<prompt> Answer this question truthfullyWhat is the natural progression or development of Hepatitis?  <response>: <reason> Hepatitis A is caused by the hepatitis A virus HAV infection. Unlike other types of hepatitis, HAV infection is always acute. The virus replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness. It is primarily spread through fecal-oral transmission, commonly after ingesting food or water that is contaminated with the virus. The infected patients have a peak infectivity during the 2 week period before onset of jaundice or elevation of liver enzymes. The likelihood of developing symptoms with HAV infection increases with age. Fewer than 10 of infections among children aged 0-4 years result in jaundice; this percentage increases to 30-40 among children aged 5-9 years, 60-80 among youths aged 10-17 years, and 80-90 among adults aged 18 years. When signs and symptoms occur, they typically last less than 2 months, although 10-15 of symptomatic persons have prolonged or relapsing disease lasting up to 6 months. HAV infection is usually acute and self-limited. The rare cases of fulminant hepatitis are more common among patients with previous liver disease, such as chronic hepatitis C. The clinical manifestations commonly start after a 30 day incubation period. The disease manifests abruptly, with the following symptoms: Fatigue Malaise Nausea Vomiting Anorexia Fever Right upper quadrant painOne week after symptom onset, patients experience:Jaundice Pruritus Dark urine Acholic stoolThe initial symptoms commonly diminish after the onset of jaundice, which is usually more intense on its second week. 