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Hepatitis A symptoms and treatment

Hepatitis A is part of a group of viruses that attack the liver. The virus is found in human faeces (poo) and is commonly passed on by eating or drinking contaminated food and water. But, it can also be passed on through unprotected sex, particularly anal sex, and via sharing needles.  

In most cases people recover completely without any treatment but a very small proportion of people can get very ill. A vaccine is available for those at greater risk of getting the virus.  

What is hepatitis A?

Hepatitis A, sometimes called Hep A or HAV, is a viral infection that attacks the liver. The virus is spread by eating or drinking food and water that is contaminated with the faeces of an infected person. It’s more common in places with poor sanitation and hygiene conditions and a lack of clean water. But, it can also be passed on through unprotected sex and via sharing needles. 

Hepatitis A is not usually serious and clears up on its own after 10 to 14 days. However, hepatitis A has many of the same symptoms as more serious types of hepatitis infections – such as hepatitis B or C – so it’s important to get tested. 

How do you get hepatitis A?

The hepatitis A virus needs to get from human faeces into the mouth to infect someone. You only need to be in contact with small amounts of faeces to become infected. 

Hepatitis A is most commonly passed on by: 

  • eating food prepared by someone with the virus who has not washed their hands properly 

  • drinking dirty water (including ice cubes) 

  • eating raw or undercooked shellfish from dirty water 

  • injecting drugs using contaminated equipment 

  • being in close contact with someone who has hepatitis A 

  • having sex with someone who has the infection without using a condom or dental dam.

You are more likely to get hepatitis A via anal sex, particularly if you touch the anus (bottom) with your fingers, mouth or tongue. Touching used condoms, sex toys and douching equipment that have been in someone else’s anus can also spread the virus. 

How do you prevent hepatitis A?

You can stop the spread of the virus by washing your hands regularly, particularly after you go to the toilet or before you prepare or eat food. 

If tap water isn’t safe you should boil it before drinking or using it to brush your teeth. You should also peel and wash all your fresh fruit and vegetables and avoid raw or undercooked meat and fish. 

Sharing contaminated needles and syringes during recreational drug use can also pass hepatitis A on, so it’s important to use new injecting equipment every time. 

You can practise safer sex by using a new external (or male) or internal (or female) condom or dental dam each time you have vaginal, anal or oral sex. You should cover sex toys with a new condom and wash them after use, as well as washing your hands after touching someone’s anus or handling used condoms and sex toys. 

Taking pre-exposure prophylaxis (PrEP), the contraceptive pill or any other type of contraception – apart from condoms – doesn’t prevent hepatitis A. 

If you’re in close contact with someone with hepatitis A or you’re in a high-risk group then having the hepatitis A vaccine (where available) is recommended.  

What are the symptoms of hepatitis A?

Many people with hepatitis A don’t have any symptoms. If symptoms do develop, you’ll usually notice them around two to seven weeks after infection. These symptoms will usually pass within two months, although some people can experience illness for up to 6 months. 

If symptoms develop, they can include: 

  • flu-like symptoms, including tiredness, a fever and aches and pains 

  • loss of appetite 

  • feeling and/or being sick 

  • diarrhoea 

  • pain in the upper right part of your tummy (abdomen) 

  • dark urine and pale faeces (poo) 

  • yellowing of the skin and eyes (jaundice) 

  • itchy skin. 

You can spread the infection even if you have no symptoms, or up to 2 weeks before symptoms appear.  

How do I test for hepatitis A?

If you think you're at risk of having hepatitis A, have been in contact with someone who has the virus or have any symptoms you should talk to a healthcare professional. You can have a test even if you do not have symptoms.  

A simple blood test will show if you have the virus. If you test positive, they may also do another type of blood test to check if your liver is working properly. You should also be tested for other STIs. 

It’s important that you tell people you live with or have close contact with, and your recent sexual partner/s so they can also get tested.  

How is hepatitis A treated?

There is currently no cure for hepatitis A. Your healthcare professional will usually recommend rest, good nutrition and plenty of fluids. Painkillers and/or medication to help with itchiness, nausea or vomiting may be prescribed. Most people will recover fully within one to two months. 

Whether you’ve got symptoms or not, don’t prepare food for others or have sex until a healthcare professional tells you that you’re no longer infectious. 

Once you’ve recovered from hepatitis A you’re immune – this means you can’t get it again. But you can still get other types of hepatitis. 

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What are the long-term effects of untreated hepatitis A?

Unlike other types of viral hepatitis, hepatitis A rarely causes long-term liver damage. It doesn't become a long-term (chronic) illness. Occasionally it can last longer and some people with severe symptoms will need medical care in a hospital. 

How do I tell my recent sexual partner(s) I have hepatitis A?

If you test positive for Hepatitis A, it’s important to tell any recent sexual partner(s) so they can also get tested, and treated if necessary. If you feel it is safe to do so then telling a partner is the responsible thing to do – it shows you respect them and want them to stay healthy. 

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