Hepatitis A
Also called: hepatitis A virus infection, HAV infection, infectious hepatitis
Hepatitis A is a short-term liver infection caught from food, water or hands soiled with traces of stool. It can cause fever, sickness and yellow eyes and skin (jaundice). Most people recover fully in weeks to months, and a vaccine can prevent it.
General health information for Pakistan. It does not give doses or brand advice. If you are worried, or symptoms are severe, see a doctor. When to see a doctor
Overview
Hepatitis A is swelling of the liver (hepatitis) caused by the hepatitis A virus. The virus leaves the body in the stool (faeces) of an infected person. Other people catch it when tiny traces of that stool get into their mouth, usually through unsafe drinking water, food made with dirty hands, or very close contact such as sex. Shaking hands or sitting near someone does not spread it.
Symptoms usually start two to four weeks after the virus enters the body. Young children often have no symptoms at all, while adults are more likely to feel unwell and turn yellow. Unlike hepatitis B and C, hepatitis A does not become a long-term (chronic) liver disease. Almost everyone gets better and is then protected for life. Recovery can take several weeks or a few months, and some people feel ill again for a while before they finally recover.
There is no medicine that kills the virus. Treatment means rest, enough fluid and food, and avoiding anything that strains the liver. A very small number of people, mostly older adults and people who already have liver disease, develop sudden liver failure. Hepatitis A is common where sanitation is poor, so safe water, clean toilets, handwashing and vaccination are the best protection.
In Pakistan
Hepatitis A is common in countries with poor sanitation, where most children catch it before age 10, often without symptoms. In a 2020-21 study of 124 children with acute liver failure at a Rawalpindi military hospital, hepatitis A was the most common cause, found in about four in ten.
Symptoms
- Fever and flu-like feelings such as tiredness, headache and aching muscles
- Loss of appetite
- Feeling sick (nausea) or vomiting
- Pain or discomfort in the upper right part of the tummy, under the ribs
- Diarrhoea, or sometimes constipation
- Dark brown urine
- Pale, grey or clay-coloured stools
- Yellow eyes and skin (jaundice); this can be harder to see on darker skin
- Itchy skin, sometimes with a raised rash (hives)
- Young children may have mild symptoms or none at all
Causes and risk factors
Causes
- Infection with the hepatitis A virus, which lives in the liver and is passed out in stool
- Drinking water that is unsafe or mixed with sewage
- Eating food that was grown or washed in dirty water, or prepared by an infected person with unwashed hands
- Eating raw or undercooked shellfish, or uncooked fruit and vegetables, from unsafe sources
- Close contact with an infected person, including sex (especially oral-anal contact) and sharing drug-injecting equipment
What makes it more likely
- Never having had the hepatitis A vaccine or the infection before
- Living with, or caring for, someone who has hepatitis A
- Poor sanitation and no access to safe drinking water
- Travelling to areas where hepatitis A is common without being vaccinated
- Men who have sex with men, and sexual partners of an infected person
- Using recreational drugs, by injection or not
- Living in crowded places such as shelters or prisons, or being homeless
- Working with sewage, or in some healthcare jobs
Complications
Most people recover fully and do not have any lasting liver damage. In some people the jaundice and itching last for many weeks (cholestatic hepatitis), and up to one in ten have a relapse, when they become ill again after seeming to get better. The most serious complication is sudden liver failure (fulminant hepatitis), which is rare but can be fatal and may need a liver transplant. The risk of severe illness is higher in older adults, pregnant women, people with weak immunity and people who already have liver disease, such as hepatitis B, hepatitis C or fatty liver. Rarely, the infection affects other organs, causing problems such as pancreatitis or joint pain.
When to see a doctor
- Symptoms of hepatitis A in someone who is pregnant, over 60, or already has a liver condition: get an urgent doctor's appointment
- Getting much worse instead of better, or feeling very unwell: go to hospital, as severe hepatitis A or liver failure needs hospital care (emergency)
- Vomiting or diarrhoea so much that you cannot keep fluids down
- Symptoms after travel, or after contact with someone who has hepatitis A: see a doctor and say you think it may be hepatitis A
- Jaundice and itching that go on for many weeks, or feeling ill again after you had started to recover
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Diagnosis
Hepatitis A looks the same as other types of viral hepatitis, so a doctor cannot tell which virus is the cause from the symptoms alone. Tell the doctor if you have been in contact with someone with hepatitis A, eaten food or water that might be unsafe, or travelled recently.
The main test is a blood test for IgM anti-HAV antibodies (proteins the body makes soon after a new hepatitis A infection). Liver function blood tests show how inflamed the liver is: the liver enzyme ALT is usually very high, and bilirubin (the yellow pigment that causes jaundice) rises a little later. A clotting test (prothrombin time or INR) checks how well the liver is working; if it is abnormal, doctors worry about liver failure. A PCR test that finds the virus's genetic material can be used in special laboratories. An ultrasound scan does not confirm hepatitis A, and a liver biopsy is rarely needed.
