{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T20:06:05Z","timestamp":1766088365100,"version":"3.41.2"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>There is limited evidence that hepatitis A virus (HAV) infection can trigger hepatic autoimmunity, but this area remains largely unexplored. This study was thus planned with the aim to compare HAV\u2010induced autoimmune\u2010like hepatitis (HAV\u2010ALH) with HAV\u2010related liver dysfunction (HAV\u2010acute viral hepatitis or HAV\u2010AVH) and classical autoimmune hepatitis (AIH). This was a retrospective review of 46 patients with HAV infection who underwent liver biopsy (including 17 cases of HAV\u2010ALH: diagnosis based on histopathology), and they were compared to 46 cases of age\u2010 and gender\u2010matched classical AIH. Overall, HAV cohort (<jats:italic>n<\/jats:italic>\u2009=\u200946) had higher prevalence of pruritus, higher bilirubin levels, higher proportion of cholestasis, lower IgG levels, higher seronegativity and lack of disease recurrence, while the classical AIH group had higher proportion\/severity of interface hepatitis, fibrosis, necrosis and pseudorosetting (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). In comparison to the classical HAV\u2010AVH group, HAV\u2010ALH group had higher AST levels, higher presence of autoantibodies, and higher prevalence of severe zone 3 perivenulitis and marked pseudorosetting on histology (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Also, HAV\u2010ALH group, in comparison to the AIH group, had more pruritus (OR 7.29, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.004) and more seronegativity (41% vs. 13%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.031), while duration of illness (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.003), IgG (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) levels and liver stiffness measurement (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.006) were significantly higher in AIH group (versus the HAV\u2010ALH and HAV\u2010AVH groups). Histologically, in comparison to AIH, HAV\u2010ALH group had significantly less interface hepatitis (OR 0.03, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and fibrosis (OR 0.08, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and significantly more cholestasis (OR 4.5, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.021). HAV infection can act as a potential trigger for immune\u2010mediated hepatic damage, akin to drug\u2010induced autoimmune\u2010like hepatitis. Larger multicentric studies are needed to further explore this aspect.<\/jats:p>","DOI":"10.1111\/jvh.14028","type":"journal-article","created":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T12:04:13Z","timestamp":1730462653000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinico\u2010Pathological Spectrum of Hepatitis A Virus\u2010Induced Autoimmune\u2010Like Hepatitis in Children"],"prefix":"10.1111","volume":"32","author":[{"given":"Samannay","family":"Das","sequence":"first","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5024-4084","authenticated-orcid":false,"given":"Vikrant","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Archana","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Department of Pathology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Pathology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjeevani","family":"Kaul","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepika","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6275-7736","authenticated-orcid":false,"given":"Bikrant Bihari","family":"Lal","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajeev","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seema","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13312-019-1640-1"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181aecb4c"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13370"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-018-3262-3"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)92858-Y"},{"issue":"1","key":"e_1_2_10_7_1","first-page":"106","article-title":"Idiopathic Autoimmune Chronic Hepatitis Triggered by Hepatitis A","volume":"89","author":"Rahaman S. 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