Hepatitis A - sexual health contacts

Quick facts:

  • Hepatitis A is passed from person to person via the faecal-oral route.
  • Worldwide, most infections result from exposure to contaminated water or food.

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 some forms of sexual activity.

Signs and symptoms

The early signs of infection include:

  • general aches and pains
  • fever
  • sweats
  • nausea
  • vomiting
  • diarrhoea
  • lack of appetite, leading to weight loss
  • pain in the abdomen.

Three to ten 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 may be caused by other conditions. It usually takes about four weeks from contact with the virus until early signs of infection appear.

Treatment

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 specific treatment for hepatitis A and patients are advised to:

  • rest
  • drink plenty of fluids
  • avoid fatty/oily foods
  • avoid alcohol
  • go back to their local doctor for a medical review to make sure the liver gets better.
Recovery from symptoms following infection may be slow and can take several weeks or months.

    Transmission

    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
    • Oral and anal sex (practices such as rimming and fisting have been linked with outbreaks of hepatitis A)
    • Handling the nappies of an infected child can also leave traces of the virus on hands.
    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.

    Prevention

    Good personal hygiene is one of the most effective ways to protect yourself and others. Hands should be thoroughly washed after going to the toilet, handling nappies or sexual contact that might expose someone to faeces, 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.

    To reduce the risk of hepatitis A transmission, condoms or dental dams should be used for anal and oral sex and disposable gloves used for digital and/or hand penetration of the anus.

    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)
    • gay, bisexual and other men who have sex with men should be vaccinated if not already immune
    • people who inject drugs.

    Control
    If you or any member of your family have been diagnosed with hepatitis A, it is important to tell all 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 a vaccine or immunoglobulin to prevent further spread.

    Health outcome

    Hepatitis A is an acute infection and 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 (persistent for a long time or constantly recurring) 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.

    Help and assistance

    Get qualified health advice 24/7 for the cost of a local call 13 HEALTH (13 43 25 84).

    This factsheet provides general information and is not intended to replace the need to see a health professional or have a sexual health check. For more information on hepatitis A or sexual health please talk to a healthcare provider. A doctor, nurse or health worker can assist with:

    • providing appropriate tests, treatment and information about how to prevent blood borne viruses and STIs
    • helping people to ensure that their sexual partners get tested and treated.

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