Atypical presentation of pediatric acute hepatitis A: Is the situation alarming?

Abstract

Hepatitis A virus (HAV) infection remains a significant public health concern in many developing countries. The annual incidence of HAV infection is 1.5 million, though this figure may be underestimated owing to the infection’s asymptomatic nature and the presence of milder disease variants. The clinical spectrum of HAV infection now ranges from asymptomatic infection to fulminant hepatitis. Despite the availability of safe and highly effective vaccines, HAV infections remain a major contributor to acute viral hepatitis worldwide.

Keywords: Acute hepatitis A; Acute viral hepatitis; Atypical manifestation; Children; Prolonged cholestasis

Core Tip: Although pediatric hepatitis A is usually self-limiting, atypical presentations, such as cholestatic, relapsing, and autoimmune-triggered forms, can prolong morbidity and, occasionally, be life-threatening. This mini-review summarizes the clinical spectrum, highlights warning signs of severe disease, and outlines practical management and prevention strategies, with a particular emphasis on vaccination.