Hepatitis A: Risk Factors & Symptoms

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Modes of Transmission:

Hepatitis A is found in feces and in the intestinal tract, and can be spread by:

• Eating contaminated food prepared by an infected person who did not wash their hands properly
• Anal/oral sexual practices
• Eating contaminated shellfish
• Drinking contaminated water

The hepatitis A virus is rarely transmitted via the blood-borne route, and is never transmitted through the air or by casual contact such as coughing, sneezing, or being in the same area as an infected person.

Symptoms:

The incubation period for hepatitis A is 15 to 50 days, with an average of 28 days.

While children who contract hepatitis A usually have no symptoms, adults may become very ill and display the following symptoms:

• Jaundice
• Dark urine
• Light stool
• Fever
• Nausea
• Vomiting
• Fatigue
• Abdominal pain
• Anorexia

Testing:

Tests commonly performed to diagnose hepatitis A include:

• IgM anti-HAV (IgM hepatitis A antibody): if a patient tests positive, they have acquired the hepatitis A virus, or have been vaccinated within the last 6 months.
• Anti-HAV total (hepatitis A antibody total): appears as the person convalesces, and gives protection against future infection.

Treatment:

• There is no specific treatment for hepatitis A, only the management of symptoms. The infection will clear up within a couple of months, and the patient will be immune to the virus.
• About 1 in 100 persons infected with hepatitis A will develop severe infection that may require a liver transplant, especially among those co-infected with chronic hepatitis B, chronic hepatitis C, or HIV/AIDS.

Vaccination and Prophylaxis:

Hepatitis A vaccination is recommended for:

• Children over 2 years of age living in areas where rates of hepatitis are twice the national average
• Persons traveling to or working in countries that have high rates of infection
• Men who have sex with men
• Users of street drugs
• Persons with clotting factor disorders
• Persons with chronic liver disease, chronic hepatitis B, or chronic hepatitis C
• Person with compromised immune systems (e.g. HIV/AIDS)

There are two types of products available for prophylaxis and prevention of hepatitis A infection:

• Hepatitis A vaccine provides active immunity against the hepatitis A virus through a series of two injections, with the second given at 6-12 months after the first. The vaccine can provide protection as soon as four weeks after the first injection. The second injection can provide immunity for possibly 20 years, but probably not life long.



• Immune Globulin (IG) provides protection against hepatitis A through passive transfer of antibody. IG provides temporary immunity to the virus for 2-3 months, if administered prior to exposure or within 2 weeks after exposure.

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