STDs Expert Forum
How common is Hepatitis A
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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How common is Hepatitis A

Dear Doctors, I have been reading that Hepatitis A can be spread via sexual contact.  I was wondering how common it is for Hepatitis A to be spread sexually in the United States and if you would recommend sexually active people to get a Hepatitis A vaccine shot?  In order for one person to give the virus to another person would they have to be obviously sick with the virus or can it lay dormant and you wouldn't be able to tell that someone was sick as they might not have jaundice or yellow eyes etc.  Have you seen many cases of sexually transmitted Hepatitis A in your many years of practicing medicine.  Thank you.
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Welcome to the Forum.  You ask a good question an I'll be happy to comment.  While all 3 forms of viral hepatitis (hepatitis A,B, and C) can be transmitted through certain types of exposure, none are very common at the present time, in part because of the high degree of effectiveness of vaccines for hepatitis A and hepatitis B (both are recommended for most people at the present time).  Only hepatitis B is transmitted with any frequency through penile-vaginal intercourse between infected and uninfected partners and this is now rare in part because an ever growing proportion of the population has been vaccinated against the infection, usually in childhood.  Hepatitis C is very rarely transmitted through receptive rectal intercourse, not through penile-vaginal intercourse.  As for hepatitis A, this virus is transmitted not in genital secretions or blood like hepatitis B and C but through ingestion of fecal material. Thus hepatitis A is only transmitted when there is oral contact of an uninfected person with an infected person's anus.  The most common way that people get hepatitis A is through eating or drinking contaminated food or drinks.  This is part of the reasons that restaurants have strict rules about hand washing by employees.

Persons can have any form of hepatitis and not be jaundice or have yellowing of the eyes.  Only hepatitis B and C have chronic forms of infection, hepatitis A is not a chronic infection so person who get the infection get over it and then are immune from re-infection..  

I hope these comments are helpful. EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
University of Alabama at Birmingham
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