HEPATITIS A
Hepatitis A is a liver disease caused by the hepatitis A virus (HAV). HAV can affect anyone. It can live outside the body for months, depending on the environmental conditions.

How it's spread
HAV is transmitted when a tiny speck of infected stool enters your body, most often through the mouth.  It can be transmitted sexually if your mouth comes in contact with an infected anus, this includes rimming (direct contact) or contact with another body part or toy that has been in contact with someone’s anus (indirect). This type of transmission is called "fecal-oral."

In the general population, HAV is most often spread through contaminated food utensils handled by an infected person, or by eating infected food or drinking infected water. HAV can also be spread from cooked food if it gets contaminated after cooking. Adequate chlorination of water, as recommended in the U.S. kills HAV that may get into the water supply.

Symptoms:
Someone with hepatitis A infection may not have any signs or symptoms of the disease. Even if they have no symptoms at all, they can still pass on HAV to others. If symptoms are present, they usually last less than 2 months; few persons are ill for as long as 6 months. Symptoms occur unexpectedly and may include:

• Fatigue
  Loss of appetite
  Nausea, abdominal discomfort
  Dark urine 
  Jaundice (yellowing of the skin and eyes)

People with HAV are considered infectious 2 weeks before and one week after the onset of symptoms. That is when the virus concentration is at its highest levels.

Treatment:
There is no specific treatment for hepatitis A. Rest is recommended during the acute phase of the disease, when the symptoms are most severe. People with hepatitis A should avoid alcohol and any substances that are toxic to the liver. If you ever had hepatitis A, you will never get it again and you cannot transmit the virus to others.

Prevention:
Two products are used to prevent hepatitis A virus infection:  immune globulin and hepatitis A vaccine (see vaccination). Other ways of preventing HAV infection are:

• Using barriers (condoms, dental dams) and washing your hands and toys after having sex
• Always wash your hands after using the bathroom, changing a diaper, or before preparing or eating food.
• Avoid sharing drug use equipment (syringes/needles, water, cookers)

Long term consequences:
Unlike hepatitis B or hepatitis C, no chronic (long term) disease develops as a result of HAV infection.

Vaccination:
Hepatitis A vaccination is recommended for men who have sex with men (MSM) and injection drug users (IDU).

Hepatitis A vaccination consists of a two-dose series given within a 6 month period. If the second dose is missed within the 6 months, it’s never too late to get it. There is no need to restart the series. There is also a hepatitis A and B combination vaccine called Twinrix.

Immune globulin can be given to persons who have already been exposed to the hepatitis A virus. This can help prevent the disease if you have been exposed to the HAV. It can also be given for short-term protection against hepatitis A, 3-5 months. It is frequently used by those who travel to countries with high rates of hepatitis A.

The hepatitis A vaccine is very safe, as it contains no live virus. Protection begins four weeks after the first dose. Soreness at the injection site is the most frequently reported side effect.