Symptoms of hepatitis A usually start on average 4 weeks after exposure to the virus, but it may range from two to eight weeks.
The likelihood of having hepatitis A symptoms is related to the age of the infected person. Seventy percent of infections in children younger than six years of age show no symptoms, while infection in adults usually causes a mild flu-like illness.
Early symptoms are a sudden onset of:
- Loss of interest in food, especially fatty food
- Distaste for cigarettes (if you are a smoker)
- Loss of ability to drink any alcohol
- Feeling unwell and tired
- Muscle aches and/or fever
Once infection is established, symptoms may include some, or all of the following:
- Nausea, with or without vomiting
- Discomfort or pain on the right side of the abdomen under the ribs (the area of the liver)
- Urine that is an unusual dark reddish-brown
- Faeces unusually pale in colour
- A yellowish tinge to the whites of the eyes and the skin (jaundice)
- Itchy skin
These symptoms can last from a week to months, depending on the response of the person infected. Generally, adults experience worse symptoms for a longer period. Pregnant women are at slightly increased risk of severe hepatitis A.
Unlike hepatitis B and C infection, people with hepatitis A do not develop long-lasting (chronic) infection. A person is immune against hepatitis A after infection and cannot be infected with hepatitis A more than once.
A small number of people (approximately 1 in 100) may experience early severe liver damage at the outset of the illness. This may entail much of the liver being destroyed, and resulting in a person going into liver failure. This is known as "fulminant hepatitis".
Signs that this may be occurring include drowsiness that progresses to coma and bleeding, usually in the gut. This is an extremely serious situation that will require the person to be cared for in an intensive care unit.
Death due to failure of the liver is a rare complication that is more common in patients with other underlying liver disease and in those older than 50 years of age, where the risk of death due to fulminant hepatitis A infection is 1 to 2%.
Revised and reviewed by Dr Karin Richter, MMed Path (Medical Virology), FC Path(SA) Viro, Dip HIV Man (SA), Dip Obst (SA), MBChB , Clinical Virologist, Senior Lecturer, Department of Medical Virology, University of Pretoria, Faculty of Health Sciences, and Consultant Pathologist, Tshwane Academic Division, National Health Laboratory Services (NHLS) February 2015.