Hepatitis A virus (HAV) is the most common cause of viral hepatitis worldwide, and in highly endemic developing countries, infection is universal during childhood. By adulthood, about 50% of the population of the United States has been infected. A member of the Picornaviridae family, HAV has only one serotype and, except for the possibility of primates, has no known animal reservoir. Unlike hepatitis B (HBV) and C (HCV) viruses, HAV is spread primarily through the fecal-oral route. HAV is carried via the bloodstream to its primary target, the hepatocyte, where it replicates robustly but without causing much damage to the cells. Newly made virus is released via the bile ducts into the intestines and out in the stool.

While adaptive immune responses are being activated, which takes about 2 to 3 weeks, the virus multiplies and is released into stool unchecked. Until that activation, the initial phase of HAV infection...

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