Can Hepatitis A be Transmitted through Kissing?

HAV Virology

Hepatitis A Virus (HAV) belongs to the Hepatovirus genus of the family Picornaviridae. Four genotypes (I, II, III, and VII) are of human origin, and 3 (IV, V, VI) are of simian origin. Genotypes I and III are the most prevalent genotypes identified in humans. Numerous outbreaks of acute HAV infection due to genotype I and III happened among men who have sex with men (homosexual activity) and using prohibited drugs. But, no reports are available on the incidence of HAV due to kissing.

Can HAV really Survive in Saliva?

Research studies have shown HAV was detected in saliva in five out of six acutely infected patients with HAV in blood. It was proved in animal studies conducted by Purcell et al., 1984. He demonstrated that infectious virus in saliva which was found to be 2 to 3 logs lower than titers of virus in serum and 5 to 8 logs lower than titers in the stool. His experiments have further shown that infectious virus is shed in saliva during the incubation period and in the early acute phase and that HAV RNA may be detected in saliva from 6 hours post inoculation until several weeks after hepatitis onset.

Can Hepatitis A be Transmitted through Kissing?

Can Hepatitis A be Transmitted through Kissing?

The saliva of HAV acutely infected patients may be contagious. Although reports are demonstrated the presence of HAV in oral fluid, the incidence and transmission HAV because of saliva remain still controversial. The relationship between HAV detection and infectivity has not been established yet and, in order to evaluate the potential risk of transmitting HAV by saliva among patients during early acute phase or convalescence period, it would be interesting to conduct experimental infection studies in animal models.

Some Exposure Risk

Regular kissing while greeting a person won’t put an individual at risk of HAV infection. However, open wounds in the mouth and contact of infective fluids (vaginal, anal, or oral sex) can increase the risk of exposure to HAV. Protected sex greatly reduces or won’t put an individual at risk of getting a STD.

But generally, HAV spread from person to person by putting something in the mouth that has been contaminated with the stool (feces, poop) of a person infected with hepatitis A virus. This type of spread is called “fecal-oral route.” A person can also be infected by drinking water contaminated with HAV or drinking beverages chilled with virus-contaminated ice. Contaminated food, water, and ice can be significant sources of infection for travelers to many areas of the world.

How long does it take to show Signs of Illness after HAV Infection?

If a person is infected with HAV, it takes 2.5 to 5 weeks to shows the initial symptoms. The symptoms exist not more than two months. It causes only acute and no chronic cases have been reported till now. Most of the cases, the symptoms reoccur after 9 -12 months and this condition are called relapsing hepatitis A.


There is strong evidence available on HAV existence and survival in the saliva of HAV infected individuals. However, no proof exists on the transmission of the virus through kissing. Experts strongly believe that the risk of transmitting this disease through saliva is extremely low. If open wounds exist in both parties like gum disease, it may increase the chance or rate of transmission. The person who transmits HAV must have more viral load over a million in oral fluids.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:November 14, 2018

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