Hepatitis A natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Complications

There are usually no complications. One in a thousand cases becomes fulminant hepatitis, which can be life threatening.

Prognosis

• The United States Centers for Disease Control and Prevention (CDC) in 1991 reported a low mortality rate of 4 deaths per 1000 cases for the general population but a higher rate of 17.5 per 1000 in those aged 50 and over.

• Young children who are infected with hepatitis A typically have a milder form of the disease, usually lasting from 1-3 weeks, whereas adults tend to experience a much more severe form of the disease.
• Adults are often confined to bed and minimal activity for about 4 weeks and have to stop their work for one to three months or longer.
• Many adults take up to 36 months and occasionally longer to recover entirely.
• Symptoms that may be experienced after the first month or two are low immunity: It is much easier to catch minor infections and for these infections to linger longer than they normally would.
• Many people experience a slow but sure improvement, over this later period.
• They are generally able to function fairly normally, still needing more sleep and reduced athletic activity.
• It is common for recovering patients to experience occasional "off" days, during which they need to rest more.
• Hepatitis A can be sexually transmitted, especially during oral-anal contact, but not after the patient has recovered.