Hepatitis A in Adults: Experience from a Moroccan Hospital Center

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Background: In children, hepatitis A virus infection is usually symptom-free and provides long-term immunity. However, in changing socio-economic environments, certain adults encounter infection risks, exposing them to symptomatic illness and complications. This study aims to outline the profile of adult hepatitis A patients. Methods: We conducted a retrospective study from 2017 to 2023, involving all patients aged over 14 years who presented with acute hepatitis and tested positive for anti-HAV antibodies. Demographic, laboratory and clinical data were analyzed. Results: The analysis involved 109 cases (mean age 21 +/- 6 years, 57.8% males). All patients were symptomatic. Among them, 71.6% presented with a pseudo-flu-like syndrome, 89% with jaundice, 50.5% with fever and 30.2% with gastrointestinal symptoms. Thirty patients were hospitalized (26.6%), among them one subfulminant was recorded. Clinically, hepatomegaly was found in 8 patients (7.3%). One patient had presented with a skin rash. Serum alanine aminotransferases levels were more than 50 times the normal range in 47.7% of cases, with an average bilirubin level of 89 mg/l. Severe acute hepatitis was observed in 26.6% of patients. Conclusion: Our findings revealed that over 25% of adult patients experienced severe acute hepatitis, with one patient progressing to acute liver failure. These results underline the importance of raising awareness of hygiene practices and prompt a study of the overall seroprevalence of hepatitis in the adult population in order to improve viral hepatitis prevention and control strategies in the country.

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