Hepatitis is an inflammation, or swelling, of the liver. Alcohol, drugs (including prescription medications), poisons, and some viruses can all cause hepatitis. Hepatitis A is a liver disease caused by the hepatitis A virus (HAV).

Up to one-third of Americans show signs of past infection with HAV and approximately 90,000 new infections occur yearly. Fortunately, if you have had HAV once, you can never get it again.

Hepatitis A does not cause chronic illness as do hepatitis B and C and most people who contract HAV can expect a full recovery. Nevertheless, in the U.S., approximately 100 people die each year because of complications of HAV. People who are at the highest risk of death from HAV include those with existing liver disease and people over the age of 50.

There is very little specific information available regarding the effect of hepatitis A on HIV+ women. There is, however, a study of HIV+ men suggesting that it may take longer for HIV+ people to recover from HAV.

Hepatitis A may cause no symptoms at all when it is contracted. A blood test is the only way to be certain if someone is infected.

Signs of HAV include:

• Jaundice (yellowing of the skin, eyes, and mucous membranes)
• Dark-colored urine
• Stool that appears pale and clay like
• Fatigue
• Loss of appetite
• Nausea
• Diarrhea
• Fever and chills
• Vomiting
• Pain in the liver area

There is currently no treatment for HAV, however rest and proper nutrition can relieve some of the symptoms. It usually takes about two months to recover, but up to 15 percent of people may have a longer or relapsing course that could last up to six months.

The time between exposure to HAV and the development of symptoms is called the incubation period. The incubation period for HAV ranges from 20 to 50 days. This means that infectious people, such as food handlers or children, can spread the disease well before they are even aware they have it. The incubation period becomes shorter with increasing age.

Getting vaccinated for HAV is the best protection against the virus. In the U.S., the HAV vaccine is licensed for use in people over two years old. The HAV vaccine is safe for use by HIV+ people. You can also get a combined hepatitis A and hepatitis B vaccine.

The HAV vaccine is given in two shots over six months. The combination vaccine requires three shots over six months. It is important to follow through and get all your shots in order to be fully protected.

The vaccine is recommended for HIV+ people, especially for those who live in or are traveling to areas with high rates of HAV. It is also recommended for men who have sex with men, injecting and non-injecting drug users, persons with clotting-factor disorders (for example, hemophilia) and persons with chronic liver disease (including hepatitis B or C). Children living in regions of the U.S. with high rates of HAV should also be immunized.

It is not yet known if the HAV vaccine is a safe option for pregnant or breast-feeding women, but because the vaccine is made from inactivated (killed) HAV virus, the risk to the fetus is expected to be low. The risk of vaccination should be weighed against the risk for exposure.

After a non-immunized person has been exposed to HAV, giving an injection of immune globulin can prevent infection. Immune globulin contains antibodies against HAV, which provide short-term protection against infection. Immune globulin can be given before and within 2 weeks after coming in contact with the virus, and is a safe vaccine alternative for pregnant and breast-feeding women.

Good personal hygiene and proper sanitation can also help prevent HAV. Always wash your hands with soap and water after using the bathroom, changing a diaper, and before preparing and eating food. Always thoroughly wash fresh fruits and vegetables with clean water before eating.

1

Ida, S., et. al. (2002). Influence of human immunodeficiency virus type 1 infection on acute hepatitis A virus infection. Clinical Infectious Diseases 34(3): 379-385.