Hepatitis A

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The Hepatitis A virus can cause liver infection. It is spread by food and water contaminated with human faeces (poo), poor hand washing, sex, or contact with someone who is already infected. In most people the disease is not serious, but in rare cases it can cause liver failure and death. Most people who catch hepatitis A make a full recovery within a couple of months, and afterwards have lifelong immunity from the disease.

Hepatitis A is most common in parts of the world without access to clean water and good sanitation (such as parts of Africa, the Indian subcontinent, the Far East, the Middle East, Central America and South America). It is not common in the UK, but some groups are at increased risk. This includes men who have sex with men and drug users who inject drugs, as well as people who travel to countries where the disease is common.

In Europe and the UK there is currently an increase in the number of cases of hepatitis A, mainly among men who have sex with men. Over 60% of UK cases so far have been in London. Public Health England is encouraging gay and bisexual men to practice good personal hygiene and ask about hepatitis A vaccination at their sexual health clinic appointments.


Some people, particularly young children, may not show any symptoms.

Symptoms of hepatitis A develop about four weeks after becoming infected, and they can come and go for up to six months. Other serious liver conditions can have similar symptoms.

Initial symptoms last from a few days to a couple of weeks. They can include:

  • feeling tired and generally unwell
  • joint and muscle pain
  • fever (usually no higher than 39°)
  • headache, sore throat and cough
  • loss of appetite or sickness
  • constipation or diarrhoea
  • pain in the upper-right part of the stomach
  • an itchy rash (hives)

Symptoms which develop later can include:

  • yellowing of the skin and eyes (jaundice)
  • dark urine and pale stools
  • itchy skin
  • swelling and tenderness in the upper-right part of the stomach

In rare cases (fewer than 1 in 250 people) hepatitis A can lead to liver failure. Signs of liver failure can include:

  • sudden and severe vomiting
  • bruising or bleeding easily (for example, nosebleeds or bleeding gums)
  • becoming irritable, drowsy or confused
  • problems with memory and concentration


The hepatitis A virus is passed on through contact with faeces (poo). In countries where there is no clean running water, people can catch the disease by drinking contaminated water, or eating food prepared by someone with hepatitis A who has not washed their hands properly. You can also catch hepatitis A if you have close contact with someone who has the disease.

Sometimes it is possible to catch hepatitis A by having sex with someone who has the disease. This is particularly a risk for men who have sex with men. It can also be passed on by injecting drugs using contaminated equipment.

Infection does not always cause symptoms, so it is possible to carry and pass on the disease without being aware of having it.


There is a vaccine that gives protection against the hepatitis A virus. In the UK it is available free of charge to people at a high risk of infection. It is also usually available free of charge as a travel vaccine. This is because of the public health risk of bringing the disease back to the UK.


Page last updated Thursday, March 22, 2018