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Review
. 2020 Jun;49(2):191-199.
doi: 10.1016/j.gtc.2020.01.002. Epub 2020 Mar 29.

Hepatitis A: Epidemiology, Natural History, Unusual Clinical Manifestations, and Prevention

Ameer Abutaleb  1 , Shyam Kottilil  2
Affiliations
Review

Hepatitis A: Epidemiology, Natural History, Unusual Clinical Manifestations, and Prevention

Ameer Abutaleb et al. Gastroenterol Clin North Am. 2020 Jun.

Abstract

Hepatitis A virus (HAV) is a positive-strand RNA virus that is transmitted feco-orally through person-to-person contact. Outbreaks are often linked to poor sanitation, overcrowding, or food and water contamination. Infection is often asymptomatic in children, but adults present with jaundice, abdominal pain, hepatitis, and hyperbilirubinemia. Diagnosis is through detection of immunoglobulin M antibodies against HAV, and treatment is supportive. Vaccination is the mainstay of prevention and should be given before exposure whenever possible.

Keywords: Acute liver failure; Hepatitis A outbreak; Hepatitis A prevention; Hepatitis A vaccine; Hepatitis A virus.

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Conflict of interest statement

Disclosure The authors have nothing to disclose.

Figures

Fig. 1.
Fig. 1.
Effects of HAV exposure in immunocompetent and immunosuppressed patients. Patients immunized against HAV before exposure can clear the virus via preformed neutralizing antibodies. Nonimmune patients who are immunocompetent typically clear the virus after the infectious hepatitis, whereas immunosuppressed patients may sustain a chronic viremia. In rare cases, both immunocompetent and immunosuppressed hosts may manifest an unusual presentation of HAV, including but not limited to liver failure, relapsing hepatitis, and prolonged cholestasis.
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References

    1. Krugman S, Ward R, Giles JP, et al. Infectious hepatitis: detection of virus during the incubation period and in clinically inapparent infection. N Engl J Med 1959; 261:729–34. - PubMed
    1. Blumberg BS, Gerstley BJ, Hungerford DA, et al. A serum antigen (Australia antigen) in Down’s syndrome, leukemia, and hepatitis. Ann Intern Med 1967;66(5): 924–31. - PubMed
    1. Feinstone SM, Kapikian AZ, Purceli RH. Hepatitis A: detection by immune electron microscopy of a viruslike antigen associated with acute illness. Science 1973;182(4116):1026–8. - PubMed
    1. Martin A, Lemon SM. Hepatitis A virus: from discovery to vaccines. Hepatology 2006;43(2 Suppl 1):S164–72. - PubMed
    1. Innis BL, Snitbhan R, Kunasol P, et al. Protection against hepatitis A by an inactivated vaccine. JAMA 1994;271(17):1328–34. - PubMed