Hepatitis virus class A (HAV), is categorized as a member of
Picornaviridae family, a non-enveloped ribonucleic acid
(RNA) virus. Its route of transmission is feco-orally and
associated
with poor sanitation and hygiene, and primarily
spreading through close contact with sick individuals leading
to infection plus inflammation of the liver.1,2 HAV shows a
high endemic rate in the underdeveloped countries, those
with deprived hygiene and sanitation, especially through
drinking contaminated water and food.3
It is the most common distributed type of viral hepatitis
around the world, as it is responsible for around 1.4 million
new infections worldwide each year. The asymptomatic childhood
infections with higher incidence are generally allied with
inadequate water treatment, poor sanitation, overcrowding,
and lower socioeconomic factors.4
Infections of hepatitis A is usually self-limiting, acute
liver illness, while the progress of the disease is not always
benign; starting with a flu-like symptoms, jaundice and/or
elevated liver enzymes (serum aminotransferases). Initially,
clinical symptoms may be like those of a viral prodrome,
and with nonspecific presentations.5,6 Complication of hepatitis
A occurs dramatically as an acute liver failure. The elder
patients especially immunosuppressed or those with
underlying liver disease are at risk for this complication. In
children, the course of hepatitis A usually has an asymptomatic
mode while the clinical presentations are more
common in adults, thus in developed populations, the symptomatic
cases proportion is higher as the infection is more
expected in elder patients due to routine vaccination coverage
in childhood.7,8