• Hepatitis A is a highly contagious infection caused by a virus that attacks the liver.
• Three tests are needed to show if you are infected, if you have immunity, or if you have no immunity and could be infected in the future.
• Vaccination is available for hepatitis A.

Hepatitis A infection is caused by the hepatitis A virus that attacks and injures your liver. Infections by hepatitis A can range from being mild to a more severe acute illness but unlike hepatitis B or C, it does not lead to ongoing illness, cirrhosis (scarring of the liver) or liver cancer.

Symptoms usually start from about two to six weeks after infection and can include:

• Fatigue
• Nausea and vomiting
• Abdominal pain (especially near the liver)
• Loss of appetite
• Dark urine
• Pale-coloured stool
• Jaundice (yellowing of the skin and eyes)
• Fever

Hepatitis A is highly contagious and can be spread through:

• Consuming contaminated food or water
• Close person-to-person contact (especially in households or infant care facilities)
• Sexual contact with an infected person
• Poor hand hygiene after using the bathroom

Diagnosing hepatitis A needs three tests to get a full picture. Two tests measure antibodies to the hepatitis A virus. When you are infected with the hepatitis A virus, as with all infections, your immune system makes antibodies to fight off the virus.

One of these tests looks for the IgM antibody to hepatitis A (also called HAV IgM). HAV IgM is the first antibody to appear in your blood following an infection with hepatitis A. It starts to rise from about two weeks after infection. This test can show if you are actively infected with hepatitis A or have recently been vaccinated.

Another test measures both the IgM and an antibody called IgG antibody. This test is called Total (IgG and IgM) HAV antibody. IgG rises later, from about six to eight weeks after infection, and stays high for many years. This can show if you have immunity to hepatitis A either through previous infection or vaccination, although it cannot tell why you have immunity.

The third test is a genetic test, hepatitis A RNA PCR, which may be ordered if the IgM antibody test is positive. This test detects the genetic material of the virus. It can be performed on blood or faeces and if the result is positive confirms that you have an active hepatitis A infection.

The test results need to be interpreted together and take into account your clinical history.

In addition to these tests your doctor may order other tests such as Liver Function Tests (LFTs).

The tests your doctor orders will depend on your medical history and symptoms.

Sample

Blood (or faeces for hepatitis A RNA PCR)

Any preparation?

None

Reading your test report

Your results will generally be presented along with those of your other tests on the same form. You will see separate columns or lines for each of these tests.

• If the HAV IgM test is positive at the time that you have symptoms of acute hepatitis, it shows you have an active infection. Your HAV IgM result will also be positive if you have recently been vaccinated for hepatitis A. A Hepatitis A RNA PCR will be requested to confirm infection.
• If the HAV IgM test is negative but the HAV Total antibody test is positive it means that you have been previously exposed to the virus through infection or vaccination, and you have immunity. There is no need for you to have additional vaccination.
• A positive HAV Total antibody result alone does not exclude an active infection.
• A negative HAV Total antibody test means you have had no previous exposure to hepatitis A and therefore have no immunity. If you are at risk of infection, your doctor may then recommend vaccination.

There is no specific treatment for hepatitis A. Most people recover on their own within a few weeks to months. Vaccines are available for hepatitis A.

If hepatitis A IgM or PCR is positive your doctor will notify your state health department as hepatitis A is a notifiable infectious disease.

The choice of tests your doctor makes will be based on your medical history and symptoms. It is important that you tell them everything you think might help.

You play a central role in making sure your test results are accurate. Do everything you can to make sure the information you provide is correct and follow instructions closely.

Talk to your doctor about any medications you are taking. Find out if you need to fast or stop any particular foods, medications or supplements. These may affect your results. Ask:

• Why does this test need to be done?
• Do I need to prepare (such as fast or avoid medications) for the sample collection?
• Will an abnormal result mean I need further tests?
• How could it change the course of my care?
• What will happen next, after the test?

Pathology and diagnostic imaging reports can be added to your My Health Record. You and your healthcare provider can now access your results whenever and wherever needed.

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