Hepatitis A may cause no symptoms at all when it is contracted, especially in children. Such individuals will only know they were infected (and have become immune — you can only get hepatitis A once) by getting a blood test later in life. However, many children and most adults will experience the sudden onset of an influenza-like illness, starting about 30 days after contracting the hepatitis A virus.
After a day or a few days of muscle aches, headache, anorexia (loss of appetite), abdominal discomfort, fever and malaise, jaundice (also termed “icterus”) sets in. Jaundice is a yellowing of the skin, eyes and mucous membranes that occurs because bile flows poorly through the liver and backs up into the blood. The urine will also turn dark with bile and the stool light or clay-colored from lack of bile. When jaundice sets in, the initial systemic manifestations begin to subside.
Hepatitis A is an acute self-limiting disease.5 “The incubation period of Hepatitis A is 15-50 days, with a mean of about 30 days.”6 The onset of symptoms is typically abrupt, and early manifestations of the disease include fever, intense malaise, anorexia, vomiting, extreme abdominal discomfort, and a persistent and disabling fatigue. There is no specific treatment for hepatitis A virus infection. Treatment and management of the infection is merely supportive.

The severity of illness associated with Hepatitis A increases with age. In general, the period of acute illness lasts from ten day to three weeks, at which time patients tend to recapture some sense of wellness as serum chemistries begin to normalize. It is not unusual, however, for serum chemistries to remain abnormal for six months (or more), prolonging the patient’s recovery for up to a year. It is therefore well-accepted that “the need for rest is best determined by the patient’s own perception of the severity of fatigue or malaise. Most patients show complete clinical and biochemical recovery within 3-6 months of the onset of illness.”7
Relapse is possible with Hepatitis A. This usually occurs within three months of the initial onset of symptoms. Although relapse is more common in children, it does occur with some regularity in adults.
The jaundice so commonly associated with Hepatitis A can linger for a prolonged period in some infected persons — sometimes as long as eight months. Additionally, pruritus, or severe “itchiness” of the skin, can also persist for several months after the onset of symptoms. These conditions are frequently accompanied by diarrhea, anorexia, and fatigue.
Hepatitis A does cause liver failure and death in the most extreme cases. However, such reactions to the infection are most frequently recorded in elderly populations, or in persons with previously compromised immune systems or with poor liver function.
The time to full recovery usually takes 2 months, but 10 — 15% of persons have a prolonged or relapsing course lasting up to 6 months.8,9 The vast majority of persons who contract Hepatitis A fully recover, and it does not lead to chronic hepatitis. Persons do not carry hepatitis A long-term (as with hepatitis B and C). Nevertheless, about 2 persons in 1000 with symptomatic acute hepatitis A will die.