Hospitalized Hepatitis A Cases in Jordan: A 10-Year Retrospective Comparison Between Pediatric and Adult Populations.

BACKGROUND: Hepatitis A virus (HAV) infection is generally self-limiting but may occasionally cause severe disease requiring hospitalization. As HAV epidemiology shifts in the Middle East with declining childhood seroprevalence and rising adult susceptibility, understanding age specific disease patterns is important. This study compared pediatric and adult patients hospitalized with HAV in northern Jordan. METHODS: A retrospective cohort study was performed of 115 serologically confirmed HAV cases admitted to King Abdullah University Hospital (KAUH) from 2015-2024. Patients were categorized as pediatric (≤17 years) or adult (≥18 years). Demographics, clinical features, laboratory and imaging findings, and outcomes were compared. RESULTS: Children accounted for 67.8% of admissions and more often lived in rural areas. Jaundice and ascites were more frequent among pediatric patients, whereas diarrhea, prolonged symptoms, and higher alanine aminotransferase (ALT) levels characterized adult cases. Gallstones were detected only in adults. Severe complications were uncommon; however, all 3 deaths occurred among pediatric patients and were associated with marked coagulopathy. CONCLUSION: Pediatric and adult HAV infections present with distinct clinical and biochemical patterns. While most cases are uncomplicated, severe pediatric outcomes, including mortality, highlight the need for strengthened prevention strategies, improved sanitation, and evaluation of routine HAV vaccination in Jordan.