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What is Hepatitis A?

hepatitis

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.

What are the symptoms of hepatitis A?

Some people have hepatitis A with no symptoms. According to NHS Choices, common symptoms can include:

  • tiredness
  • yellowing of the skin and eyes (known as jaundice)
  • pale stools
  • dark urine
  • nausea and vomiting
  • itchy skin
  • appetite loss
  • fever
  • joint and muscle pain.

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.


How is hepatitis A transmitted?

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.


How can infection with hepatitis A be prevented?

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):

  • wash your hands (ideally also your buttocks, groin and penis) after sex
  • use a condom during sex, changing them if switching between anal and oral sex
  • don’t share sex toys
  • use protection if you’re fingering, fisting or rimming someone.

The hepatitis A vaccination

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.


Post-exposure prophylaxis after hepatitis A exposure

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.


How is hepatitis A diagnosed?

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).


Can hepatitis A be treated?

You can normally expect to get better without any treatment. NHS Choices recommends the following to help manage symptoms:

  • get plenty of rest
  • eat a healthy, balanced diet
  • smaller, lighter meals can help with feeling sick
  • if you feel itchy keep cool, wear loose clothing and avoid hot baths and showers
  • avoid alcohol
  • paracetamol and ibuprofen can help relieve the pain but check with your doctor first because if you have any liver damage you'll probably advised not to.

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.


More help:

Call our free helpline THT Direct on 0808 802 1221 to get referred to a clinic.


Next: Hepatitis B ››

 

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The Information Standard: Certified member

This article was last reviewed on 31/10/2017 by Anna Peters

Date due for the next review: 31/10/2020

Content Author: S. Corkery (NAM)

Current Owner: Kerri Virani

More information:

Hepatitis A
NAM Aidsmap
April 2015

BRITISH HIV ASSOCIATION GUIDELINES ON THE USE OF VACCINES IN HIV POSITIVE ADULTS 2015
Prof 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 - Symptoms
NHS Choices
April 2016

Hepatitis A - Causes
NHS Choices
April 2016

Hepatitis A - Treatment
NHS Choices
April 2016

Hepatitis A - Vaccination
NHS Choices
April 2016

Hepatitis A outbreak in gay and bisexual men in Europe is growing
Keith Alcorn
NAM Aidsmap
July 2017

Hepatitis A outbreaks mostly affecting men who have sex with men – European Region and the Americas
World Health Organization
June 2017

Hepatitis A among gay and bisexual men
Public Health England
June 2017

Hepatitis A
British Liver Trust
2017

BHIVA guidelines for the routine investigation and monitoring of adult HIV - 1 - positive individuals
Brian 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
2016

Looking after yourself
British Liver Trust

Hepatitis vaccinations
Liz Highleyman
NAM Aidsmap
April 2015

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