I. Intro

The number of reported cases of hepatitis A has fluctuated over the years. While these numbers dropped by more than 95% from 1995 to 2011, cases increased by 140% from 2011 to 2017. Person-to-person outbreaks jumped in 2017 largely due to drug use and homelessness in certain regions of the country. While there were 3,366 cases of acute hepatitis A infections reported in 2017, the Centers for Disease Control and Prevention (CDC) estimates this number to be 6,700 due to under-reporting. In 2017, reported cases in men increased more than in women, and hepatitis A was listed as the underlying or a contributing cause of death in 91 people in the U.S.

This guide provides basic information on the STD known as hepatitis A. Readers will learn about potential symptoms, which are numerous and vary in severity. The different types of tests used to diagnose hepatitis A will also be reviewed, including what the results of these tests mean. Other information discussed includes treatment options to ease symptoms and the importance of vaccination.

General Information
Formal NameHepatitis A (HAV)
Other Commonly Used NamesHep A
Testing Collection MethodA blood sample drawn from a vein in your arm
Transmission/RiskInjection drug use, person-to-person contact, foodborne outbreaks, sexual/household contact with a hepatitis A patient, international travel to a region where hepatitis A is regularly found, contact with a child/employee in a daycare center, men who have sex with men, homelessness

II. Overview of Hepatitis A Testing

The purpose of a hepatitis A test is to help diagnose a liver infection due to the hepatitis A virus. The Mayo Clinic recommends you get tested if you attend or work in a childcare center or preschool, have a clotting-factor disorder like hemophilia, or you’ve recently:

  • Traveled outside the country, especially to an area with poor sanitation
  • Eaten at a restaurant that reported a hepatitis A outbreak
  • Had sex or sexual contact with someone diagnosed with hepatitis A
  • Been in direct contact with someone diagnosed with hepatitis A, such as a family member, friend, roommate, or caregiver

The National Institute of Health (NIH) also recommends you get tested if you work with primates, including apes, chimpanzees, and monkeys. Getting tested only requires a simple blood test using a blood sample taken from a vein, and there isn’t any preparation required prior to testing.

You can avoid the need for testing through vaccination. Children and adolescents have lower rates of infection due to vaccinations being recommended since 1996. Adults can also lower their risk of hepatitis A infections by getting vaccinated. The CDC recommends that all children get the hepatitis A vaccination at age one. Other people who should get vaccinated include anyone who:

  • Is homeless
  • Uses illegal drugs
  • Plans to travel to countries with a high rate of the virus
  • Engages in male-to-male sex
  • Has an increased risk for infection
  • Has an increased risk for complications from hepatitis A
  • Wants to have immunity to the virus

If you’ve recently been exposed to hepatitis A, you should still get vaccinated. Hepatitis A vaccines are effective in protecting you from the virus even if you get it up to 15 days after you’ve been exposed to the virus.

III. How a Hepatitis A Infection Works

Hepatitis A is spread by eating contaminated food, but it is more commonly caused by close person-to-person contact with someone infected with the virus. Most recently, person-to-person transmission has increased between people who use drugs, people who are homeless, or men who have sex with other men. The CDC’s Division of Viral Hepatitis has been assisting numerous state and local health departments with outbreaks of hepatitis A spread through person-to-person contact since March of 2017.

The only stages of hepatitis A infection are current and previous infection. People who get hepatitis A are in a current stage of infection and may never display any symptoms, but they still have and can spread the virus. If you do experience symptoms, you are actually most contagious before symptoms appear. Symptoms may be mild and last a few weeks, or they may be severe and last several months. In rare cases, death may occur, but most people fully recover without any lasting damage to the liver. Once you’ve had hepatitis A, you’re in the previous infection stage, which includes a lifelong immunity to reinfection.

There are several variations of viral hepatitis, besides hepatitis A. The two most common types are hepatitis B and C, both of which are more serious than hepatitis A. Rare forms of the virus include hepatitis D and E, but both of these variations are very uncommon in the United States. Noninfectious variations of hepatitis also exist and can be caused by drinking too much alcohol, abusing or overdosing on medications, exposure to certain chemicals or poisons, or an autoimmune disorder.

IV. The Symptoms of Hepatitis A

Many people who get hepatitis A never have any symptoms or symptoms are so mild, they don’t realize they have the virus. Older people are more likely to suffer symptoms than children. If hepatitis A symptoms do occur, they typically appear about four weeks after you’ve been exposed to the virus. However, symptoms may occur as early as two weeks or as late as seven weeks. Some of the most common symptoms include:

  • Abdominal pain
  • Dark brownish urine
  • Diarrhea
  • Fatigue
  • Fever
  • Gray-colored stools
  • Jaundice (yellow skin or eyes)
  • Joint pain
  • Loss of appetite
  • Nausea
  • Rash
  • Vomiting

Symptoms aren’t usually severe and go away on their own. However, you should contact your doctor or a healthcare professional if your nausea and vomiting don’t improve in one or two days. Severe vomiting can lead to dehydration, which can become life-threatening. You should also seek medical care if your symptoms include jaundice, pain in the belly, or dark-colored urine. If you can’t reach your doctor and you have severe pain and/or high fever, become confused or delirious, or find it difficult to wake up, go to the emergency room.

