Hepatitis A

Symptoms of hepatitis A

The symptoms of hepatitis A develop around four weeks after you become infected. However, not everyone will experience them.

Symptoms can include:

• feeling tired and generally unwell
• joint and muscle pain
• a high temperature (fever)
• loss of appetite
• feeling or being sick
• pain in the upper-right part of your tummy
• yellowing of the skin and eyes (jaundice)
• dark urine and pale stools
• itchy skin

Symptoms will usually pass within a couple of months.

When to get medical advice

See your GP for advice if:

• you have symptoms of hepatitis A – a blood test can usually confirm if you have the infection
• you might have been exposed to the hepatitis A virus recently but don't have any symptoms
• you think you might need the hepatitis A vaccine – your GP can advise on whether you should have the vaccine

Hepatitis A isn't usually serious. However, it's important to get a proper diagnosis to rule out more serious conditions with similar symptoms, such as:

• hepatitis C
• cirrhosis (scarring of the liver)

Your friends, family and any sexual partners may also need tested in case you've spread the infection to them.

How hepatitis A is spread

Hepatitis A is most widespread in parts of the world where standards of sanitation and food hygiene are generally poor, such as:

• parts of Africa
• the Indian subcontinent
• the Middle East
• Central and South America

You can get the infection from:

• eating food prepared by someone with the infection who hasn't washed their hands properly or washed them in water contaminated with sewage
• drinking contaminated water (including ice cubes)
• eating raw or undercooked shellfish from contaminated water
• close contact with someone who has hepatitis A

Less common ways of becoming infected include:

• having sex with someone who has the infection (this is a particular risk for men who have sex with men)
• injecting drugs using contaminated equipment

Someone with hepatitis A is most infectious from around two weeks before their symptoms appear until about a week after the symptoms first develop.

Treatments for hepatitis A

There's currently no cure for hepatitis A, but it will normally pass on its own within a couple of months. You can usually look after yourself at home.

While you're ill, it's a good idea to:

• get plenty of rest 
• take painkillers such as paracetamol or ibuprofen for any aches and pains – ask your GP for advice about this
• other symptoms such as nausea and itch can also be treated if necessary - speak to your GP
• maintain a cool, well-ventilated environment, wear loose clothing, and avoid hot baths or showers to reduce any itching
• eat smaller meals to help reduce nausea and vomiting
• avoid alcohol to reduce the strain on your liver
• stay off work or school and avoid having sex until at least a week after your jaundice or other symptoms started
• practise good hygiene, such as washing your hands with soap and water regularly 

Speak to your GP if your symptoms are severe or haven't started to improve within a couple of months. They can prescribe medications to help with itchiness, nausea or vomiting, if necessary.

Vaccination against hepatitis A

Vaccination against hepatitis A isn't routinely offered in the UK because the risk of infection is low for most people. It's only recommended for people at an increased risk, including:

• close contacts of someone with hepatitis A
• people planning to travel to places where hepatitis A is widespread, particularly if sanitation and food hygiene are poor
• people with any type of long-term liver disease
• men who have sex with other men
• people who inject illegal drugs

People who may be exposed to hepatitis A through their job including: 

• sewage workers
• staff of institutions where personal hygiene levels may be poor (such as a homeless shelter)
• people working with monkeys, apes and gorillas

The hepatitis A vaccine is usually available for free on the NHS for anyone who needs it.

Outlook for hepatitis A

For most people, hepatitis A will pass within two months with no long-term effects. Once it passes, you normally develop life-long immunity.

For some people with the infection, the symptoms may come and go for up to 6 months before eventually passing. Life-threatening complications such as liver failure are rare with hepatitis A.

People most at risk include:

• those with pre-existing liver problems
• elderly people

If liver failure does occur, a transplant is usually needed to treat it.

• Read more about hepatitis A on the NHS website

More useful links

• How to use your health services