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Complications
The most feared complication of hepatitis A is acute liver failure. It is a devastating condition with high mortality rates. Around half of the patients with acute liver failure die or survive after transplantation. This complication is more common in older adults and those with underlying liver problems—for example, patients with cirrhosis or an underlying chronic liver failure.
The clinical manifestations of these complications are life-threatening and alarming. It causes hepatic encephalopathy with changes in levels of consciousness and behavior. In the heart tissue, it causes myocardial injuries that often go unnoticed. It causes pancreatitis and causes metabolic alterations in the kidneys (electrolyte abnormalities) and the liver itself (hypoglycemia, hyperammonemia). It causes a systemic inflammatory response, acute respiratory distress syndrome, and suppression of the bone marrow.
Luckily, this is not the most common complication. Most patients have a full recovery, even older adults. But some of them have minor complications such as prolonged jaundice, a hepatitis A relapse after several months, or cholestatic hepatitis.
