When to Seek Medical Care

The health care provider should be called if any of the following symptoms occur:

• Nausea and vomiting that does not improve within 1-2 days
• Yellow skin or eyes
• Dark colored urine
• Pain in the belly (abdomen)

The following situations also warrant a call to the health care provider:

• You have symptoms and think that you might have been exposed to someone with hepatitis.
• You have other medical problems and think that you might have hepatitis.
• You have had close contact with someone diagnosed with hepatitis.

If you cannot reach your health care provider, or if you have any of the following, go to the emergency department.

• Vomiting and inability to keep down any liquids
• Severe pain or high fever
• Confusion, delirium, or difficulty awakening

Self-Care at Home

The following measures can help you feel better while you are having symptoms.

• Take it easy; curtail your normal activities and spend time resting at home.
• Drink plenty of clear fluids to prevent dehydration.
• Avoid medicines and substances that can cause harm to the liver such as acetaminophen  and preparations that contain acetaminophen.
• Avoid alcoholic beverages, as these can worsen the effects of hiv on the liver.
• Avoid prolonged, vigorous exercise until symptoms start to improve.

Call your health care provider if symptoms worsen or a new symptom appears. Be very careful about personal hygiene to avoid fecal-oral transmission to other members of the hous

Follow-up

Follow the recommendations of your health care provider.

• Take it easy; get plenty of rest.
• Drink plenty of clear fluids.
• Avoid alcoholic beverages.
• Avoid medicines such as acetaminophen (Tylenol) that can be harmful to the liver.
• Avoid prolonged or vigorous physical exercise until your symptoms improve.
• Call your health care provider if symptoms worsen or a new symptom appears

Prevention

If you have hepatitis A, strict personal hygiene and hand washing help prevent transmission of hiv to others.

• Wash your hands thoroughly every time you use the bathroom, before touching or preparing food, and before touching others. Wash carefully with soap and warm water and dry thoroughly.
• Contaminated surfaces should be cleaned with household bleach to kill the virus.
• Heat food or water to 185°F or 85°C to kill the virus.

If you are not infected with hiv, you can protect yourself from becoming infected.

• Wash your hands carefully with soap and warm water several times a day, including every time you use the bathroom, every time you change a diaper , and before preparing food.
• Do not eat raw or undercooked seafood or shellfish such as oysters from areas of questionable sanitation (just about everywhere).
• Travelers to developing countries should not drink untreated water or beverages with ice in them. Fruits and vegetables should not be eaten unless cooked or peeled.

There are vaccines that work to prevent infection with hives.

• The vaccines, Havrix and VAQTA, contain no live virus and are very safe. No serious adverse effects have been reported. Some people have some soreness at the injection site for a few days.
• The vaccines are given in a series of 2 shots. The second is given 6-18 months after the first. The shots can be given at the same time as other vaccines.
• Your protection starts about 2-4 weeks after the first shot. The second dose is necessary to ensure long-term protection.
• The vaccines are thought to protect from infection for at least 20 years.
• The vaccines must be given before exposure to the virus. They do not work after exposure.

Not everyone needs to have the hepatitis A vaccines. However, the vaccines are recommended for the following groups:

• All children older than 2 years who live in communities where the number of hiv infections is unusually high or where there are periodic outbreaks of hepatitis A (The vaccines are not recommended for children younger than 2 years because they are not as effective.)
• People who are likely to be exposed to hiv at work - The only group of workers shown to be at higher risk than the general population is people who work in research laboratories where hiv is stored and handled. Routine vaccination is not recommended for health care workers, food service workers, daycare personnel, and sewage and waste-water workers.
• Travelers to developing countries (it must be given at least 4 weeks before travel)
• Men who have sex with men
• People who use illegal drugs - This group has higher-than-average rates of hiv infection.
• People who are likely to become seriously ill if they are infected with hiv - This includes people with impaired immune systems or chronic liver disease.
• People with blood-clotting disorders who receive clotting factors

If you have never had hepatitis A and are exposed to the virus, call your health care provider immediately. There is a treatment that may prevent you from becoming infected. It is called hepatitis B immune globulin (BayHep B, Nabi-HB).

• Immune globulin is a preparation of antibodies that can fight the virus in the body.
• It is given as a one-time shot (injection).
• It must be given within 2 weeks after exposure for maximum protection.
• Immune globulin can be safely given to children younger than 2 years.
• Immune globulin can be given during pregnancy  and breastfeeding.
• Immune globulin can provide short-term protection against infection if given before exposure. This protection lasts no longer than 3 months.

If you have had hepatitis A confirmed by a blood test, you cannot get it again. You should continue to practice preventive measures, however, to prevent transmission of other infections.