HAV vaccine is currently licensed for children age 2 years and older. Pre-exposure prophylaxis with HAV vaccine is recommended for persons 2 years of age and older who will be traveling to countries where HAV infection is endemic. If travel will take place in fewer than 2 weeks time, or the patient is younger than 2 years of age, then IG should be given. Post-exposure prophylaxis consists of administration of IG to contacts as soon as possible, but not longer then 2 weeks after exposure. Contact precautions recommended for hospitalized patients for 1 week after the onset of symptoms.
Complications are few.
Fulminant hepatitis with massive hepatic necrosis and liver failure due to HAV infection is rare. Cholestatic hepatitis occurs in a very small percentage of patients. It is identified by persistent hyperbilirubinemia, pruritus, and constitutional symptoms that last for 12-16 weeks in the absence of biliary obstruction on ultrasound. Except in rare cases of fulminant hepatitis, pediatric patients recover without sequelae. Chronic active hepatitis, which can be seen in hepatitis B or hepatitis C infections, does not occur in HAV infection.