Skeleton model

HAV does not cause chronic hepatitis or a carrier state.

Case fatalities from HAV occur at a very low rate, when patients have preexisting liver disease from other causes such as HBV or alcohol

Close personal contact with an infected individual during the period of fecal shedding, with fecal-oral contamination, accounts for most cases and explains the outbreaks in institutional settings such as schools and nurseries

Because HAV viremia is transient, blood-borne transmission of HAV occurs only rarelyThe virus itself does not seem to be toxic to hepatocytes, and hence the liver injury seems to result from T cell-mediated damage of infected hepatocytes.