{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:43:01Z","timestamp":1755225781554,"version":"3.43.0"},"reference-count":18,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Hepatitis A is an acute viral infection of the liver caused by hepatitis A virus (HAV) that is acquired through the feco-oral route. It has the highest incidence among the four major acute viral hepatitis types (A, B, C, and E) and usually occurs in early childhood. However, the prevalence of acute hepatitis A has recently increased among teenagers and young adults, and it is usually misdiagnosed. This study emphasizes the significance of awareness among healthcare workers about the increasing incidence of acute hepatitis A among this group to ensure accurate diagnosis and appropriate management.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A hospital-based retrospective cross-sectional study was employed. Fifty-eight confirmed acute HAV patients who visited Adera Medical and Surgical Center (AMSC) between August 2023 and January 2024 were enrolled. Sociodemographic, clinical, and laboratory parameters and documented management data, including hospitalization and any trial of antibiotic treatment before considering HAV or in the course of the illness, were collected. The data were entered and analyzed using SPSS (SPSS, Version 26.0).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The sex ratio was similar, with a slight male predominance (M\/F\u2009=\u20091.07). The mean age [\u00b1 SD] of the patients was 19.3[\u00b1 8.8] years. Thirty-nine (67.2%) of the patients were students, and all of the patients were from Addis Ababa. Vomiting (82.8%), anorexia (70.7%) and yellowish discoloration of the eyes (62.1%) were the most common presenting symptoms, while icteric sclera 44 (75.9%) and epigastric tenderness 17 (29.3%) were the most common physical findings. More than half of the patients (55.2%) were initially misdiagnosed with typhoid fever (TF) (46.8%), peptic ulcer disease (PUD) (31.2%) or urinary tract infection (UTI) (15.6%). All patients recovered fully, and liver function tests (LFTs) normalized with supportive care within 2\u20134 weeks.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This study revealed the shift in the age of HAV susceptibility and subsequent infection towards adolescents and young adults (mean [\u00b1 SD] age 19.31 [\u00b1 8.8] years) in our cohort, with more than half of the patients (55.2%) initially being misdiagnosed with TF, PUD or UTI, causing diagnostic and treatment challenges. This necessitates heightened awareness among healthcare workers and the public. Early HAV diagnosis through targeted laboratory investigations and avoiding unnecessary antibiotics are crucial for effective management and prevention via hygienic and immunization strategies.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0330212","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T17:44:34Z","timestamp":1755107074000},"page":"e0330212","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hepatitis A beyond childhood causing diagnostic and therapeutic challenges in Addis Ababa, Ethiopia"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1640-1461","authenticated-orcid":true,"given":"Abate Bane","family":"Shewaye","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6726-5757","authenticated-orcid":true,"given":"Kaleb Assefa","family":"Berhane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amsalework Daniel","family":"Fanta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"issue":"3","key":"pone.0330212.ref001","doi-asserted-by":"crossref","first-page":"7436","DOI":"10.51894\/001c.7436","article-title":"Hepatitis A: a case report example of a growing epidemiological threat","volume":"3","author":"A Foster","year":"2019","journal-title":"Spartan Med Res J"},{"issue":"5","key":"pone.0330212.ref002","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1080\/21645515.2020.1819742","article-title":"Hepatitis A vaccination and its immunological and epidemiological long-term effects - a review of the evidence","volume":"17","author":"C Herzog","year":"2021","journal-title":"Hum Vaccin Immunother"},{"issue":"5","key":"pone.0330212.ref003","doi-asserted-by":"crossref","first-page":"861","DOI":"10.3390\/v13050861","article-title":"Mechanisms of hepatocellular injury in hepatitis A","volume":"13","author":"M Wang","year":"2021","journal-title":"Viruses"},{"key":"pone.0330212.ref004","volume-title":"WHO Immunological Basis for Immunization Series, Module 18: Hepatitis A