Clinical spectrum of hepatitis a infection in children: An overview

Hepatitis A virus (HAV) infection is an enterically transmitted disease, endemic in many developing countries. In young children acute hepatitis A infection is usually asymptomatic, but older children may present with a range of clinical manifestations, which may include atypical presentations like relapsing hepatitis, cholestatic hepatitis, and extra hepatic manifestations. Both the cholestatic and relapsing variants have been associated with an increased frequency of disorders mediated by immune-complex deposition including cutaneous vasculitis, arthritis and cryoglobinemia. Protracted HAV infection has been associated with HLA-DRB 1310, a markerof pediatric autoimmune hepatitis. While evaluating a child with chronic cholestasis or recurrent jaundice, the diagnosis of atypical Hepatitis A infection should be considered in the differential diagnosis.