What does hepatitis A virus infection look like on the genitals?

Hepatitis A Does Not Cause Genital Lesions

Hepatitis A virus (HAV) does not produce any visible manifestations on the genitals. HAV is a liver infection transmitted by the fecal-oral route, not a sexually transmitted infection that causes genital lesions 1.

Why This Question Reflects a Common Misunderstanding

You may be confusing HAV with other conditions that do cause genital lesions:

• Herpes Simplex Virus (HSV-2) causes painful genital ulcers and blisters
• Human Papillomavirus (HPV) causes genital warts (flesh-colored, raised lesions) 1
• Syphilis causes painless genital ulcers (chancres)

How Hepatitis A Actually Presents

HAV affects the liver, not the skin or genitals. The clinical manifestations include 1:

• Systemic symptoms: Jaundice (yellowing of skin/eyes), dark urine, pale stools, fatigue, nausea, vomiting, abdominal pain 2, 3
• No skin lesions: HAV does not cause any rashes, ulcers, warts, or other visible skin changes on the genitals or elsewhere 1
• Age-dependent presentation: Approximately 70% of adults develop symptomatic acute viral hepatitis, while most children have asymptomatic or unrecognized infection 1

Transmission Context That May Cause Confusion

HAV can be transmitted during sexual activity, but only through fecal-oral contact—not through genital-to-genital contact. 1

• Transmission occurs when fecal material containing the virus enters the mouth, which can happen during certain sexual practices (particularly oral-anal contact) 1
• Men who have sex with men (MSM) are at higher risk for HAV transmission during sexual activity 1
• Standard STD prevention measures like condoms do not prevent HAV transmission because the virus is spread fecal-orally, not through genital secretions 1

Critical Clinical Distinction

If you see lesions on the genitals, you are NOT looking at hepatitis A. 1

• HAV replicates in the liver and is shed in high concentrations in feces from 2-3 weeks before to 1 week after symptom onset 1
• The incubation period averages 28 days (range: 15-50 days) 1, 4
• Diagnosis requires serologic testing (IgM anti-HAV for acute infection), not visual inspection of the genitals 1

What to Do If You're Concerned About Genital Lesions

Seek evaluation for actual STDs that cause genital lesions:

• HSV testing for painful ulcers/blisters
• HPV evaluation for warts 1
• Syphilis serology for painless ulcers
• Consider HAV vaccination if you're in a high-risk group (MSM, injection drug users, persons with chronic liver disease), but this is for liver protection, not genital lesion prevention 1