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Hepatitis A - Management
Basis for recommendation

Travellers 1 year of age and older

  • The recommendation to offer vaccination to travellers 1 year of age and older is based on expert opinion in the document from the Department of Health Immunisation against infectious disease (the 'Green Book') [DH, 2009a], a review by the National Travel Health Network and Centre [NaTHNaC, 2009], and a review article [Stauffer et al, 2003].
    • Young children rarely become significantly ill from hepatitis A infection, but immunization is considered to be important to protect public health because children are extremely efficient at disease transmission. The risks of disease for children younger than 1 year of age are low, and the vaccines are not licensed for this age group. In young babies, particular care should be taken to prevent exposure to hepatitis A through food and water.

People with chronic liver disease and clotting factor disorders, injecting drug users, and those at occupational risk

  • The recommendation to offer vaccination to people with chronic liver disease, clotting factor disorders, injecting drug users, and those at occupational risk is based on expert opinion in the document from the Department of Health Immunisation against infectious disease (the 'Green Book') [DH, 2009a] and a review article [Steele et al, 2009].

Men who have sex with men

  • Guidance from the World Health Organization, Department of Health, Health Protection Agency, and National Travel Health Network and Centre recommends pre-exposure vaccination for all men who have sex with men [WHO, 2003; DH, 2009a; HPA, 2009a; NaTHNaC, 2009]. However, the British Association for Sexual Health and HIV (BASHH) recommends that, as current evidence suggests that most men who have sex with men are not at increased risk of hepatitis A infection, universal vaccination in this group cannot be firmly recommended. BASHH suggests that vaccination is offered in large cities, such as central London, where outbreaks have been reported, particularly where there are increased rates of infection [BASHH, 2008].

People infected with HIV

  • The recommendation to offer vaccination to people infected with HIV that belong to a group at risk of hepatitis A infection or its complications is based on expert opinion in a British HIV Association guideline for the immunization of HIV-infected adults [Geretti et al, 2008].

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