Hepatitis A

Hepatitis A symptoms can be so mild you may not realise you have it, but up to six weeks after infection it can cause mild flu-like symptoms.

You may get diarrhoea, feel sick or very tired or have itchy skin and stomach pain. You may get jaundice, meaning your skin and the whites of your eyes turn yellow, your urine is dark and your faeces (poo) are pale.

Symptoms can last several weeks, taking months to get back to normal.

Someone with hepatitis A is most infectious two weeks before the symptoms appear. The virus lives in faeces and minute traces of it carry the infection on the hands or on food prepared by an infected person. Water can also be contaminated, especially abroad.

The virus needs to get into the mouth to infect someone. This can happen during sex when tiny amounts of faeces get on fingers and into mouths through:

• rimming 
• fingering 
• anal sex without condoms 
• handling used condoms and sex toys that have been in someone else’s anus.

Protect yourself and others

You can protect yourself by getting vaccinated. People at higher risk of hepatitis A are recommended to have a vaccination, eg, close contacts of someone with the infection, gay men, and those travelling to parts of the world where the infection is common. You might be able to get vaccinated for free by your GP or sexual health clinic. The vaccine protects you for 10 years or longer. A vaccine exists that protects against hepatitis A and B.

If you have hepatitis A tell people you live with or have recently had sex with to ask their doctor about having an urgent vaccination. Avoid sex and preparing food for others until told you are no longer infectious.

Although they are not as good as being vaccinated these also cut the risk: 

• avoiding sex that involves contact with faeces 
• using condoms for anal sex 
• washing hands after touching someone’s anus or handling used condoms and sex toys 
• using a latex barrier (like a condom cut into a square) for rimming and latex gloves for fisting.
  

What can I do if I think I have hepatitis A?

Most cases are diagnosed by GPs (family doctors) rather than sexual health clinics and no special treatment is needed. If you recently had sex with someone or share your house with others, they should see a doctor straight away about getting vaccinated to stop them getting infected. Avoid sex and preparing food for others until told you are no longer infectious.

Testing

A blood test will confirm whether you have picked up the virus.

Treatment

Rest is the usual treatment for hepatitis A. You may need several weeks off work and will be advised to avoid alcohol until your liver recovers. Smokers often avoid smoke as it can make them feel sick. Recreational drugs should be avoided to allow your liver to get better. Once you have had the infection you’re immune and can’t get it again, but you can get other types of hepatitis.