Majeed AA, Sarfraz M, Butt AS. Evolving trends in hepatitis A epidemiology: Shifting patterns, emerging risks, and future strategies. World J Virol 2025; 14(4): 112590 [DOI: 10.5501/wjv.v14.i4.112590]
Corresponding Author of This Article
Amna Subhan Butt, Associate Professor, Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi 74800, Pakistan. amna.subhan@aku.edu
Research Domain of This Article
Virology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Virol. Dec 25, 2025; 14(4): 112590 Published online Dec 25, 2025. doi: 10.5501/wjv.v14.i4.112590
Evolving trends in hepatitis A epidemiology: Shifting patterns, emerging risks, and future strategies
Ammara Abdul Majeed, Maham Sarfraz, Amna Subhan Butt
Ammara Abdul Majeed, Maham Sarfraz, Amna Subhan Butt, Department of Medicine, Aga Khan University Hospital, Karachi 74800, Pakistan
Author contributions: Majeed AA and Sarfraz M did literature search and wrote this review article; Butt AS received the invitation for review article, developed abstracts and received approval, developed outline, further reviewed article for important intellectual content and; all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amna Subhan Butt, Associate Professor, Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi 74800, Pakistan. amna.subhan@aku.edu
Received: July 31, 2025 Revised: October 25, 2025 Accepted: December 16, 2025 Published online: December 25, 2025 Processing time: 147 Days and 14.3 Hours
Abstract
Hepatitis A, a vaccine-preventable liver infection caused by the hepatitis A virus, is undergoing significant epidemiological shifts worldwide. Traditionally considered a disease of childhood in endemic regions, improved sanitation, economic development, and widespread vaccination have led to a decline in incidence, particularly in developed nations. However, this decline has resulted in a growing population of susceptible adults, increasing the risk of severe outbreaks. Additionally, changes in travel patterns, urbanization, and socioeconomic disparities have altered disease distribution, leading to sporadic outbreaks in low-endemicity regions and a rising burden in certain high-risk populations. This review explores the evolving epidemiology of hepatitis A, emphasizing the transition from endemic childhood infections to adult susceptibility. We examine the impact of changing risk factors, including shifting demographics, increased international travel, and regional disparities in vaccination coverage. Furthermore, the review highlights the emergence of new viral strains and their potential implications for disease control. Updated vaccination policies, including targeted immunization strategies and their role in preventing outbreaks, are also discussed. Given these dynamic changes, continued surveillance and public health preparedness tailored to evolving risk groups are crucial for sustained hepatitis A control. By synthesizing recent epidemiological data and policy updates, this review provides insights into the future of hepatitis A prevention and control, offering guidance for clinicians, researchers, and public health professionals.
Core Tip: The epidemiology of hepatitis A is undergoing a profound shift, driven by changing socioeconomic conditions, living standards worldwide and ongoing viral evolution. This has resulted in a shift in epidemiology, with decreasing exposure to the virus among children, leaving adolescent and adult populations susceptible to more clinically significant disease. This change leads to more severe disease in older populations, highlighting the need for updated vaccination guidelines targeting susceptible adults, vigilant surveillance to monitor viral evolution and antigenic variation, and strengthened public health measures including enhanced hygiene and outbreak prevention strategies.
