Viral hepatitis A (HAV) is a self limited disease which can cause mild or severe liver injury. HAV is acquired by eating food that is contaminated with HAV. HAV can also be spread from person-to-person by a person with acute HAV.
The average adult who develops HAV has several days of flu-like symptoms progressive fatigue elevated liver enzymes in the blood and jaundice. In all patients the disease is self limited. No patients develop chronic HAV. It lasts for several days to several weeks before the liver enzymes return to normal and jaundice resolves. Fatigue may last for an additional several weeks to months. After the illness resolves the patient develops antibodies which will prevent any future HAV infection.
The severity of the liver injury in HAV increases with increasing age. Patients greater than 50 years of age can have such a severe case of HAV that they may develop liver failure and die unless they receive an emergency liver transplant. Patients with underlying chronic liver disease and especially cirrhosis are also at high risk to develop liver failure if they become infected with HAV.
HAV is uncommon in the USA but is very common in many counties of the world where Americans vacation. This includes most Caribbean Islands, Mexico and may part of Africa and Asia. Americans who travel to these areas of the world should therefore be vaccinated against HAV to prevent them from developing an infection. In addition, all patients with chronic liver disease and especially all patients with cirrhosis should also be vaccinated against HAV. HAV vaccination is highly effective. Over 98% of persons respond to 2 doses of vaccine administered one month apart. Vaccination against of all patients with chronic liver disease against HAV is routinely recommended and provided at the Liver Institute of Virginia.