Complications of hepatitis A virus infection

• prolonged jaundice and/or relapses
  • seen in around 15% of the patients
• cholestatic hepatitis (1)
• fulminant (acute) liver failure
  • occurs in approximately 0.4% of cases
  • common in patients with associated chronic hepatitis B or C
  • mortality is around 40% without liver transplant (2)
• in pregnancy - increased risk of miscarriage and prematurity proportional to the severity (2)

The overall mortality is less than 0.1%, although this rises to 40% in those with acute liver failure (2) and symptomatic hepatitis, severe disease, and death are more likely to occur when infection occurs at an older age (3)

Reference:

1. World Health Organization (WHO) 2009. The global prevalence of hepatitis A virus infection and susceptibility: a systematic review
2. United Kingdom National Guideline on the Management of the viral hepatitides A, B and C; British Association for Sexual Health and HIV (2015)
3. Aggarwal R, Goel A; Hepatitis A: epidemiology in resource-poor countries. Curr Opin Infect Dis. 2015 Oct;28(5):488-96.