Hepatitis A: a new look at an old problem (lecture)

Hepatitis A is a serious medico-social problem in the health care system worldwide. In the Russian Federation, hepatitis A virus continues to be the major etiological agent of acute viral hepatitis. The features of Hepatitis A at the present are its frequent association with chronic alcohol intoxication, chronic hepatitis B and C, HIV infection, a tendency to a prolonged course with exacerbations and relapses, the presence of cholestatic syndrome and an autoimmune disorder, more frequent development of severe forms of the disease due to the incidence declined in children and increased in adults. Due to the lack of specific antiviral therapy, vaccination is currently recognized as the most effective measure to combat hepatitis A. Thus, hepatitis A vaccination is included in the National Immunization Program in at least 20 countries, including the United States, China and Brazil. Expansion of the National Immunization Program and inclusion of hepatitis A vaccination will significantly reduce the incidence of this disease in the Russian Federation. The article describes the features of the hepatitis A virus reproduction cycle, including a description of quasi-enveloped form of virions. Current data on the epidemiology and pathogenesis of hepatitis A are presented. Clinical manifestations of manifest forms of hepatitis A are considered. The main and most promising methods of laboratory diagnostics of hepatitis A, as well as methods of specific disease prevention are described.