ABSTRACT
Viral hepatitis is a major health concern worldwide with higher incidence in developing countries than in the developed countries.1,2 Hepatitis A virus (HAV) is one of the etiologic agents of acute viral hepatitis. Most infection occur in children and generally are self-limiting.1 Transmission of HAV is primarily via the fecal-oral route, either by contact with an infected person or by ingestion of contaminated food and water.1 In the industrialized countries, due to improvements of public health and socioeconomic conditions, there has been a shift of HAV infection toward a higher age with an increase of hospitalized and severe cases associated with outbreaks.3 The illness severity is age-dependent. Generally,
HAV infection in children is asymptomatic and rarely develops jaundice, whereas in older children and adults are symptomatic infection with a wide range of clinical manifestations from mild and anicteric infection to severe and fulminant hepatic failure (FHF).1 Infected people can excrete HAV in feces for about 3 months or longer, and viremia is detectable by reverse transcription-polymerase chain reaction (RT-PCR) in the majority of patients at the onset of symptoms and can persist for several weeks after aminotransferase peak.4 Viral replication occurs primarily within hepatocytes, and then the viruses are secreted into bile through the bile ducts which results in large amount of virus being shed in the feces.5