V. Testing for Hepatitis A

If you’ve been exposed to hepatitis A or have symptoms that indicate you may have hepatitis A, your doctor can determine whether you have the virus through testing. Diagnosis starts with a series of questions about your symptoms and whether you’re at risk of exposure. Your doctor may then order a blood test after taking a blood sample from a vein.

Hepatitis A tests evaluate your blood for HAV antibodies produced by your body in response to this viral infection. There are a few versions of the test to detect different classes of hepatitis A antibodies, including:

  • HAV IgM antibody tests look for the first antibody produced by your body following exposure to hepatitis A. This test is used to detect early or recent hepatitis A infections or make a diagnosis when you have symptoms.
  • HAV IgG tests detect the antibodies that develop later and may show up even if you don’t currently have the virus. A positive result on this test may simply mean you previously had the virus, or you have developed immunity due to a previous infection or vaccination.

A total antibody test includes both tests. Besides testing for current infection, your doctor may ask for an HAV IgG test to see whether you should be vaccinated or if you’re already immune. You can also find walk-in laboratories, health clinics, STD testing sites, and other health care facilities that provide testing for hepatitis A

VI. Treatment for Hepatitis A

Like any form of hepatitis, your liver becomes swollen when you have hepatitis A. However, unlike hepatitis B and C, hepatitis A doesn’t cause chronic or ongoing disease. Hepatitis A typically goes away on its own, and your liver completely heals without any long-term damage. Therefore, there isn’t a specific treatment for hepatitis A or specific medications to cure the infection. If you do receive treatment, the purpose is to relieve symptoms, avoid dehydration, and prevent passing your infection onto others.

Unless you have severe symptoms, you can usually treat yourself at home. To help you feel better, you should:

  • Take it easy and get plenty of bed rest
  • Prevent dehydration by drinking plenty of clear liquids
  • Avoid alcoholic beverages that make your liver inflammation worse
  • Avoid medications that may cause liver damage, such as pain relievers and fever reducers
  • Contact your doctor if your symptoms become worse

If you do require medical treatment, your doctor may:

  • Prescribe medications to relieve severe nausea and vomiting
  • Prescribe IV fluids to prevent dehydration
  • Hospitalize you if you’re extremely confused or difficult to wake up

Symptoms typically last less than two months, but it may take up to six months to fully recover. Once you’ve had hepatitis A, you develop a lifelong immunity, and it’s unlikely you’ll get the disease again. The hepatitis A vaccine is the best way to prevent infection from occurring and has been shown to provide up to 95% protection in healthy people for up to 11 years. If you’re unvaccinated and have been exposed to hepatitis A in the last two weeks, it’s recommended you receive postexposure prophylaxis right away.

VII. Frequently Asked Questions

How is the hepatitis A test used?

Currently, there aren’t any at-home test kits available for hepatitis A. However, you can order tests online. Once you place and pay for your order, you must then visit one of the labs that run tests for the company you purchased your test from. Your blood sample is taken at the lab, and the results are usually available online and typically with a few days. You can also usually schedule a test with your regular doctor or other health care facility, but test results through traditional providers become part of your permanent medical record. Tests ordered online generally don’t go through your insurance, so testing and results are private.

How can you order a hepatitis A test?

You can’t currently order a hepatitis A test to take at home, but you can schedule one with your doctor or with many walk-in laboratories, health clinics, STD testing sites, and other health care facilities. While you can order a test online, the company doesn’t send you a test kit to do at home. Instead, you pay for the test and go to a walk-in laboratory to have the sample drawn and tested. Results are usually available quickly, within days.

What does a positive result for hepatitis A mean?

Because there are two different tests for hepatitis A, positive results can mean different things, including:

If you test positive for the HAV IgG antibody and negative for the HAV IgM antibody, you don’t have an active infection, and you are immune to hepatitis A infection due to a previous infection or vaccination.

If you test positive for the HAV IgG antibody and you weren’t tested for the HAV IgM antibody, you’ve been exposed to hepatitis A either through infection or vaccination, and it may mean you currently have an acute hepatitis A infection.

If you test positive for the HAV IgM antibody, you have an acute or recent hepatitis A infection, even if you test negative or positive for the HAV IgG antibody or this test wasn’t administered.

What does a negative result for hepatitis A mean?

If both your HAV IgM antibody test and your HAV IgG antibody test come back negative, you don’t have a current or previous hepatitis A infection, and you have no immunity to the virus, meaning you’ve never received a vaccination. However, if you test negative on your HAV IgM antibody test and positive on your HAV IgG antibody test, you don’t have a current infection, but you do have immunity due to a previous infection or vaccination.

What’s important to know about hepatitis A?

After you’ve been infected with hepatitis A, you have permanent immunity, and it would be extremely rare for you to get it again. The best way to prevent ever getting hepatitis A is to be vaccinated. Hepatitis A vaccines are effective even when given up to 15 days after exposure to the virus, so it may not be too late to get one. The hepatitis A virus can survive outside the body for months.

How long does it take to get results from a hepatitis A test?

The length of time it takes to receive your hepatitis A test result varies, depending on where you get tested and the type and location of the laboratory used. Many walk-in laboratories only take one to three days to send your results, but other facilities that must mail your test to an outside laboratory may need a few weeks before your results are available.

VIII. Additional Resources

IX. Sources