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Hepatitis A in MSM

What is hepatitis A?

Hepatitis A is a virus that infects the liver. It usually causes a mild illness that will go away on its own within 1 to 2 weeks, without needing any treatment.

Occasionally it can cause a more severe illness lasting several months. Most people will make a complete recovery.

In the recent past, sexually transmitted hepatitis A has been increasing in men who have sex with men (MSM) across Europe, including Ireland.

A safe and effective vaccine is available for the prevention of hepatitis A infection.

How common is hepatitis A?

Hepatitis A infection occurs worldwide though it is now rare in Western Europe, including Ireland.

Since 2005, several European countries have reported national outbreaks of hepatitis A in MSM. In 2016 the number of hepatitis A cases in MSM in Europe increased, including in the United Kingdom. Since the start of 2017, a small number of cases of hepatitis A have been diagnosed in MSM in Ireland.

How do I get hepatitis A?

Hepatitis A virus is usually spread from person to person by the faecal-oral route (that is, ingestion of something that has been contaminated with the faeces of an infected person). Sometimes it is spread through food that has been contaminated by infected food handlers or by contaminated water.

You can also get hepatitis A through sexual activity, such as rimming (mouth-to-anus contact) and/or swallowing something that has been infected with faeces (poo).

You cannot catch hepatitis A from:

  • casual contact
  • hugging
  • sneezing or coughing
  • breastfeeding

What symptoms would I have with hepatitis A?

Most people who get hepatitis A do not experience any symptoms.

Hepatitis A symptoms can take some weeks to appear after you have picked up the infection.

The most common symptoms are fever, tiredness, loss of appetite, feeling sick (nausea), diarrhoea and stomach pain or discomfort, dark-coloured urine, pale faeces (poo) and jaundice (a yellowing of the skin).

Severe illness with hepatitis A can cause debilitating symptoms and very occasionally acute liver failure, which can be fatal.

How can I be tested for hepatitis A?

Testing for hepatitis A involves a blood test that looks for your body's reaction to the infection (antibodies).

How can I prevent myself from getting hepatitis A?

There are vaccines that prevent infection with hepatitis A.

MSM can also avoid getting hepatitis A by:

  • washing hands after sex (buttocks, groin and penis too, ideally)
  • changing condoms between anal and oral sex
  • using latex gloves for fingering or fisting
  • using a barrier for rimming (such as a square of latex)
  • not sharing sex toys or douching equipment

To prevent sexual transmission, who should be vaccinated against hepatitis A?

Vaccination is recommended for:

  • men who have sex with men and partners
  • people in recent close contact with infected individuals

It is recommended that MSM are vaccinated against both hepatitis A and B.

Can hepatitis A be treated?

There is no specific treatment for hepatitis A and it usually clears on its own.

If you have symptoms of hepatitis A, treatment usually involves making sure that you are not dehydrated and your blood salts are okay, sometimes this involves having a drip of fluids into your vein in hospital.

What about my partner?

If you have hepatitis A, the people you have sex with may be at risk of getting the infection from you and will need to be tested and offered vaccination. This will be explained to you by the doctor or nurse who sees you.

When can I have sex again?

Your partner or any new partners should be tested and vaccinated against hepatitis A before having sex with them. This will be explained to you by the doctor or nurse who sees you.

What happens if my hepatitis A is left untreated?

There is no specific treatment for hepatitis A and it usually clears on its own.

Hepatitis A infection does not usually lead to long-term liver problems and is rarely fatal.

Download the Hepatitis A leaflet here.