Hepatitis A is a virus that affects the liver. It can cause a short-term illness that normally lasts between 10 and 14 days. It doesn’t have a chronic phase, unlike other forms of hepatitis.
Some people have hepatitis A with no symptoms. According to NHS Choices, common symptoms can include:
These symptoms can be made worse by drinking alcohol, tea or coffee and eating fatty food.
People who also have hepatitis B or C may become more seriously ill with hepatitis A, and people with HIV may be ill with hepatitis A for longer.
The infection is spread by contact with infected human faeces (poo), so washing hands after going to the toilet is very important. Food and water contaminated by faeces from someone infected with hepatitis A are common sources of infection, but it can be spread during sex, especially by rimming (oral-anal contact). It's rarely spread through blood.
In the UK and Europe there have been outbreaks of hepatitis A among men who have sex with men (MSM), so it's important to be aware of ways to prevent transmission.
Good personal hygiene can prevent the transmission of hepatitis A – washing your hands after going to the toilet and before preparing or eating food.
Public Health England recommend the following precautions for MSM (who are at more risk of getting hepatitis A sexually):
There’s a vaccination against hepatitis A for people travelling to parts of the world where it’s common, or if you’re a gay man travelling to a Pride festival.
The vaccine usually involves two injections, given six months apart, and gives immunity for about 10 years. The length of immunity may be reduced in people living with HIV who have a low CD4 count and an unsuppressed viral load. In cases where people have a CD4 count below 350 they are advised to have three doses of the vaccination.
These vaccinations are given at GP or travel health clinics rather than at sexual health clinics. The vaccination works well in people living with HIV. Everybody who has HIV is recommended to have this vaccine unless they're naturally immune to the infection (a test before vaccination can show this).
People who are at a continued risk are advised to have a booster vaccination after 10 years.
If you've been in close contact with someone with hepatitis A, it’s possible to have an injection of antibodies called human normal immunoglobulin (HNIG) combined with the vaccine. You need to have this within two weeks of exposure to hepatitis A.
A blood test can show present or prior hepatitis A infection. Once you've had hepatitis A you cannot get it again. You should be tested for hepatitis A soon after your diagnosis with HIV to see if you have natural immunity against it (meaning that you've had hepatitis A in the past and your body has cleared it).
You can normally expect to get better without any treatment. NHS Choices recommends the following to help manage symptoms:
Many anti-HIV drugs (as well as medicines used to treat other conditions) are processed using the liver. The liver inflammation that hepatitis A causes can mean that some people need to stop taking their HIV treatment or other medicines when they have hepatitis A. But this needs to be discussed with your doctor.
It's also important to understand how your hepatitis treatment may interact with your HIV medication.
Call our free helpline THT Direct on 0808 802 1221 to get referred to a clinic.
Next: Hepatitis B ››
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This article was last reviewed on
by Anna Peters
Date due for the next review: 31/10/2020
Content Author: S. Corkery (NAM)
Current Owner: Kerri Virani
Hepatitis ANAM Aidsmap
BRITISH HIV ASSOCIATION GUIDELINES ON THE USE OF VACCINES IN HIV POSITIVE ADULTS 2015Prof Anna Maria Geretti; Dr Gary Brook, Central Middlesex Hospital; London Ms Claire Cameron, Public Health England; London Dr David Chadwick, James Cook University Hospital, Middlesbrough; Prof Neil French, University Of Liverpool; Prof Robert Heyderman, University College London; Dr Antonia Ho, University Of Liverpool; Dr Michael Hunter, Belfast Health and Social Care Trust; Dr Shamez Ladhani, Public Health England, London; Dr Mark Lawton, Royal Liverpool University Hospital; Dr Eithne MacMahon, Guy’s & St Thomas’ NHS Foundation Trust & King’s College London; Dr John McSorley, Central Middlesex Hospital, London; Dr Anton Pozniak, Chelsea and Westminster Hospital, London; Dr Alison Rodger, University College London
Hepatitis A - SymptomsNHS Choices
Hepatitis A - CausesNHS Choices
Hepatitis A - TreatmentNHS Choices
Hepatitis A - VaccinationNHS Choices
Hepatitis A outbreak in gay and bisexual men in Europe is growingKeith Alcorn
Hepatitis A outbreaks mostly affecting men who have sex with men – European Region and the AmericasWorld Health Organization
Hepatitis A among gay and bisexual menPublic Health England
Hepatitis ABritish Liver Trust
BHIVA guidelines for the routine investigation and monitoring of adult HIV - 1 - positive individualsBrian Angus, Gary Brook, Funmi Awosusi, Gary Barker, Marta Boffito, Satyajit Das, Lucy Dorrell, Esther Dixon-Williams, Charlotte Hall, Bridie Howe, Sebastian Kalwij, Nashaba Matin, Eleni Nastouli, Frank Post, Melinda Tenant-Flowers, Erasmus Smit, Dan Wheals
Looking after yourselfBritish Liver Trust
Hepatitis vaccinationsLiz Highleyman
Prevention of Hepatitis A, B and C and other Hepatotoxic Factors in People Living with HIV: Clinical Protocol for the WHO European Region WHO: http://www.euro.who.int/__data/assets/pdf_file/0010/78157/E90840_Chapter_8.pdf
NHS – Hepatitis A: http://www.nhs.uk/conditions/hepatitis-a/pages/introduction.aspx
Various people talk about their experiences of living with HIV.
CAB - Citizens Advice Bureau
HIV Drug Interactions
George House Trust
Equality and Human Rights Commission
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