Update.","author":"World Health Organization","year":"2019"},{"key":"pone.0330212.ref005","article-title":"Hepatitis A","volume-title":"StatPearls","author":"N Iorio","year":"2023"},{"issue":"10","key":"pone.0330212.ref006","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.3390\/v13101900","article-title":"Hepatitis A: epidemiology, high-risk groups, prevention and research on antiviral treatment","volume":"13","author":"M Migueres","year":"2021","journal-title":"Viruses"},{"key":"pone.0330212.ref007","article-title":"Type A viral hepatitis: A summary and update on the molecular virology, epidemiology, pathogenesis and prevention","author":"SM Lemon","year":"2017","journal-title":"J Hepatol"},{"issue":"9","key":"pone.0330212.ref008","article-title":"Natural history, clinical manifestations, and pathogenesis of hepatitis A","volume":"8","author":"E-C Shin","year":"2018","journal-title":"Cold Spring Harb Perspect Med"},{"issue":"2","key":"pone.0330212.ref009","first-page":"255","article-title":"Increasing burden of acute hepatitis A among Ethiopian children, adolescents, and young adults: a change in epidemiological pattern and need for hepatitis a vaccine","volume":"32","author":"A Bane","year":"2022","journal-title":"Ethiop J Health Sci"},{"issue":"5","key":"pone.0330212.ref010","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1007\/s12072-021-10232-4","article-title":"The global trends and regional differences in incidence and mortality of hepatitis A from 1990 to 2019 and implications for its prevention","volume":"15","author":"G Cao","year":"2021","journal-title":"Hepatol Int"},{"issue":"3","key":"pone.0330212.ref011","doi-asserted-by":"crossref","first-page":"68","DOI":"10.4254\/wjh.v4.i3.68","article-title":"Hepatitis A: epidemiology and prevention in developing countries","volume":"4","author":"E Franco","year":"2012","journal-title":"World J Hepatol"},{"issue":"8","key":"pone.0330212.ref012","doi-asserted-by":"crossref","first-page":"1942","DOI":"10.1080\/21645515.2017.1323158","article-title":"Modeling the hepatitis A epidemiological transition in Brazil and Mexico","volume":"13","author":"T Van Effelterre","year":"2017","journal-title":"Hum Vaccin Immunother"},{"issue":"4","key":"pone.0330212.ref013","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1007\/s40121-019-00270-9","article-title":"Increasing burden of hepatitis A in adolescents and adults and the need for long-term protection: a review from the Indian subcontinent","volume":"8","author":"A Agrawal","year":"2019","journal-title":"Infect Dis Ther"},{"issue":"1","key":"pone.0330212.ref014","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1186\/s12879-019-4235-5","article-title":"A systematic review of the epidemiology of hepatitis A in Africa","volume":"19","author":"J Patterson","year":"2019","journal-title":"BMC Infect Dis"},{"key":"pone.0330212.ref015","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.ijid.2017.12.021","article-title":"Changing sero-epidemiology of hepatitis A in Asia Pacific countries: a systematic review","volume":"68","author":"M Gripenberg","year":"2018","journal-title":"Int J Infect Dis"},{"issue":"5","key":"pone.0330212.ref016","doi-asserted-by":"crossref","first-page":"825","DOI":"10.4269\/ajtmh.1999.61.825","article-title":"Hepatitis A in Latin America: a changing epidemiologic pattern","volume":"61","author":"R Tapia-Conyer","year":"1999","journal-title":"Am J Trop Med Hyg"},{"issue":"2","key":"pone.0330212.ref017","doi-asserted-by":"crossref","first-page":"145","DOI":"10.3109\/00365549009037894","article-title":"Age-specific prevalence of hepatitis A virus antibody in Ethiopian children","volume":"22","author":"E Tsega","year":"1990","journal-title":"Scand J Infect Dis"},{"issue":"43","key":"pone.0330212.ref018","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.15585\/mmwr.mm6743a5","article-title":"Update: Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Postexposure Prophylaxis and for Preexposure Prophylaxis for International Travel.","volume":"67","author":"NP Nelson","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0330212","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T17:44:37Z","timestamp":1755107077000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0330212"}},"subtitle":[],"editor":[{"given":"Yury E","family":"Khudyakov","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,8,13]]},"references-count":18,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0330212","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,13]]}}}