Hepatitis A

Old and new

Research output: Contribution to journalArticle

270 Citations (Scopus)

Abstract

The hepatitis A virus (HAV), a picornavirus, is a common cause of hepatitis worldwide. Spread of infection is generally person to person or by oral intake after fecal contamination of skin or mucous membranes; less commonly, there is fecal contamination of food or water. Hepatitis A is endemic in developing countries, and most residents are exposed in childhood. In contrast, the adult population in developed countries demonstrates falling rates of exposure with improvements in hygiene and sanitation. The export of food that cannot be sterilized, from countries of high endemicity to areas with low rates of infection, is a potentially important source of infection. After ingestion and uptake from the gastrointestinal tract, the virus replicates in the liver and is excreted into the bile. Cellular immune responses to the virus lead to destruction of infected hepatocytes with consequent development of symptoms and signs of disease. Humoral immune responses are the basis for diagnostic serologic assays. Acute HAV infection is clinically indistinguishable from other causes of acute viral hepatitis. In young children the diseases is often asymptomatic, whereas in older children and adults there may be a range of clinical manifestations from mild, anicteric infection to fulminant hepatic failure. Clinical variants include prolonged, relapsing, and cholestatic forms. Management of the acute illness is supportive, and complete recovery without sequelae is the usual outcome. Research efforts during World War II led to the development of passive immunoprophylaxis. Pooled immune serum globulin is efficacious in the prevention and attenuation of disease in exposed individuals. More recently, active immunoprophylaxis by vaccination has been accomplished. Future eradication of this disease can now be contemplated.

Original languageEnglish (US)
Pages (from-to)38-58
Number of pages21
JournalClinical Microbiology Reviews
Volume14
Issue number1
DOIs
StatePublished - 2001

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Hepatitis A
Hepatitis A virus
Infection
Hepatitis
Disease Eradication
Food Contamination
Viruses
Picornaviridae
Serum Globulins
World War II
Sanitation
Acute Liver Failure
Virus Diseases
Humoral Immunity
Hygiene
Developed Countries
Bile
Cellular Immunity
Developing Countries
Signs and Symptoms

ASJC Scopus subject areas

  • Microbiology

Cite this

Hepatitis A : Old and new. / Cuthbert, J. A.

In: Clinical Microbiology Reviews, Vol. 14, No. 1, 2001, p. 38-58.

Research output: Contribution to journalArticle

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