Hepatitis A (Hep A)

Medically Reviewed by Poonam Sachdev on January 31, 2024
7 min read

Hepatitis A, also called hep A, is a contagious liver infection caused by the hepatitis A virus. Some people have only a mild illness that lasts a few weeks. Others have more severe problems that can last months. 

The hepatitis A virus usually isn’t dangerous. Almost everyone who has it gets better. But because it can take a while to go away, you’ll need to take care of yourself in the meantime.

Hepatitis A vs. B vs. C

These are all caused by different viruses. The hepatitis B virus spreads through syringes, blood, and other bodily fluids. If you have it when you're pregnant, you can pass it to your baby. It's more serious than hepatitis A. It can cause long-term damage to your liver and may lead to cirrhosis or liver cancer. Hepatitis C is spread through infected blood or to a baby during childbirth. It also can lead to long-term liver problems.

Hepatitis A is very contagious and can spread through either of these two ways:

  • Person-to-person contact. You might get hepatitis A if you have sexual contact with someone who has it, use street drugs with them, or care for someone who is ill with the disease. 
  • Contaminated food or drink. Food-borne cases of hepatitis A are most common in countries that have more cases of the disease. The contamination can happen at any stage as the food is grown, processed, handled, or even cooked. Food or drinks might be exposed to the poop of someone with hepatitis A in the ground or somewhere else along the line. Or someone with hepatitis A might handle your food or drink and contaminate it.

If you have this infection, the virus is causing inflammation in your liver. Some people, especially many children, don’t have symptoms. Others might have:

  • Jaundice (yellow eyes and skin)
  • Belly pain
  • Dark urine
  • Loss of appetite
  • Upset stomach
  • Vomiting
  • Itching
  • Pale-colored poop
  • Joint pain
  • Fever
  • Diarrhea
  • Fatigue

These problems tend to go away after about 2 months but might keep coming back for up to 6 months.

You can spread the hepatitis A virus even if you feel fine. You can also spread it about 2 weeks before your symptoms appear and during the first week after they show up.

You can catch the disease by drinking water or eating food that's been contaminated by someone with the virus. You can also get hepatitis A if you:

  • Eat fruits, vegetables, or other foods handled or prepared by a person who has the virus
  • Eat raw shellfish harvested from water where the virus lives
  • Swallow contaminated ice
  • Have sex with someone who has it
  • Touch your mouth after touching a contaminated object

You could be at higher risk of getting the disease if you:

  • Have close contact with someone who's infected
  • Travel to countries where hepatitis A is common
  • Are homeless
  • Use recreational drugs, even without needles
  • Have a blood clotting disorder such as hemophilia
  • Work with primates
  • Have HIV

Also, the following individuals are at higher risk for hepatitis A:

  • Men who have sex with men
  • Kids in childcare and their teachers

Your doctor will first ask about your symptoms and check for high levels of liver enzymes in your blood. Then, you'll have blood taken for testing to look for hepatitis antigens and antibodies.

Antigens are substances in the hepatitis virus. Antibodies are substances your immune system makes to fight off the virus. There are two types:

  • IgM (immunoglobulin M) antibodies. Your body makes these when you’re first exposed to hepatitis A. They stay in your blood for about 3-6 months.
  • IgG (immunoglobulin G) antibodies. These show up after the virus has been in your body for a while. You may have them all your life. They protect you against hepatitis A. If you test positive for them but not for IgM antibodies, it means you had a hepatitis A infection in the past or had vaccinations to protect against it.

No medication can get rid of the hepatitis A virus once you have it. Your doctor will treat your symptoms (they may call this supportive care) until it goes away. They’ll also do tests that check how well your liver is working to be sure your body is healing like it should.

You can take these steps to make yourself more comfortable:

  • Get some rest. You’ll probably feel tired and sick and have less energy than usual.
  • Try to keep food down. The nausea that sometimes comes with hepatitis A can make it tough to eat. It may be easier to snack during the day than to eat full meals. To make sure you get enough nutrients, go for more high-calorie foods and drink fruit juice or milk instead of water. Fluids will also help keep you hydrated if you’re throwing up.
  • Avoid alcohol. It’s harder for your liver to handle medications and alcohol when you have the virus. Plus, drinking can lead to more liver damage. Tell your doctor about any medications you take, including over-the-counter drugs, as these might also hurt your liver.

