Hepatitis A

Hep A | HAV |

Overview

  • Hepatitis A is an acute infection of the liver.
  • Most infections are from contaminated food or water but sexual transmission can occur, especially in men who have sex with men (MSM).
  • Does not cause chronic hepatitis, care is usually symptomatic.

Cause

Hepatitis A virus (HAV), a small single-stranded RNA virus.

Clinical presentation

Symptoms

Incubation period 15-50 days, mean of 28 days

Acute hepatitis: lethargy, nausea, fever, anorexia for a few days then jaundice, pale stools and dark urine

Usually asymptomatic in children, more severe illness in elderly and pregnant women, usually resolves in 1 month

Complications

Liver failure is rare

Diagnosis

TestSite/SpecimenConsideration
AST, ALT, bilirubin

Blood

Raised in acute hepatitis
Anti-HAV IgM

Blood

Acute HAV infection, persists for 3-6 months
Anti-HAV Ig-total

Blood

Previous infection or vaccination

AST – Aspartate aminotransferase
ALT – Alanine aminotransferase
Anti-HAV IgM – Hepatitis A virus IgM antibodies
Anti-HAV Ig-total – Total antibody count (includes IgM, IgG and IgA)

Investigations

Exclude other causes of acute hepatitis, including hepatitis B and hepatitis C.

Management

Principle treatment option
SituationRecommended
Symptomatic infection Supportive care. Hospitalisation if severe illness or clinical deterioration.

Other immediate management

Special treatment situations

Special considerations

Consider seeking specialist advice before treating any complicated presentation.

SituationRecommended
Complicated infection Severe hepatitis may require hospital admission.
Pregnant women 
pregnancy
Seek specialist advice. Severe hepatitis can be more severe in pregnant women.

Contact tracing

See Australasian Contract Tracing Manual – Hepatitis A for more information.

Follow up

Review in 1 week provides an opportunity to:

Auditable outcomes

Last Updated: Wednesday, 11 July 2018