Hepatitis A Virus (HAV): Quick Reference Guide for Health Care Professionals

Download PDF version formatted for print:
Hepatitis A Virus (HAV): Quick Reference Guide for Health Care Professionals (PDF)

Report hepatitis A (HAV) infection (positive anti-HAV IgM) to the Minnesota Department of Health.

Etiology

• HAV is an RNA virus in the picornavirus group.

Signs and symptoms

• May be asymptomatic.
• Symptoms usually occur abruptly and may include fever, tiredness, loss of appetite, nausea, abdominal discomfort, dark urine, or jaundice. Children are unlikely to experience symptoms.
• Symptoms generally last less than two months; occasionally, prolonged or relapsing illness can last up to six months.
• Average incubation period is 28 days (range: 15-50 days).

Long-term effects

• Chronic infection does not occur.
• HAV infection confers life-long immunity.

Transmission

• Fecal-oral transmission by:
  • Person-to-person contact.
  • Ingestion of contaminated food or water.

Communicability

• Two weeks before symptom onset until two weeks after symptom onset or one week after jaundice (if present).

Risk groups

• Persons who use injection and non-injection drugs.
• Persons experiencing homelessness.
• Persons who are currently or recently incarcerated.
• Men who have sex with men (MSM).
• Household contacts of infected persons.
• Sexual contacts of infected persons.
• Persons traveling to regions of the United States with high rates of HAV infection.
• Persons traveling to regions where HAV is common, including Central and South America, Africa, and Asia.

Prevention

• Hepatitis A vaccine is the best way to prevent infection.
• Hand washing with soap and water after using the bathroom or changing diapers and before preparing or eating food.

Vaccine recommendations

• Hepatitis A vaccine is recommended for:
  • Persons who use injection and non-injection drugs.
  • Persons experiencing homelessness.
  • Persons who are currently or recently incarcerated.
  • Men who have sex with men (MSM).
  • Household contacts of infected persons.
  • Sexual contacts of infected persons.
  • Persons traveling to regions of the United States with high rates of HAV infection.
  • Persons traveling to regions where HAV is common, including Central and South America, Africa, and Asia.
  • Persons with chronic liver disease.
  • Persons with clotting-factor disorders (e.g., hemophilia).
  • Anyone seeking protection from hepatitis A.

Medical management

• Supportive care.

Post-exposure management

• Hepatitis A vaccine should be administered for post-exposure prophylaxis to stop the onset of symptoms for all persons age 12 months and older exposed within the previous 2 weeks.
• In addition to hepatitis A vaccine, Immune Globulin (IG) may be administered to persons age 40 years and older depending on the extent of exposure and immunocompetence of the exposed individual.
• For children under 12 months of age, immune globulin (IG) may be given in persons exposed within the previous two weeks.