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PubMed · 12442495

[Relapsing hepatitis A].

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T Saibara, S Onishi. 1995. [Relapsing hepatitis A].. https://pubmed.ncbi.nlm.nih.gov/12442495/

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[Hepatitis A].

Hepatitis A infection is known since the ancient Chinese, Greek and Roman civilizations but the first documented report was published in the eighteenth century. The hepatovirus belongs to the Picornaviridae family, and carries a single strand RNA. There are 7 genotypes. Antibodies of the IgM and IgA classes, during natural infections, appear early in the serum, together with the first clinical manifestations of the disease, but they may also appear at the end of the first week of infection. There is a spectrum of clinical presentation: asymptomatic infection, symptomatic without jaundice and symptomatic jaundiced. A rare fatal form of hepatitis has been described. Diagnosis of the hepatitis A infection is confirmed by the finding of IgM anti-HAV antibodies, routinely performed using an ELISA test. Treatment is supportive. Intramuscular anti-A gamma globulin is used for passive immune prophylaxis, and there is an efficient vaccine for active immune prophylaxis.

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The effectiveness and safety of hepatitis A vaccine: a systematic review.

We report on the conduct of a systematic review to assess the efficacy and the safety of hepatitis A vaccines in adults and children. We identified, retrieved, and assessed all trials evaluating the effects of hepatitis A vaccines on prevention of cases of hepatitis A, death from hepatitis A, and assessing nature and frequency of adverse events. We included eight randomised trials, four containing efficacy outcomes, three containing only safety outcomes and a single study containing efficacy and adverse events outcomes. Combined inactivated vaccine effectiveness was 86% (95% CI: 63-95%). Combined attenuated vaccine effectiveness was 95% (95% CI: 81-99%). Inactivated vaccine effectiveness in the prevention of HAV secondary cases, compared to non-intervention was 82% (95% CI: 23-96%). Safety profile of vaccines was similar to that of their comparators. Despite poor design and reporting of trials, we found convincing evidence of the effectiveness and safety of inactivated HAV vaccines.

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