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Hepatitis refers to an inflammatory condition of the liver. It's commonly caused by a viral infection, but there are other possible causes of hepatitis. These includeautoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol.

The most common reported risk factor for HAV in the U.S. is international travel. Even among people staying in luxury hotels, 3 in every 1,000 acquire HAV each month.

Anyone who has not been vaccinated or previously infected is susceptible.

Others factors that increase the risk include:

• sexual or household contact with an infected person

• living or working in a community residence

• attending or working in a daycare center

• homosexual activity

• injecting drugs, especially if sharing needles

• other drug use

• food handling

• working with HAV-infected primates or with HAV in a research laboratory

• exposure to food or waterborne outbreaks

• people with clotting-factor disorders

In the U.S., routine vaccination of all infants began in 1999. In 2006, the CDC recommended expanding vaccination for all children in the U.S. aged 12 to 23 months.

This has resulted in a 95-percent reduction in the number of infections.

However, infection can affect those at a higher risk and adolescents who missed the vaccination implementation.

In places where there is no immunization, an outbreak can be explosive. In 1988, a single outbreak in Shanghai affected 300,000 people.

Many people have no symptoms with HAV, but if symptoms appear, it is usually 15 to 50 daysafter infection. Most adults will experience symptoms similar to the flu.

These include:

• nausea, loss of appetite, and vomiting

• abdominal pain and diarrhea

• fever

• malaise and fatigue

• joint pain

• jaundice, a yellowing of the skin and whites of the eyes

• dark-colored urine and pale stools

Children below the age of 6 years do not usually show symptoms.

Jaundice will affect:

• fewer than 10 percent of children under the age of 6 years

• from 40 to 50 percent of those aged 6 to 14 years

• from 70 to 80 percent of people aged over 14 years

Symptoms often pass within 3 to 6 months of first being infected, but around 15 percent of people with HAV will have ongoing or recurring symptoms for 6 to 9 months.

HAV can be fatal in older patients and in someone who already has chronic liver disease.

Your doctor will ask about your:

• History of alcohol use

• Exposure to toxic chemicals

• Use of medications that can cause liver damage

• History of unprotected sex

• History of intravenous drug use

• Recent meal of shellfish

• Travel to a country where hepatitis infections are common

• Exposure to someone known to have hepatitis

Your doctor will examine you. He or she will look for signs of jaundice. Your doctor will also check for tenderness and swelling near your liver.

To confirm a hepatitis diagnosis, your doctor will order blood tests. You may also need other tests, such as a liver biopsy.

• Bed rest, abstaining from alcohol, and taking medication to help relieve symptoms. Most people who have hepatitis A and E get well on their own after a few weeks.
• Hepatitis B is treated with drugs, such as lamivudine and adefovir dipivoxil. Hepatitis C is treated with a combination of peginterferon and ribovarin.
• Liver transplant of hepatitis B or C, or D-caused liver failure.

• Hepatitis A
  Immunization of children (1-18 years of age) consists of two or three doses of the vaccine. Adults need a booster dose six to 12 months following the initial dose of vaccine. The vaccine is thought to be effective for 15–20 years or more.
• Hepatitis B
  Safe and effective vaccines provide protection against hepatitis B for 15 years and possibly much longer. Currently, the Center for Disease Control and Prevention recommends that all newborns and individuals up to 18 years of age and adult participating at risk of infection be vaccinated. Three injections over a six to 12 month period are required to provide full protection.
• In General:
  • Wash your hands after going to the bathroom and before fixing food or eating.
  • Use latex condoms, which may lower the risk of transmission.
  • Avoid tap water when traveling to certain countries or regions. Ask your doctor about risks before you travel or call the Centers for Disease Control and Prevention at 877-FYI-TRIP.
  • Don't share drug needles.
  • Don't share personal items—such as toothbrushes, razors and nail clippers—with an infected person.