Hepatitis

Viral

Hepatitis A (ssRNA; 30–45% of acute viral hepatitis in U.S.; MMWR 2018;67:1208)

  • Transmission & RFs: fecal–oral route; contam. food, water, shellfish; daycare ctr; intl travel
  • Incubation: 2–6 wk; no chronic carrier state
  • Sx: ↓ appetite, malaise, fever, N/V, RUQ pain, jaundice; rarely ALF (↑ w/ chronic HCV)
  • Diagnosis: acute hepatitis = ⊕ IgM anti-HAV; past exposure = ⊕ IgG anti-HAV (⊖IgM)
  • Rx for acute HAV: supportive care; refer to liver txplnt center if acute liver failure
  • Postexposure ppx: age 1–40 y → vaccine; age <1 y or >40 y, immunosupp, er dis. → Ig