Hepatitis A is a disease caused by the hepatitis A virus (HAV). HAV belongs to the genera Hepatovirus in the family Picornaviridae and can cause a potentially serious inflammation of the liver.
HAV is shed in the feces of an infected person, and the disease spreads through fecal–oral route. You can for instance be infected by eating food that has been prepared by contaminated hands.
Having survived hepatitis A will give you lifelong immunity against hepatitis A, but it will not make your immune to the viruses that causes hepatitis B, C, D and E.
Hepatitis A occurs world wide, but the disease is less common in Western Europe, Canada, United States, Australia and New Zealand. Examples of areas where the disease is very common are Africa, South-East Asia, Mongolia, Greenland, Central America, and certain parts of South America.
Children infected with the hepatitis A virus commonly develop no symptoms or only mild symptoms. In many parts of the world, hepatitis A is a very common childhood disease, and surviving children are immune to the disease. A person that is exposed to the hepatitis A virus for the first time in adulthood is much more likely to develop serious symptoms and require medical care. This is why hepatitis A vaccination is recommended when a person from a country where hepatitis A is rare plans to travel to a country where hepatitis A is common.
Vaccination against Hepatitis A
In the United Kingdom, you are usually recommended to have the hepatitis vaccine if:
- You will travel to a part of the world where hepatitis A is widespread.
- You are or will be in close contact with someone who has hepatitis A.
- You are or will be in close contact with someone who has an increased risk of having hepatitis A but haven’t been tested yet, such as a recently adopted child from a high-risk country.
- You inject illegal drugs, especially if sharing needles with others.
- You have any type of chronic liver disease.
- You are a man who has sex with other men.
- You have an increased risk of hepatitis A exposure at work.
Hap A only or combined vaccine?
There are three main types of hepatitis A vaccination administered in the UK:
- Vaccine against hepatitis A only.
- Combined vaccine against hepatitis A and hepatitis B.
- Combined vaccine against hepatitis A and typhoid fever.
Examples of hepatitis A vaccines available within the UK:
- Ambirix (Hep A + Hep B combined vaccine)
- Avaxim (only Hep A)
- Avaxim (combined vaccine)
- Epaxal (only Hep A)
- Havrix Monodose (only Hep A)
- Havrix Junior Monodose (only Hep A)
- Hepatyrix (Hep A + Typhoid combined vaccine)
- Vaqta Adult (only Hep A)
- Vaqta Paediatric (only Hep A)
- ViATIM (Hep A + Typhoid combined vaccine)
- Twinrix (Hep A + Hep B combined vaccine)
- Twinrix Paediatric (Hep A + Hep B combined vaccine)
Ideally, get your first dose at least three weeks before your need the protection.
If you are in a hurry because you are leaving the country soon, please note that there are some hep A vaccines that can be given up to the day of your departure if necessary.
Contact your GP.
Vaccine for hepatitis A only, combined vaccine for hepatitis A and hepatitis B, and combined vaccine for hepatitis A and typhoid fever are usually available for free on the NHS.
The Hepatitis A vaccine is usually given in the form of two or three injections, following a specific schedule that allow enough days to pass between each injection. The exact number of injections and the recommended amount of time between each injection will vary depending on which vaccine you use (brand and type).
One example of a common vaccination schedule is one initial dose (that provides protection for a year) followed by another dose 6 – 12 months later to ensure at least 30 year long protection. With many hep A vaccines, the second dose will provide long-term protection as long as it is received within 10 years of the first injection.
The injections are usually given in the upper arm for adults. For small children, the upper leg is more common. Older children are injected in the arm, just like adults.
There are hepatitis A vaccines that are approved for pregnant women.
There are hepatitis A vaccines that are approved for breast feeding women.
Side effects of Hepatitis A vaccination
The virus in hepatitis A vaccines is not alive, but certain side effects can occur anyway.
Examples of common side effects of Hepatitis A vaccination
- Swelling, redness and tenderness at the injection site.
- A small painless lump at the injection site.
Examples of less common side effects of Hepatitis A vaccination
- A slightly raised body temperature
- Loss of appetite
- Feeling unwell
About Hepatitis A
Infected children usually develop no symptoms or mild symptoms only.
The incubation period for hepatitis A is usually 2-6 weeks.
An adult infected with hepatitis A virus will typically go through three stages of the disease. In an otherwise healthy individual, the immune system will usually overcome hepatitis A within a few weeks after the first symptoms appeared, and the liver is typically be back to normal within three months. However, fatigue and loss of appetite can linger on for much longer.
Stage 1: This stage typically feels a bit like influenza, with fever, headache, muscleache and fatigue. Stage one will usually last for one week, with the fever subsiding after just four days.
Stage 2: This stage typically consists of a few days of nausea and loss of appetite, sometimes also with vomiting.
Stage 3: During stage three, it will normally become evident that the liver is inflamed and doesn’t work properly. This can manifest in various ways, including yellowing of the skin, yellowing of the eyes, dark urine, clay-colored feces, itchy skin, and pain in the liver region (to the right, below the rib cage).
In rare cases, acute liver necrosis is a complication of hepatitis A. Symptoms of acute liver necrosis include confusion, anxiety and extreme fatigue.
Hepatitis A treatment
There is no specific medical treatment that kills the hepatitis A virus, although general anti-viral medication can be administered in certain circumstances. Hepatitis A treatment is normally focused on handling the symptoms, preventing complications and generally aiding the body as it fights the virus. You may for instance be prescribed anti-itch medication.
When your liver is inflamed, it is very important to stay away from anything that would increase its workload. This includes alcohol and other toxins, both legal and illegal. Even certain over-the-counter medicines, such as paracetamol, should be avoided.