Hepatitis A: Viral Structure, Classification, Life Cycle, Clinical Symptoms, Diagnosis Error, and Vaccination

Abstract

Hepatitis A virus (HAV) is one of the well-known viruses that cause hepatitis all around the globe. Although this illness has decreased in developed countries due to extensive immunization, numerous developing and under-developed countries are struggling with this virus. HAV infection can be spread by oral-fecal contact, and there are frequent epidemics through nutrition. Improvements in socioeconomic and sanitary circumstances have caused a shift in the disease’s prevalence worldwide. Younger children are usually asymptomatic, but as they become older, the infection symptoms begin to appear. Symptoms range from slight inflammation and jaundice to acute liver failure in older individuals. While an acute infection may be self-limiting, unrecognized persistent infections, and the misapplication of therapeutic methods based on clinical guidelines are linked to a higher incidence of cirrhosis, hepatocellular carcinoma, and mortality. Fortunately, most patients recover within two months of infection, though 10–15% of patients will relapse within the first six months. A virus seldom leads to persistent infection or liver damage. The mainstay of therapy is based on supportive care. All children from 12–23 months, as well as some susceptible populations, should receive routine vaccinations, according to the Centers for Disease Control and Prevention and the American Academy of Pediatrics. Laboratory diagnosis of HAV is based on antigen detection, checking liver enzyme levels, and antibody screening. Furthermore, polymerase chain reaction (PCR) technology has identified HAV in suspected nutrition sources; therefore, this technique is used for preventative measures and food-related laws.

Association Between Inflammatory Bowel Disease and Viral Infections

“…The hepatitis B virus is a widespread infection worldwide. HBV is a DNA virus of the Hepadnaviridae family that is a significant cause of morbidity and mortality [73]. The prevalence of HBV infection varies geographically, with areas of low (< 2%), medium (2-7%), and high (> 8%) endemicity [74].…”

Recent advances in hepatitis A virus research and clinical practice guidelines for hepatitis A virus infection in Japan

“…134 A relapsing course with re-elevation of ALT is observed in 1.5%-15% of patients within the first 6 months, although most patients with hepatitis A recover within 2 months of infection. 135,136 Prolonged cholestasis has been observed in 4.7% of patients, and may be predicted by pre-existing chronic HBV infection, prolonged PT, and higher total bilirubin levels. 68 There are several reports about cholestatic hepatitis A in childhood [137][138][139][140] or adolescence.…”

“…However, relapse and prolonged cholestasis are unusual manifestations of hepatitis A, with most patients recovering 134 . A relapsing course with re‐elevation of ALT is observed in 1.5%–15% of patients within the first 6 months, although most patients with hepatitis A recover within 2 months of infection 135,136 …”

HAV‐induced acalculous cholecystitis: A case report and literature review

“…8 Although mostly self-limiting, HAV has several unusual and life-threatening hepatic manifestations and complications, such as acute liver failure, relapsing hepatitis and HAV-associated prolonged cholestasis. [9][10][11] Extrahepatic manifestations of HAV include skin rash, acute renal failure, myocarditis, Guillain-Barre syndrome, ascites, pleural effusion, and acute acalculous cholecystitis (AAC). [12][13][14][15] AAC, a rare extrahepatic manifestation of HAV, is an acute inflammatory disease of the gallbladder without evidence of cholecystolithiasis that accounts for 5%-10% of all cases of acute cholecystitis.…”