Preventing Hepatitis A Recurrence
Hepatitis A does not recur after initial infection because IgG anti-HAV antibodies produced during the acute infection persist for life and provide complete protection against reinfection. 1, 2, 3
Understanding HAV Immunity
- Once you recover from hepatitis A infection, you develop lifelong immunity through persistent IgG anti-HAV antibodies that protect against any future HAV exposure. 1, 2, 3
- HAV is an acute, self-limited disease that does not result in chronic infection or chronic liver disease. 4, 3
- The virus does not establish persistent infection in the body, unlike hepatitis B or C. 4
Relapsing Disease vs. Reinfection
It is critical to distinguish between relapsing disease (which can occur) and true reinfection (which cannot occur):
- Approximately 10-15% of patients experience relapsing hepatitis A, with symptoms recurring within 6 months of the initial illness. 5, 2
- About 20% of patients with relapsing disease may have multiple relapses during this 6-month period. 5
- These relapses represent continuation of the original infection with recurrent viral shedding, not new infections. 6
- Even with relapses, the overall prognosis remains excellent, and complete recovery is expected. 4
Clinical Implications
Since true HAV reinfection does not occur, "prevention of recurrence" is not applicable in the traditional sense. However, you should be aware of:
- Patients may shed virus for extended periods: children can shed HAV for up to 10 weeks after illness onset, and infants infected as neonates may shed for up to 6 months. 5, 4
- During relapsing episodes, patients may again become infectious and shed virus in stool. 6
- Most patients recover completely within 3-4 weeks, though some experience prolonged courses up to 6 months. 4, 2
Vaccination After Natural Infection
- Vaccination is not necessary after documented HAV infection because natural immunity is lifelong and complete. 3
- Serologic testing for IgG anti-HAV can confirm prior infection and immunity if documentation is uncertain. 5
- Vaccine-induced antibodies also confer long-term protection, but vaccination adds no benefit to those with natural immunity. 1, 3