Hepatitis A virus (HAV) causes acute self-limited hepatitis and never progresses to chronic infection. Which property of HAV best explains its inability to establish chronicity?

• A HAV is rapidly cleared by neutralizing IgA antibodies in the gut lumen before viremia can be established
• B HAV is an RNA virus that replicates in the cytoplasm without forming a DNA intermediate or integrating into the host genome ✓
• C HAV lacks surface antigenic variation, allowing effective vaccine-induced immunity to prevent persistence
• D HAV genome has a built-in apoptotic signal that destroys infected hepatocytes before persistent infection can develop

Explanation

HAV is a positive-sense RNA picornavirus that replicates entirely in the cytoplasm via an RNA-dependent RNA polymerase. It never forms a DNA intermediate and does not integrate into the host genome, which explains why it cannot establish latent or persistent infection. Distractor A is wrong because HAV does cause significant viremia and is shed in bile despite IgA responses. The lack of chronicity is a fundamental replication property, not an immune-evasion failure.

Reference: Fields Virology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.