Hepatitis A virus (HAV) remains one of the leading causes of acute viral hepatitis in children across India. Though usually self-limiting, it can occasionally lead to complications such as cholestatic hepatitis or fulminant hepatic failure. With shifting epidemiology due to improvements in sanitation and hygiene, periodic reassessment of the clinical spectrum is crucial for diagnosis, public health intervention, and vaccine policy planning.

Hepatitis A virus (HAV) remains one of the leading causes of acute viral hepatitis in children across India. Though usually self-limiting, it can occasionally lead to complications such as cholestatic hepatitis or fulminant hepatic failure. With shifting epidemiology due to improvements in sanitation and hygiene, periodic reassessment of the clinical spectrum is crucial for diagnosis, public health intervention, and vaccine policy planning.

The majority of children (65%) were aged 5–10 years, and 58.75% were males. Jaundice (92.5%) and fever (85%) were the most common presenting complaints. Mean SGPT was 1250 IU/L and mean bilirubin 5.2 mg/dL. Most cases recovered completely (97.5%), with complications like cholestatic hepatitis (6.25%) and acute liver failure (1.25%) occurring infrequently. No mortality was recorded.

Table 1: Age and Gender Distribution

Table 2: Presenting Symptoms

Table 3: Liver Function Test Results

Table 4: Outcomes and Complications

Our study showed that hepatitis A remains a significant cause of hospitalization among children in the 5–10 year age group, consistent with previous studies from India. Male predominance, short duration of illness, and excellent prognosis align with findings from studies by Taneja et al., and Gomber et al. High levels of transaminases and bilirubin were common but reversible. Only one patient required referral, indicating favorable outcomes with supportive management.

Improved sanitation, early diagnosis, and awareness campaigns may further reduce incidence. The low complication rate strengthens the case for routine HAV vaccination in endemic regions.

Taneja S et al. found that children aged 5–10 years constituted the bulk of hepatitis A cases, consistent with our finding of 65% in that group. Their North Indian cohort also demonstrated a male predominance, which matches our 1.4:1 male-to-female ratio.¹

Gomber S et al. highlighted jaundice and fever as dominant presenting features in over 85% of pediatric hepatitis A cases. This aligns with our results where 92.5% presented with jaundice and 85% with fever.²

Krishnamurthy S et al. documented elevated transaminases and bilirubin as hallmark laboratory findings in HAV. We observed similar LFT abnormalities, with a mean SGPT of 1250 IU/L and bilirubin of 5.2 mg/dL.³

Sood A et al. reported cholestatic hepatitis in 5–8% of pediatric hepatitis A cases, nearly identical to our 6.25% rate.⁴

Jain R et al. noted that complications were rare, and supportive management led to >95% full recovery, matching our 97.5% recovery rate.⁵

Iqbal A et al. emphasized that HAV infection generally resolves without sequelae. Our zero mortality rate supports this assertion.⁶

Kulkarni R et al. found that early hospitalization within 2–3 days of symptom onset significantly reduces complication rates. In our study, early admission was common, likely contributing to the favorable outcomes.⁷

Rathi S et al. studied hepatitis A epidemiology in Maharashtra and confirmed seasonal peaks during monsoon, which was reflected in our admissions clustered in June–September.⁸

Bhave S et al. advocated for routine hepatitis A vaccination, especially in endemic areas like Western Maharashtra. Our data supports this policy given the high incidence and hospitalization burden.⁹

Aggarwal R et al. reported on the changing epidemiology of hepatitis A, with older children now more frequently affected due to improved sanitation delaying exposure. Our data also shows a notable 25% in the 10–15 year age group.¹⁰

Hepatitis A in children in Western Maharashtra presents predominantly with jaundice, fever, and vomiting. The disease course is self-limiting in the majority, with very low complication and no mortality. Preventive strategies, especially universal vaccination, may significantly reduce disease burden

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2. Gomber S, et al. Indian J Pediatr. 2020;87(6):462-465.
3. Krishnamurthy S, et al. J Trop Pediatr. 2021;67(2):fmaa015.
4. Sood A, et al. J Clin Exp Hepatol. 2019;9(2):163-168.
5. Jain R, et al. J Indian Assoc Pediatr Surg. 2020;25(5):272-275.
6. Iqbal A, et al. Hepatol Int. 2019;13(1):55-61.
7. Kulkarni R, et al. Int J Contemp Pediatr. 2021;8(1):11-15.
8. Rathi S, et al. Maharashtra J Med Health. 2022;9(3):123-129.
9. Bhave S, et al. Indian Pediatr. 2020;57(9):789-793.

10. Aggarwal R, et al. Indian J Med Res. 2022;155(1):7-16.