Treatment
- See a doctor to confirm the diagnosis with a blood test and to check your liver tests
- Rest at home; most people do not need to stay in hospital and get better on their own
- Drink plenty of fluids and eat what you can, to replace fluid lost through vomiting or diarrhoea
- Do not take paracetamol or any other medicine, including over-the-counter ones, unless your doctor or pharmacist says it is safe for your liver; they decide which medicine and how much
- Your doctor may prescribe medicine for sickness or for severe itching if needed
- People with severe illness or signs of liver failure are treated in hospital, and a few may be referred for a liver transplant
- Close contacts who are not protected should see a doctor soon after exposure about the hepatitis A vaccine or an immunoglobulin injection
Medicines in Pakistan
Medicines a doctor may use, by group. Read the role: some are only for special cases. Each link opens our page for that medicine, with every brand and its official DRAP price. Your doctor decides which medicine and dose are right for you.
| Group | Role | Medicines |
|---|---|---|
| Hepatitis A vaccines | prevention; the best way to avoid hepatitis A, and also used soon after contact with an infected person to stop infection; available from vaccination centres, clinics and travel clinics; your doctor or vaccinator advises who needs it | Hepatitis A vaccine (1 brand), Hepatitis A vaccine, inactivated (1 brand), Hepatitis A vaccine (human diploid cell), inactivated (2 brands) |
| Human normal immunoglobulin | ready-made antibodies given by injection after close contact with a case; used mainly for people who cannot have the vaccine, and sometimes added to the vaccine for people with weak immunity or long-term liver disease; doctor decides | Human normal immunoglobulin (IgG) (5 brands) |
Self-care and prevention
Self-care
- Rest as much as you need; recovery can take weeks or a few months
- Drink plenty of fluids and try to eat small, regular meals
- Do not drink alcohol while you are ill
- Ask a doctor or pharmacist before taking any painkiller or other medicine, because some can harm the liver
- For itching, keep your room cool and airy, wear loose clothes and avoid hot baths and showers
- Wash your hands well with soap after using the toilet and before touching food
- Do not prepare food or drinks for others, and avoid sex without a condom or dental dam, while you are infectious
- Stay off work, school or nursery for about a week after the jaundice starts (or after symptoms start if you have no jaundice)
Prevention
- Get vaccinated against hepatitis A; ask your doctor, clinic or travel clinic whether you or your children need it
- Drink only safe, treated water; when travelling to areas where hepatitis A is common, drink bottled water
- Wash hands with soap before eating or cooking and after using the toilet
- Use a proper toilet and make sure sewage is safely disposed of
- Avoid raw shellfish and uncooked fruit and vegetables that may have been washed in unsafe water
- Use a condom or dental dam during sex, especially oral-anal sex
Common questions
Is hepatitis A contagious?
Yes. It spreads when traces of stool from an infected person reach someone else's mouth, through food, water, hands or close contact such as sex. People are most infectious in the two weeks before jaundice appears, and much less so about a week after it starts. Casual contact does not spread it.
Does hepatitis A become chronic like hepatitis B or C?
No. Hepatitis A does not cause long-term liver disease. Almost everyone recovers fully, and after recovery you are protected against hepatitis A for life.
Is there a medicine to cure hepatitis A?
There is no medicine that kills the hepatitis A virus. The body clears it by itself. Treatment is rest, fluids, food and avoiding alcohol and medicines that could strain the liver. Hospital care is only needed for severe illness.
Can I take paracetamol for fever or pain with hepatitis A?
WHO advises avoiding unnecessary medicines that can harm the liver, and names paracetamol. Do not take any painkiller without first asking your doctor or pharmacist, who will decide whether it is safe for you and how much.
Is there a vaccine for hepatitis A?
Yes. Inactivated (non-live) hepatitis A vaccines are given by injection and protect well. They are available through doctors, vaccination centres and travel clinics. Your doctor or vaccinator will tell you whether you need it and when.
Sources
- WHO (fact sheet). Hepatitis A (2026).
- CDC. Hepatitis A | CDC (n.d.).
- CDC (MMWR, ACIP). Appendices for Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020 | MMWR (2020).
- NHS 111 Wales. NHS 111 Wales - Health A-Z : Hepatitis A (n.d.).
- StatPearls (NCBI Bookshelf). Hepatitis A - StatPearls - NCBI Bookshelf (2024).
- Pakistan Armed Forces Medical Journal. Aetiologies and Outcomes of Acute Liver Failure in Children at a Tertiary Care Hospital in Rawalpindi (2026).
Prepared from the sources listed below by the MedInfoBase team. Last reviewed 16 October 2026. This page is general health information, not medical advice. It gives no doses and does not replace a doctor: talk to your doctor or pharmacist before starting, stopping or changing any medicine. How we write and check our pages.
Related conditions
Hepatitis BHepatitis CAcute gastroenteritis (diarrhoea and vomiting)Typhoid feverCholera