Secondary haemophagocytic lymphohistiocytosis associated with acute viral hepatitis A - A case series

Hepatitis A-associated haemophagocytic lymphohistiocytosis (HLH) is an uncommon but severe complication that arises from an exaggerated immune response triggered by multiple aetiology. HLH is characterised by excessive inflammation and tissue destruction due to abnormal immune activation, often leading to multi-organ failure and high mortality if not promptly diagnosed and treated. Although HLH is more commonly associated with other viral infections, its occurrence with hepatitis A virus (HAV) is rare and primarily documented through case reports. The present case series aims to report the clinical presentations, diagnostic challenges, treatment strategies and outcomes of five cases of HAV-associated HLH.