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Hepatitis A virus (HAV)
is one of several viruses that specifically target the liver. Infection with
HAV generally leads to a self-limited illness that causes temporary liver inflammation (damage to cells) but does not require specific
treatment. However, in rare cases, the infection may result in a more serious
illness, leading to liver failure (loss of liver
functions) or death. As many as 30% of individuals in the United States have
evidence of past infection with the virus. The virus is found in the feces
of infected persons and is most commonly transmitted through person-to-person
contact and through the ingestion of water or food that has been contaminated
with feces from infected individuals. Infection with HAV is more common in
developing countries where poor hygiene may be more common. The July 13, 2005,
issue of JAMA includes an article about trends in
HAV infection in the United States over the past decade.
Nausea, vomiting, and diarrhea
Dark or cola-colored urine
Liver pain (pain in the upper right area of the abdomen)
Jaundice (yellowing of the skin and the
In addition to a complete medical history and physical examination,
your doctor will order blood tests to detect HAV infection and to measure
liver function. Your doctor may also order blood tests to look for hepatitis B virus and hepatitis C virus (see
below) infection because these viruses can cause similar symptoms.
Routine vaccination against HAV is currently recommended for children
older than 2 years living in states with particularly high rates of HAV infection.
Vaccination is also recommended for any person with an increased risk of becoming
infected with HAV, including travelers to countries where HAV is common, persons
who use illegal drugs, and men who have sex with men. It is also important
to contact your doctor if you think you may have been exposed to someone with
the virus because a special type of immunization is available that may prevent
the infection from developing.
Unlike HAV infection, infection with the other hepatitis viruses can
cause chronic (long-lasting) infection leading to cirrhosis (liver scarring) and liver cancer.
Hepatitis B is transmitted through contact
with the blood of an infected person, which can occur through sexual contact,
mother-to-baby transmission, illegal drug use (with contaminated needles or
other drug injection equipment), or through the receipt of contaminated blood
or blood products (although this is very rare now in the United States). Vaccination
is available against this virus and is recommended for all newborns.
Hepatitis C is also transmitted through
contact with the blood of an infected person, which can occur during illegal
drug use or other use of contaminated needles, sexual contact, mother-to-baby
infection, or through the receipt of infected blood or blood products.
American Liver Foundation800/GO-LIVER (465-4837)http://www.liverfoundation.org
National Institute of Diabetes and Digestive and Kidney Diseases800/891-5389 http://www.niddk.nih.gov
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. A previous Patient Page on hepatitis B infection was published in
the November 10, 1999, issue; and one on hepatitis C infection was published
in the May 14, 2003, issue.
Source: National Institute of Diabetes and Digestive and Kidney Diseases
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. To purchase bulk reprints, call 718/946-7424.
TOPIC: INFECTIOUS DISEASES
Ringold S, Lynm C, Glass RM. Hepatitis A Virus. JAMA. 2005;294(2):270. doi:10.1001/jama.294.2.270