
- When the liver is inflamed or damaged, its function can be affected.
- Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis, but it is often caused by a virus.
- In the United States, the most common hepatitis viruses are hepatitis A virus, hepatitis B virus, and hepatitis C virus.
- Hepatitis A is a highly contagious, short-term liver infection caused by the hepatitis A virus.
- People who get hepatitis A may feel sick for a few weeks to several months but usually recover completely and do not have lasting liver damage. In rare cases, hepatitis A can cause liver failure and even death; this is more common in older people and in people with other serious health issues, such as chronic liver disease.
Incidence[edit | edit source]
- In 2018, there were an estimated 24,900 hepatitis A cases were reported in the United States.
- Because some people don’t ever get diagnosed, the actual number of cases reported in that year is probably closer to 24,900.
- Since 2016, person-to-person outbreaks of hepatitis A have been occurring across the United States mainly among people who use injection drugs or are experiencing homelessness, resulting in more than 32,000 cases.
Risk factors[edit | edit source]
- International travelers
- Men who have sex with men
- People who use injection or non-injection drugs (all those who use illegal drugs)
- People with occupational risk for exposure
- People who anticipate close personal contact with an international adoptee
- People experiencing homelessness
- People at increased risk for severe disease from HAV infection
- People with chronic liver disease
- People with human immunodeficiency virus infection
- For more information about assessing risk for hepatitis A, refer to Table 3 in Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020.
Signs and symptoms[edit | edit source]
Among older children and adults, infection is typically symptomatic. Symptoms usually occur abruptly and can include the following:
- Fever
- Fatigue
- Loss of appetite
- Nausea
- Vomiting
- Abdominal pain
- Dark urine
- Diarrhea
- Clay-colored stool
- Joint pain
- Jaundice
Most (70%) of infections in children younger than age 6 are not accompanied by symptoms. When symptoms are present, young children typically do not have jaundice; most (>70%) older children and adults with HAV infection have this symptom.
Incubation period[edit | edit source]
- Symptoms of hepatitis A usually last less than 2 months, although 10%–15% of symptomatic persons have prolonged or relapsing disease for up to 6 months (9–13).
- The average incubation period for HAV is 28 days and ranges between 15–50 days.
Diagnosis[edit | edit source]
Diagnosis is with a combination of history, physical examination including travel and food history, symptoms, ordering a blood tests for hepatitis A.
Treatment[edit | edit source]
- To treat the symptoms of hepatitis A, rest, adequate nutrition, fluids and other supportive measures are recommended.
- Some people with severe symptoms will need medical care in a hospital.
Vaccination[edit | edit source]
- Vaccination with the full, two-dose series of hepatitis A vaccine is the best way to prevent infection.
- Hepatitis A vaccine has been licensed in the United States for use in people 1 year of age and older.
The following people should be vaccinated against hepatitis A:
Children
- All children aged 12–23 months
- All children and adolescents 2–18 years of age who have not previously received hepatitis A vaccine (known as “catch up” vaccination)
- People at increased risk for hepatitis A
People at increased risk for severe disease from hepatitis A infection
Other people recommended for vaccination
- Pregnant women at risk for hepatitis A or risk for severe outcome from hepatitis A infection
- Any person who requests vaccination
- How is the hepatitis A vaccine given?
- There are two types of hepatitis A vaccine.
Vaccination schedule[edit | edit source]
- The first type, the single-dose hepatitis A vaccine, is given as two shots, 6 months apart, and both shots are needed for long-term protection against hepatitis A.
- The other type is a combination vaccine that protects people against both hepatitis A and hepatitis B.
- The combination vaccine can be given to anyone 18 years of age and older and is given as three shots over 6 months.
- All three shots are needed for long-term protection for both hepatitis A and hepatitis B.
Immunoglobulins[edit | edit source]
- Immune globulin can provide short-term protection against hepatitis A, both pre- and postexposure.
- Immune globulin must be administered within 2 weeks after exposure for maximum protection.
- Given that the virus is transmitted through the fecal-oral route, good hand hygiene—including handwashing after using the bathroom, changing diapers, and before preparing or eating food—is integral to hepatitis A prevention.
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Contributors: Prab R. Tumpati, MD