Key points
- There are no specific treatments for hepatitis A. Rest, a balanced diet with healthy food and plenty of fluids are typically enough to treat symptoms.
- Hepatitis A does not become chronic.
- Clinicians should offer vaccination to all children between 12–23 months old, catch-up vaccination for children and adolescents 2–18 years old who have not previously been vaccinated, and adults at risk for hepatitis A virus (HAV) infection or severe disease from HAV infection.
- Clinicians should vaccinate or offer immune globulin to susceptible people traveling to countries that have high or intermediate HAV endemicity.
- Clinicians should administer single-antigen hepatitis A vaccine, immune globulin, or both to patients who have been exposed to HAV within the last 2 weeks and who have not been vaccinated previously as soon as possible within 2 weeks of exposure.
Treatment options
Most cases can be managed with rest, proper nutrition, and hydration. People with severe cases may be hospitalized. Also, in most hepatitis A cases, symptoms last less than 2 months, but 10%–15% of cases have relapsing symptoms for up to 6 months. Hepatitis A does not become chronic.
Vaccination
CDC recommends that all children between 12–23 months old, children and adolescents 2–18 years old who have not previously been vaccinated, and adults at risk for HAV infection or severe disease from HAV infection be vaccinated against hepatitis A with a complete vaccine series. The exact duration of protection against HAV infection after vaccination is unknown but appears to last for at least 20 years.
A dose of single-antigen hepatitis A vaccine should be administered as soon as possible, within 2 weeks of exposure, to all unvaccinated people ages 12 months and older who have recently been exposed to HAV. In addition to hepatitis A vaccine, coadministration of immune globulin is recommended under certain circumstances according to age and health status of the exposed person.
Immune globulin
Immune globulin can provide short-term protection against HAV, both preexposure and postexposure. Immune globulin must be given within 2 weeks after exposure for maximum protection. Immune globulin can be given alongside a vaccine dose in certain circumstances. More information on GamaSTAN™ S/D, the only immune globulin product approved by the United States Food and Drug Administration (FDA) for hepatitis A prophylaxis, is available from FDA.
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Treatment recommendations
There are preventative treatments for some high-risk groups.
Preventative treatment
People who are unvaccinated or have never been infected with hepatitis A are at an increased risk of contracting the disease and should use caution when visiting places with high or intermediate HAV rates.
People who are unvaccinated and at least 12 months old should receive a vaccine dose as soon as travel is considered and at least 2 weeks before their trip. They should complete the vaccine series on schedule. People who can't or elect not to receive vaccine should receive immune globulin 2 weeks before traveling internationally to high-risk places.
For more information on international travel and hepatitis A, see CDC's travel page or ACIP's Updated Recommendations on Use of the Hepatitis A Vaccine for Postexposure Prophylaxis and for Preexposure Prophylaxis for International Travel.
Children under 12 months
For infants under 6 months, offer immune globulin before travel when protection against HAV is recommended.
For infants 6–11 months, offer hepatitis A vaccine if traveling to a country where protection against hepatitis A is recommended. This vaccine dose does not count toward the 2-dose series. You should still initiate the 2-dose hepatitis A vaccine series at 12 months. See additional information on protection against hepatitis A before travel.
Postexposure vaccination for hepatitis A
For all unvaccinated people ages 12 months and older who have recently been exposed to HAV, a dose of single-antigen hepatitis A vaccine should be administered as soon as possible within 2 weeks of exposure. In addition to hepatitis A vaccine, coadministration of immune globulin is recommended under certain circumstances according to age and health status of the exposed person.
Immune globulin use and dosage
In addition to hepatitis A vaccine, coadministration of FDA-approved GamaSTAN™ S/D immune globulin (0.1 mL/kg) is recommended depending on the person's age and health. More information on GamaSTAN™ S/D is available from FDA.
Dosage recommendations
Below are indications and dosage recommendations for GamaSTAN™ S/D human immune globulin for preexposure and postexposure prophylaxis (PEP) against hepatitis A infection.
| Indication | Dose |
|---|---|
| Preexposure prophylaxis | |
| Up to 1 month of travel | 0.1 mL/kg |
| Up to 2 months of travel | 0.2 mL/kg |
| 2 months of travel or longer | 0.2 mL/kg (repeat every 2 months) |
| Postexposure prophylaxis | 0.1 mL/kg |
Learn more about CDC's recommendations and dosing instructions for immune globulin.
Treatment precautions
Certain groups of people may require special consideration, particularly when it comes to PEP. Twinrix™ is not recommended for use as PEP.
Immunocompromised people
People who are immunocompromised or have chronic liver disease and who have been exposed to HAV within the past 2 weeks and not previously completed the hepatitis A vaccination series should receive both immune globulin and hepatitis A vaccine simultaneously. Administer the doses in different places on the body, such as separate limbs, as soon as possible after exposure.
If this is the exposed individual's first time receiving a dose of hepatitis A vaccine, administer a second dose 6 months after for long-term protection.
Pregnant people
People with increased likelihood of exposure to hepatitis A during pregnancy can receive immune globulin. There has been no observed increase in maternal or infant adverse events after hepatitis A vaccination or immune globulin administration in pregnancy.
Helping patients stay well
People who get hepatitis A usually recover completely and do not have lasting liver damage.
Hepatitis A reinfection
Patients do not need to worry about hepatitis A reinfection. Immunoglobulin G antibodies to HAV, which appear early in the course of infection, provide lifelong protection against the disease.
Resources
- Centers for Disease Control and Prevention. CDC Yellow Book: Health Information for International Travel: Hepatitis A Chapter. National Center for Emerging and Zoonotic Infections Diseases (NCEZID), Division of Global Migration Health (DGMH), 2023
- Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020 MMWR 2020;69(5);1–38