Clinical course and consequences of hepatitis A infection.
Hepatitis A virus (HAV) is a small, non-enveloped RNA virus belonging to the Picornaviridae, for which only one serotype has been identified. Transmission is usually through the faecal-oral route by person-to-person contact. The most common risk factors are household or sexual contact with a sufferer, attendance or working at a day-care centre, international travel, and association with food or waterborne outbreaks; 55% of cases have no identifiable risk factors. HAV infection may be symptomatic or asymptomatic, and shows three phases. Virus is shed during the incubation phase, anti-HAV IgM appears during the symptomatic phase and can be used for diagnosis, and anti-HAV IgG appears at the same time but persists lifelong. Unusual clinical manifestations of hepatitis A include cholestatic, relapsing and fulminant hepatitis. Hepatitis A accounts for 93% of cases of acute hepatitis in Argentina, including 7% of atypical clinical cases. Hepatitis A is the major cause of fulminant hepatitis, and has been reported to account for 10% of liver transplants in children in France and 20% in Argentina. One-year survival after liver transplantation is 64%. Prevention must be considered as the main means of averting this severe illness.
Ciocca
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Paediatric Hepatologist, Children's Hospital Juan P. Garrahan, Combate de los Pozos 1881 (CP 1245), Capital Federal, Buenos Aires, Argentina.
D000293:Adolescent; D001118:Argentina / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006506:Hepatitis A / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007223:Infant; D017093:Liver Failure / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation; D011379:Prognosis; D012307:Risk Factors