saudigastro.com/patients/hepatitis-a
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Common
Red flags
5
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
What is it?
Hepatitis A is an infection of the liver caused by the hepatitis A virus. "Hepatitis" simply means inflammation of the liver. Unlike hepatitis B and C, hepatitis A does not become a long-term (chronic) infection. Most people recover fully within weeks to a few months and then have lifelong immunity (protection from getting it again). Rarely, particularly in older adults or in people who already have liver disease, it can cause severe liver damage.
How common is it?
Hepatitis A is one of the most common causes of acute (sudden-onset) hepatitis worldwide. It is more common where sanitation and clean water are limited. In places with improved sanitation, fewer children are infected, so more young adults are not immune and can become ill later in life, when the illness is often more severe. Infection in young children is often mild or has no symptoms at all.
Why does it happen?
The virus passes in the stool of an infected person and spreads by the "fecal-oral" route: eating food or drinking water contaminated with it, eating raw or undercooked shellfish from polluted water, or close contact with an infected person (including household contact and some sexual contact). Poor hand washing after the toilet or before food preparation helps it spread. Symptoms start about two to six weeks after exposure. A person can pass on the virus from about two weeks before symptoms until about a week after jaundice appears.
Symptoms
- Tiredness and feeling generally unwell
- Loss of appetite, nausea, vomiting
- Pain or discomfort in the upper right side of the abdomen
- Low-grade fever
- Dark (tea-colored) urine and pale (clay-colored) stools
- Jaundice: yellow skin and whites of the eyes
- Itching of the skin
- Many children have no symptoms at all
Red flags — seek urgent medical care
Confusion, unusual sleepiness, or being hard to wake
Possible acute liver failure — go to the emergency department immediately.
Vomiting blood or passing black stools or easy bruising and bleeding
The liver may not be making clotting proteins — emergency.
Repeated vomiting so you cannot keep fluids down, or very little urine
Dehydration — you may need fluids in hospital.
Jaundice in an older adult, pregnant woman, or someone with existing liver disease
Higher risk of a severe course — see a doctor the same day.
Severe or worsening abdominal pain, or jaundice lasting many weeks
Needs reassessment for complications or another cause.
How is it diagnosed?
The diagnosis is made with a blood test for hepatitis A antibodies called IgM anti-HAV, which is positive during recent infection. Liver blood tests (ALT, AST, bilirubin) show how much the liver is inflamed, and a clotting test (INR) shows how well the liver is working. Your doctor may also test for hepatitis B and C and other causes of jaundice. Imaging is usually not needed unless there is pain or doubt about the diagnosis.
Outlook — what to expect
Most people feel better within a few weeks, though tiredness can last for a couple of months, and some people have a relapse of symptoms before full recovery. Once recovered, you are immune for life. Severe liver failure is uncommon, and people who develop it may need to be treated in a specialist unit, sometimes including consideration for liver transplant.
Treatment
Habits & Lifestyle
There is no specific antiviral treatment; care is supportive while the liver heals, and prevention of spread is important.
- Rest as needed and return to normal activity gradually as you feel able.
- Wash your hands with soap and water after the toilet and before preparing or eating food.
- Stay away from work, school or nursery until your doctor says you are no longer infectious, and avoid preparing food for others.
- Household members and close contacts should speak to their doctor or clinic about vaccination.
- Avoid alcohol until your liver tests have returned to normal.
Diet
There is no special diet, but eating when you can helps recovery.
- Eat small, frequent, light meals if you feel sick; fatty meals may feel worse.
- Drink plenty of fluids to prevent dehydration, especially if vomiting.
- Do not use herbal or "liver cleansing" products. Some can damage the liver.
- Avoid raw or undercooked shellfish and unwashed raw vegetables; drink safe bottled or treated water when travelling.
Medications
Medicines are used only to relieve symptoms. Many medicines are broken down by the liver, so always ask your doctor or pharmacist before taking any.
- Do not take extra paracetamol (acetaminophen) or combination cold remedies that contain it; ask your doctor what is safe for you.
- Avoid anti-inflammatory painkillers and other unnecessary medicines unless your doctor agrees.
- Anti-nausea medicine or treatment for itching may be prescribed by your doctor if needed.
- Vaccination: two doses of the hepatitis A vaccine give long-lasting protection and are safe for most people.
- After a recent exposure, a vaccine dose (and sometimes immune globulin for higher-risk people) may prevent illness if given soon enough; contact a doctor promptly.
Procedures & Surgery
No procedure is needed for most people. Hospital care is for those who are severely unwell.
- Hospital admission may be needed for persistent vomiting, dehydration or abnormal clotting tests.
- Intensive care and liver transplant assessment are only for the rare cases of liver failure.
Living with the condition
- Once you have recovered you will not get hepatitis A again.
- Follow up with your doctor until liver blood tests are normal.
- If you have chronic liver disease, the vaccine is especially important; ask whether you are immune.
In the Saudi context
Hepatitis A vaccination is commonly recommended before travel to areas with limited sanitation and for people at higher risk, including those with chronic liver disease. Ask your primary care clinic or travel clinic about availability and your schedule; do not assume you are protected. Pilgrims and travelers should wash hands with soap and water, eat freshly cooked food, and drink bottled or treated water. Fasting during Ramadan is not advised while you are acutely ill with jaundice, vomiting or dehydration; discuss it with your doctor.
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- How do I know if I am immune to hepatitis A, and do I need the vaccine?
- How long am I contagious, and when can I return to work or school?
- Which painkillers and other medicines are safe while my liver recovers?
- Should my family or close contacts be vaccinated?
- Which warning signs mean I should go straight to the emergency department?
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Status: Approved for publication by SGA; individual clinician review is ongoing · Published 24/04/2026
For general education only; it does not replace your doctor’s advice. Individual clinician review of this guide is ongoing. SGA clinician? Review this guide