Hepatitis A - sexual health contacts
Hepatitis A virus is passed from person to person through the "faecal-oral" route. This means that minute traces of hepatitis A virus contained in faecal matter on the hands of an infected person make it into the mouth of an uninfected person. Transmission may occur from contaminated food, liquid or eating utensils, or during sex.
The early signs of infection include:
- general aches and pains
- lack of appetite, leading to weight loss
- pain in the abdomen.
Three to 10 days later, signs might include:
- skin and whites of the eyes start to look yellow (jaundice)
- urine may become dark in colour
- faeces can be pale-coloured.
Many of these symptoms can be due to other reasons and therefore are not always caused by hepatitis A. It usually takes about four weeks from contact with the virus until early signs of infection appear.
Hepatitis A can be detected through a blood test. As the symptoms and signs can be caused by other diseases, other tests can be done at the same time.
There is no cure for hepatitis A and patients are advised to:
- drink plenty of fluids
- avoid fatty/oily foods
- avoid alcohol
- go back to their local doctor for a check up and tests to make sure the liver gets better.
Handling the nappies of an infected child can also leave traces of the virus on hands.
The virus can be spread through:
- food or drink prepared by an infected person
- using eating utensils that have been handled by an infected person
- sharing a cigarette or smoking equipment (such as bongs) with an infected person.
- poor personal hygiene
- oral and anal sex (more extreme behaviours such as "rimming" and "fisting" have been linked with outbreaks of hepatitis A).
Touching a condom, penis or even a finger that has been inserted into the anus of an infected person may leave traces of faeces on the hands, which can then get into the mouth transmitting hepatitis A.
Hands should be thoroughly washed after going to the toilet or handling nappies, but even the best hand washing may still leave traces of hepatitis A virus.
People with hepatitis A can pass the infection on to other people. Until at least one week after jaundice develops, they should avoid:
- handling or preparing food for other people
- sharing cigarettes, smoking implements, toothbrushes, food or drinks with other people
- sexual contact.
Condoms should be worn for anal sex and gloves used for digital and/or hand penetration of the anus to reduce the risk of hepatitis A infection. If you are giving a man oral sex (his penis in your mouth), then he should wear a condom. It does not matter whether you are male or female, if you put your mouth in contact with your partner's anus or vulva while having sex, you should use a dental dam.
People in close contact with someone with hepatitis A may be at risk of getting the infection. They should see their doctor to discuss their risk. The risk can be reduced by being vaccinated against hepatitis A or having an injection of immunoglobulin.
Where possible exposure to hepatitis A has occurred, both vaccination and immunoglobulin are effective in reducing the chance of hepatitis A infection only if administered within two weeks of contact with infection.
Vaccination is recommended for people at high risk of coming into contact with the virus, such as:
- travellers, particularly people travelling to areas where hepatitis A is common (Asia, Africa, South Pacific, Central and South America)
- homosexual and bisexual men should be vaccinated if not already immune, as condoms do not protect against this risk
- people who inject drugs.
If you or any member of your family have been diagnosed with hepatitis A, it is important to tell any people with whom you have had close contact, including sexual partners. People at risk of getting hepatitis A through contact with someone with the infection can be given vaccine or immunoglobulin to prevent further spread.
Hepatitis A is an acute (short term) infection most people who become infected with Hepatitis A recover completely. Around 15 per cent of cases have recurrences for up to a year after initial infection.
No chronic infection is known to occur. However, people who already have chronic liver disease at time of becoming infected do have increased risk of dying from serious hepatitis A infection.
For more information on Hepatitis A, you can talk to:
- your local doctor
- your local sexual health clinic
- your local family planning clinic
- Hepatitis Queensland.