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).

According to the Centers for Disease Control and Prevention (CDC), rates of hepatitis A in the US have decreased 92 percent since the HAV vaccine became available in 1995. Nevertheless, in the US, about 100 people die each year from complications of HAV. People at the highest risk of death from HAV include those with existing liver disease and people over the age of 60.

Worldwide, Hepatitis A outbreaks tend to occur every now and then and are often related to contaminated food or water. According to the World Health Organization (WHO), 1.4 million people become infected with HAV each year.

Hepatitis A does not cause chronic (long-term) illness as do hepatitis B and hepatitis C, and most people who get HAV can expect a full recovery.

There is very little specific information available regarding the effect of hepatitis A on women living with HIV (HIV+). However, research involving HIV+ men suggests that it may take longer for HIV+ people to recover from HAV. Having HAV does not increase a person’s chance of getting HIV.

A blood test for antibodies to HAV is the only way to be certain if someone is infected with hepatitis A. Hepatitis A is an acute disease, which means that symptoms start suddenly and usually last no more than six months.

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, which is just below the right ribcage

Some people who get hepatitis A have no symptoms at all, while others think they have the flu. 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 ten 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 can spread the disease well before they are aware they have it. The incubation period becomes shorter as people get older.

Getting vaccinated for HAV is the best protection against the virus. In the US, 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 (HBV) vaccine.

The HAV vaccine is given in two shots over six months. Some HIV+ people with low CD4 counts may need either a higher dose of these two shots, or additional shots to complete their HIV vaccination. The combination (HAV + HBV) 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, as well as 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 blood clotting disorders (for example, hemophilia), and persons with chronic liver disease (including hepatitis B or C). Children living in regions of the US 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. However, 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. This is called post-exposure prophylaxis, or PEP. 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. In 2007, the CDC changed the US guidelines to allow the use of not only immune globulin but also the Hepatitis A vaccine to prevent infection after exposure in healthy persons aged one to 40 years.

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.