Hepatitis A Virus (HAV)

HAV causes 'infectious/epidemic hepatitis'. Known for centuries & (wrongly) believed to be spread by aerosols. Spread by faecal-oral route - outbreaks frequently associated with consumption of shellfish.
Clinically, very variable; >90% childhood infections asymptomatic, 25-50% adult infections (as usual, the older you get, the worse it is). Incubation period from 10-50 days, fever, jaundice are main symptoms. 99% cases recover completely, a few cases experience permanent liver damage, fatalities ~0.1%.

The virus was first isolated by Purcell in 1973. In vitro, grows in a variety of cell lines, but rather poorly. HAV is a Picornavirus, formerly classified in the genus Enterovirus. Genome studies (sequence homology) showed that it did not belong in this genus and it has been reclassified in a genus of its own: Hepatovirus.

Both inactivated and attenuated vaccines are available, the inactivated form being more widely used. The availability of assays for and vaccines against HAV means that the incidence is likely to decrease in future.

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