Hepatitis A

The hepatitis A virus (HAV) is a common infectious etiology of acute hepatitis worldwide. HAV is most commonly transmitted through the fecal-oral route via exposure to contaminated food, water, or close physical contact with an infectious person. According to the World Health Organization, infection rates in high-resource countries are low. However, high-risk groups include injected drug users, men who have sex with men, people traveling to endemic areas, and isolated communities.

HAV does not cause chronic liver disease, unlike hepatitis B or C. Acute HAV infection usually presents as a self-limited illness; the development of fulminant hepatitis is rare. Typical symptoms of acute infection include nausea, vomiting, abdominal pain, fatigue, malaise, poor appetite, and fever; management is with supportive care. Alternate clinical patterns include cholestatic, prolonged, and relapsing disease.

Vaccination against HAV is recommended for children 12 months or older and adults with the risk of exposure, including travelers to endemic countries, men who have sex with men, people who use drugs (injected and non injected), potential occupational exposure, and chronic liver disease. Globally, the rates of HAV have decreased due to improvements in public healthcare policies, sanitation, and education, but infection rates of other hepatitis viruses appear to be increasing.