Hepatitis A

What is hepatitis A and how common is it?

Hepatitis A (also known as ‘hep A’ or ‘HAV’) is an inflammation of the liver caused by the hepatitis A virus. Worldwide, approximately 1.4 million cases of hepatitis A are reported each year. Sub-Saharan Africa, India, south-east Asia, and South America have the highest prevalence of hepatitis A. Rates of hepatitis A in the UK are low.

How is hepatitis A transmitted?

Hepatitis A is transmitted through the faecal-oral route. The virus has to be present in faeces (poo) and get into your mouth. This can happen through:

• Close person-to-person contact with an infected person
• Sexual contact with an infected person
• Eating contaminated food (e.g. shellfish, unwashed fruit and vegetables) or drinking contaminated water

Anyone who has not been vaccinated or previously infected can get infected with the hepatitis A virus. In areas where the virus is widespread (high endemicity), most hepatitis A infections occur during early childhood.

What are the symptoms of hepatitis A?

Symptoms of hepatitis A range from mild to severe and can include fever, malaise, loss of appetite, diarrhoea, nausea, abdominal discomfort, dark-coloured urine and jaundice (yellowing of the skin or eyes). Not everyone who is infected will have all the symptoms.

How is it hepatitis A diagnosed?

Hepatitis A is diagnosed by a blood test. A blood test can also detect if a person has immunity or has had hepatitis A in the past.

How is it hepatitis A treated?

There is no specific treatment for hepatitis A. Recovery from symptoms following infection will happen spontaneously but in some cases may be slow and can take several weeks. It is important to avoid unnecessary medications that can adversely affect the liver, e.g. paracetamol, and consider lifestyle modifications such as avoiding alcohol.

Hospitalisation is rare but may be necessary in cases with extreme fluid loss from vomiting or diarrhoea. This is more likely in in older patients and those with pre-existing liver disease.

Vaccination for hepatitis A

Who is eligible for hepatitis A vaccination?

• Men who have sex with men (MSM)
• Gender diverse individuals
• People living with HIV
• People with pre-existing liver disease e.g. hepatitis B or hepatitis C

Recently, there have been large outbreaks of hepatitis A in Europe within MSM communities. We therefore recommend hepatitis A vaccination for all MSM. Clinics in some parts of the country can offer a combined vaccine for hepatitis A and hepatitis B, this is not currently available at Brighton and Hove SHAC where these vaccinations are given separately.

How do I book an appointment for a hepatitis A vaccination?

If you attend as a new patient and are eligible for hepatitis A vaccinations, we will do a blood test at your first appointment to see if you already have immunity to hepatitis A. If you don’t already have immunity to hepatitis A, we will contact you to let you know your results by text, with a message that says ‘your results show you have no immunity to hepatitis A’. Vaccinations can be given at routine sexual health appointments where needed. If you receive this text, or if you believe you might be at risk of hepatitis A infection, are eligible and have not been previously tested or vaccinated please call us to book an appointment on 01273 523 388.

Phone line opening times:

*Phone lines are closed on Bank Holidays

What is the vaccination schedule?

A full vaccination course consists of 2 vaccines ideally given 6 to 12 months apart. Even when the second dose is delayed for up to 3 years successful boosting occurs, so the course does not need to be re-started.

Are there any side effects?

Hepatitis A vaccinations are generally very well tolerated. Some people experience temporary redness of the skin at the injection site.

How does the vaccine work?

Hepatitis A vaccines contain dead (inactivated) hepatitis A virus that stimulates an immune response. This causes your body’s immune system to produce antibodies to hepatitis A. When there are enough of these antibodies, you are protected against the infection. The majority of people will develop an immune response (protection) after vaccination so we do not need to test for this.

The exact duration of protection against hepatitis A virus infection after two vaccinations is unknown. However, many reports suggest protection from the vaccine lasts at least 10 years.

Hepatitis A vaccination for travel and occupational risk

Please note we are funded to provide hepatitis A vaccinations for the purpose of preventing the sexual transmission of the virus. If you want a hepatitis A vaccine for travel or because of the job you do, we are unfortunately unable to provide this at Brighton and Hove SHAC.

Hepatitis A vaccination is often recommended as a travel vaccine for many countries and is available for free from your GP. Vaccinations can also be booked via travel vaccine clinics and many pharmacies. More information about hepatitis A for travellers can be found at TravelHealthPro.

Occupational health services and GP surgeries may provide hepatitis A vaccination if you are at occupational risk, for example people who work with untreated sewage.