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Hepatitis A virus infection

Nature Reviews Disease Primers volume 9, Article number: 51 (2023) Cite this article

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Abstract

Hepatitis A is a vaccine-preventable infection caused by the hepatitis A virus (HAV). Over 150 million new infections of hepatitis A occur annually. HAV causes an acute inflammatory reaction in the liver that usually resolves spontaneously without chronic sequelae. However, up to 20% of patients experience a prolonged or relapsed course and <1% experience acute liver failure. Host factors, such as immunological status, age, pregnancy and underlying hepatic diseases, can affect the severity of disease. Anti-HAV IgG antibodies produced in response to HAV infection persist for life and protect against re-infection; vaccine-induced antibodies against hepatitis A confer long-term protection. The WHO recommends vaccination for individuals at higher risk of infection and/or severe disease in countries with very low and low hepatitis A virus endemicity, and universal childhood vaccination in intermediate endemicity countries. To date, >25 countries worldwide have implemented such programmes, resulting in a reduction in the incidence of HAV infection. Improving hygiene and sanitation, rapid identification of outbreaks and fast and accurate intervention in outbreak control are essential to reducing HAV transmission.

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Fig. 1: Map of estimated age (in years) at midpoint of population immunity to HAV infection by country in 2015.
Fig. 2: Phylogeny and genome organization.
Fig. 3: HAV replication cycle.
Fig. 4: Immune responses to HAV infection.
Fig. 5: Natural evolution of HAV infection in children and adults.
Fig. 6: Clinical and laboratory manifestations of acute hepatitis A.

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Authors and Affiliations

  1. Centre for the Evaluation of Vaccination, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

    Pierre Van Damme

  2. Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain

    Rosa M. Pintó

  3. Centre for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA

    Zongdi Feng

  4. Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People’s Republic of China

    Fuqiang Cui

  5. Department of Epidemiology, Hospital de Niños Ricardo Gutierrez, University of Buenos Aires, Buenos Aires, Argentina

    Angela Gentile

  6. Institute of Hepatology, Hadassah-Hebrew University Hospital, Jerusalem, Israel

    Daniel Shouval

Authors
  1. Pierre Van Damme
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  2. Rosa M. Pintó
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  3. Zongdi Feng
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  4. Fuqiang Cui
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  5. Angela Gentile
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  6. Daniel Shouval
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Contributions

Introduction (P.V.D. and D.S.); Epidemiology (P.V.D., D.S. and A.G.); Mechanisms/pathophysiology (R.M.P., Z.F. and D.S.); Diagnosis, screening and prevention (P.V.D., D.S., A.G. and F.C.); Management (D.S. and A.G.); Quality of life (P.V.D. and D.S.); Outlook (P.V.D., D.S., A.G., F.C., R.M.P. and Z.F.); Overview of Primer (P.V.D. and D.S.).

Corresponding author

Correspondence to Pierre Van Damme.

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Nature Reviews Disease Primers thanks R. Aggarwal, H. Askling, G. Dusheiko, S. Lemon, Y. Li, L. Mak and M. Yuen for their contribution to the peer review of this work.

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Van Damme, P., Pintó, R.M., Feng, Z. et al. Hepatitis A virus infection. Nat Rev Dis Primers 9, 51 (2023). https://doi.org/10.1038/s41572-023-00461-2

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