Relapsing Hepatitis A: An Asymptomatic Recurrence of Elevated Liver Chemistries

A 29-year-old male with a history of anxiety and ADHD experienced a relapsing hepatitis A infection, characterized by asymptomatic recurrences of elevated liver chemistries. Initially presenting with fever and later developing scleral icterus and nausea, his lab results showed elevated AST and ALT levels. Despite stopping his home medications and having no significant family or travel history, his liver chemistries remained elevated, and viral serology confirmed HAV infection. Two months later, he had another elevation in liver chemistries, but remained asymptomatic. Relapsing hepatitis A, a rare complication of HAV infection, typically occurs within six months of the initial infection and is managed conservatively. This case highlights the importance of recognizing relapsing hepatitis A, especially amid recent outbreaks, to avoid unnecessary interventions.