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Hepatitis A

Last reviewed: 12 Nov 2024
Last updated: 21 Feb 2024

Summary

Definition

History and exam

Key diagnostic factors

  • fever
  • malaise
  • nausea and vomiting
  • jaundice
  • hepatomegaly
  • right upper quadrant pain
  • clay-colored stools
Full details

Other diagnostic factors

  • fatigue
  • headache
  • dark urine
  • pruritus
  • arthralgias and myalgias
  • cough
  • diarrhea
  • constipation
  • splenomegaly
  • posterior cervical lymphadenopathy
  • evanescent rash
  • bradycardia
Full details

Risk factors

  • living in endemic region
  • travel to endemic region
  • close personal contact with an infected person
  • men who have sex with men
  • known foodborne outbreak
  • illegal drug use
  • homelessness
  • occupational exposure
Full details

Diagnostic tests

1st tests to order

  • serum aminotransferases
  • serum bilirubin
  • BUN
  • serum creatinine
  • prothrombin time
  • IgM anti-hepatitis A virus (HAV)
Full details

Tests to consider

  • IgG anti-hepatitis A virus (HAV)
  • hepatitis A virus RNA detection
Full details

Treatment algorithm

INITIAL

unvaccinated people with recent exposure to hepatitis A (<2 weeks)

ACUTE

confirmed hepatitis A

Contributors

Authors

Doan Y Dao, MD

Assistant Professor of Medicine

Director, Center of Excellence for Liver Disease in Vietnam

Johns Hopkins School of Medicine

Department of Medicine

Division of GI and Hepatology

Baltimore, MD

Disclosures

DYD receives grants from Roche, serves as guest director of hepatology for Tech University, and is a member of the Data and Safety Monitoring Board of the IQVIA.

Acknowledgements

Dr Doan Dao would like to gratefully acknowledge Dr Musaddiq Waheed and the late Dr Fida A. Khan, the previous contributors to this topic.

Disclosures

MW and FAK declared that they have no competing interests.

Peer reviewers

Howard J. Worman, MD

Professor of Medicine and Cell Biology

Columbia University College of Physicians and Surgeons

New York

NY

Disclosures

HJW declares that he has no competing interests.

Srikrishna Nagri, MD

Gastroenterologist

Dartmouth-Hitchcock Nashua

Nashua

NH

Disclosures

SN declares that he has no competing interests.

George Y. Wu, MD, PhD

Professor of Medicine

University of Connecticut Health Center

Farmington

CT

Disclosures

GYW is on the medical advisory boards of the following: Gilead Sciences, Bristol-Myers Squibb, AbbVie, and Intercept.

Kittichai Promrat, MD

Assistant Professor

Division of Gastroenterology

Department of Medicine

Brown University

RI

Disclosures

KP declares that he has no competing interests.

Pierre Van Damme, MD, PhD

Professor

Director of Vaccine & Infectious Disease Institute

University of Antwerp

Antwerp

Belgium

Disclosures

PVD has been and still is principal investigator of vaccine trials for several vaccine manufacturing companies, from which the university obtained and obtains research contracts and funds for conducting such vaccine trials.

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