IgG persists for life and provides ongoing immunity against reinfection. Imaging studies are generally not necessary. Ultrasound examination of the liver may be helpful when cholelithiasis is a consideration. Histologic findings are similar to those found in other forms of acute viral hepatitis and include inflammatory cell infiltration, hepatocellular necrosis and liver cell regeneration. Liver biopsy is not indicated due to the self-limited nature of HAV and lack of chronic infection.
Treatment is supportive as there is no specific therapy for the virus.
Hospitalization is indicated for patients with significant dehydration due to vomiting or those with fulminant hepatitis. Avoid medications that have known liver toxicity. Subspecialist consultation is generally not required. Fulminant hepatitis warrants care by a pediatric gastroenterologist and possibly an intensive care specialist. There are no specific dietary needs.