Hepatitis A virus (HAV) remains a significant global public health concern, particularly as a foodborne pathogen. Despite advances in vaccination and sanitation, HAV continues to cause outbreaks, especially in regions with uneven immunization coverage or inadequate hygiene infrastructure. This review comprehensively examines HAV from virological, clinical, and epidemiological perspectives, highlighting its pathogenesis, transmission routes, genomic diversity, and foodborne risks. We discuss the evolving global epidemiology of HAV, emphasizing the shift from high to low endemicity in vaccinated populations and the emergence of susceptible cohorts in moderately developed regions. The review underscores the challenges in foodborne HAV detection, including the limitations of current methods and the promise of emerging technologies like reverse transcription digital polymerase chain reaction (RT-dPCR) for enhanced sensitivity. Additionally, we summarize emerging antiviral approaches in food safety control, including plant-derived bioactive compounds and edible coatings, for controlling HAV transmission through the food chain. Finally, we present an overview of WHO-recommended vaccination strategies based on endemicity levels—targeted immunization for high-risk groups in low-endemic areas, universal childhood vaccination in moderate-endemic regions, and reliance on naturally acquired immunity in high-endemic zones. Our synthesis aims to bridge gaps between virology, clinical medicine, and food safety, offering insights for interdisciplinary collaboration in HAV prevention and control.
Shi et al. (Fri,) studied this question.