Hepatitis A

The infection is spread by contact with infected human faeces (stools, excrement, shit). Contaminated food and water are often common sources of infection, but it can be spread during sex, especially by rimming (oral-anal contact).

Good personal hygiene can prevent the transmission of hepatitis A – washing your hands after going to the toilet and before preparing or eating food.

There is a vaccine against hepatitis A. This involves two injections, given six months apart, and gives immunity for about ten years. These vaccinations are given at GP or travel health clinics rather than at sexual health clinics. The vaccination works well in people with HIV, although people with a low CD4 count (under 200) may need to have an injection of antibodies called immunoglobulin at the same time, or be revaccinated once their CD4 count has increased. Everybody who has HIV is recommended to have this vaccine unless they are naturally immune to the infection (a test before vaccination can show this). It is particularly recommended that people who also have hepatitis B or C be vaccinated against hepatitis A.

If you have been in close contact with someone with hepatitis A, or you need protection from hepatitis A before travelling but don’t have time for the vaccination, you can have an immunoglobulin injection for short-term protection. You need to have this within two weeks of exposure to hepatitis A.

Diagnosis

 
A blood test can show present or prior hepatitis A infection. Once you've had hepatitis A you cannot get it again.

Some people have no symptoms of hepatitis A. But symptoms can include tiredness, a yellowing of the skin, pale stools, diarrhoea, nausea and vomiting. 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.

You can normally expect to get better without any treatment. It is helpful to rest, eat a healthy, balanced diet and avoid alcohol and drugs processed through the liver, such as paracetamol.

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 treatment 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. Find out more about HIV drug interactions.