The virus usually doesn't cause any long-term problems or complications. If you're elderly or have existing liver problems, there's a small risk hepatitis A will cause sudden liver failure. You'll have to spend time in the hospital and might need a liver transplant. This is a rare complication.

The vaccine to prevent it is about 95% effective in healthy adults and can work for more than 20 years. In children, it’s about 85% effective and can last 15-20 years.

Experts recommend that certain people get vaccinated:

  • Travelers to countries with more hepatitis A infections
  • Children aged 13-23 months
  • Children and adolescents aged 2-18 who did not previously receive a vaccine
  • Families adopting children from countries where the virus is common
  • Men who have sex with men
  • People who have a blood clotting problem
  • Those experiencing homelessness
  • People who have direct contact with a person with the virus
  • People who use recreational drugs
  • People who have long-term liver disease
  • Anyone else who wants to be protected against the virus

The hepatitis A vaccine includes two injections 6 months apart. A combination vaccine for hepatitis A and B has three shots over 6 months.

Where to get a hepatitis A vaccine

You may be able to get the vaccine from your doctor, a local pharmacy, or your county health department. The Department of Health and Human Services has a website with advice and links for finding vaccines.

Hepatitis A vaccine schedule

Children need two doses of the vaccine. The first is given between the ages of 12 and 23 months. The second is given between the ages of 2 and 4 years.

Adults also need two doses. They are given 6-18 months apart.

Hepatitis A vaccine price

How much you'll pay for the vaccine depends on many factors, including your insurance coverage. Medicare covers the entire cost of hepatitis A vaccines. If your child is covered by Medicaid, the vaccine is free. Under the Affordable Care Act, you may be able to get the vaccine at no cost. The out-of-pocket cost with no insurance can be around $125 per dose.

Hepatitis A vaccine side effects

It's unlikely you'll have serious side effects from the hepatitis A vaccine -- they're very rare. You might have mild side effects, including:

  • Fever
  • Headache
  • Tiredness
  • Soreness or redness at the injection spot

If you’re going to a country where hepatitis A is common and you’ve never had the virus or the vaccine, start the vaccination process as soon as you can. It takes 2-4 weeks after the first dose for the vaccine to work, but even one shot a few days before you leave will give you some protection.

People who are allergic to something in the vaccine and children younger than 6 months might instead get a shot of immune globulin (IG), which will protect against hepatitis A for up to 2 months.

The vaccine is your best defense. If you come into contact with someone who has hepatitis A, you can get the vaccine or an IG shot within 2 weeks for some protection.

Good hygiene is also important. Always wash your hands with soap and water after using the bathroom, before and after handling food, and after changing a diaper.

When you travel to a place with poor sanitation, don’t drink tap water or eat raw food.

When you have hepatitis A, take these steps to avoid giving it to others:

  • Avoid all sexual activity.
  • Wash your hands after you use the bathroom or change diapers.
  • Don’t prepare food for other people.

Once you're exposed to hepatitis A, the incubation period, which is the duration between exposure to the virus and the onset of symptoms, averages about 28 days. 

Some people start to feel sick in as little as 15 days. Others might not have symptoms until 50 days after they've been exposed.

Hepatitis A is a viral infection that affects your liver. The effects usually aren't as long-lasting or serious as other types of hepatitis. You pick up the virus either by contact with someone who has it or by eating or drinking something contaminated by the virus. There's no specific treatment for the virus itself, but you can take steps to ease the symptoms. A vaccine is available and recommended for children and certain adults.

Is hepatitis A an STD?

Hepatitis A can be spread by sexual contact, but that's just one of many ways you can become infected with the virus. A lot of people get it from contaminated food or drinks.

Is hepatitis A curable?

There's no cure for hepatitis A. Your doctor will help you manage your symptoms while the virus runs its course. Most people don't have long-term effects from the disease.

What is the survival rate of hepatitis A?

Almost everyone who gets hepatitis A recovers within a few months. In rare cases (usually involving older people or those who already have liver problems), it can lead to liver failure and death.