Hepatitis A: What Happens

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What Happens

After the hepatitis A virus (HAV) enters your body, the amount of virus grows for 2 to 7 weeks. The average incubation period is about 4 weeks.

• Your stools (feces) and body fluids contain the highest levels of the virus 2 weeks before symptoms start (if there are any symptoms). This is the time when you are most contagious. However, you still may pass the virus to another person until all of your symptoms have gone away.
• From 5 to 10 days after you become infected with HAV, your body usually starts to make HAV antibodies.
• Between 3 and 6 months after you become infected with the virus, antibodies develop that will give you lifelong protection (immunity) against HAV infection. The antibodies can always be detected in your blood, indicating that you were infected with the hepatitis A virus some time in the past.

Symptoms of hepatitis A usually last less than 2 months. More than 99% of people who have hepatitis A recover fully. Within 1 to 2 months after your symptoms go away, your liver will be completely healed.

Possible complications of hepatitis A include the following:

• About 15% of people with HAV have a temporary return (relapse) of symptoms or prolonged symptoms of HAV infection 6 to 9 months after infection first occurred.¹
• A rare condition called cholestatic hepatitis may develop and is associated with severe itching. In some people, the illness lasts weeks or months.
• Problems with other organs, including sudden gallbladder inflammation (acute cholecystitis) and inflammation of the pancreas (pancreatitis), may occur, but these complications are uncommon.
• A very small number of people, most often older adults or those with long-term (chronic) liver disease, rapidly develop severe liver failure when they become infected with HAV. This condition is called fulminant hepatitis. Up to 70% of people with fulminant hepatitis A recover without major treatment. But some people may require a liver transplant to avoid liver failure and death.²

Hepatitis A during pregnancy

Hepatitis A does not increase the risk of stillbirth, miscarriage, or birth defects.

Preventive treatment with immune globulin, which contains hepatitis A antibodies, is safe for pregnant women who have been exposed to the virus.

Last updated:	September 09, 2008
Author:	Maria G. Essig, MS, ELS
Reviewed By:	Kathleen Romito, MD - Family Medicine, W. Thomas London, MD - Hepatology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC