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FAQs about Hepatitis A and E

What are hepatitis A and E?

Hepatitis A is typically a self-limited, acute viral infection of the liver. It is an RNA virus that can be found in blood, stool and the liver during the acute phase of the disease. The virus is found in the stool of people who are infected.

The incidence of hepatitis A in the United States has declined substantially over the last decade since vaccination was recommended for persons at increased risk and universal vaccination of infants was recommended in 2006. The majority of infected people will recover without long-term effects. In rare cases, it can cause liver failure.

Like hepatitis A, hepatitis E is both endemic to underdeveloped countries and self-limiting. Recent studies suggest that exposure to hepatitis E is common in the United States, particularly in people who have pets and/or eat liver or other organ meats.

What causes hepatitis A or E?

Hepatitis A and E are spread through contaminated food, water and human waste. Poor personal hygiene, poor sanitation and sexual or intimate contact facilitate viral transmission. Travel to areas with a high incidence of hepatitis A is the greatest risk factor for acquiring hepatitis A in the United States. Intravenous drug use is another risk factor. Developing countries commonly experience water- or food-borne epidemics. Ingestion of contaminated food (especially raw shellfish) and water may provide another route of transmission.  

Who is at risk for hepatitis A or E?

The incidence of hepatitis A varies widely with age, socioeconomic class, geography and other factors. It can occur sporadically or as an epidemic, especially after floods. Travel to endemic areas such as Mexico and Central/South America is the highest risk factor for acquiring hepatitis A in United States.

Hepatitis E is seen mostly in young adults with the highest incidences occurring in people between the ages of 15 of 40.

What are the symptoms of hepatitis A and E?

Hepatitis A and E infection may develop without clinical signs or symptoms, or patients may report nonspecific symptoms that appear for a short time with or without jaundice. When symptoms do occur, they may vary in severity from flu-like symptoms to liver failure. Early in the disease process some patients report arthralgia, fever and rash. Later, patients may experience malaise, fatigue, myalgia, anorexia, weight loss, cough, abdominal pain, jaundice, dark urine and light-colored stools.  

How are hepatitis A and E diagnosed? 

A doctor will diagnose hepatitis A and hepatitis E by asking about risk factors, taking a comprehensive patient history and doing a physical examination. Hepatitis A is diagnosed by a blood test. Hepatitis E is diagnosed by detection of the virus in the blood or stool.

Can hepatitis A and E be prevented? 

Improved hygiene and drinking clean water are the key factors in prevention. Children and high-risk individuals should receive the vaccination for hepatitis A. Others should receive the vaccination if they are travelling to areas where hepatitis A is prevalent.

How are hepatitis A and E treated?

Both forms of hepatitis resolve spontaneously after about four weeks. Doctors will treat symptoms during the course of the virus. Patients are rarely hospitalized unless the disease course is complicated.  

What are the complications of hepatitis A and E? 

Although quite rare, fulminant hepatitis (the most severe form) may be a complication of hepatitis A and E. Even more rarely, patients may progress to severe liver failure, which would require a liver transplant. Pregnant women who get hepatitis A or E are at high risk of severe liver failure. Immunosuppressed people, especially organ transplant recipients, can develop chronic hepatitis E and cirrhosis.

What should people with hepatitis A or E do?

Avoid alcohol, which can harm the liver.