Hepatitis A Flashcards
Etiology:
HAV
Genetic material of HAV:
Single-stranded RNA
Transmission:
Fecal-oral
Serotypes:
Only one
Incubation period:
2-6 weeks
contacts of recently infected individuals, foreign travelers (particularly those to developing nations), male homosexuals, childcare workers, institutionalized individuals, and those living in poverty:
High-risk groups
General prognosis:
Excellent
The single most important determinant of illness severity:
+50 years old
Complications:
Prolonged Cholestasis and Fulminant Hepatic Failure
Jaundice + 3 months:
Prolonged Cholestasis
May shorten the period of cholestasis:
Corticosteroids and Ursodeoxycholic acid
Jaundice, pruritus, fever, diarrhea and weight loss:
Cholestatic Viral Hepatitis A
Avoid uncontrolled water sources, raw shellfish, and uncooked food. Boiling water or adding iodine inactivates the virus. All fruit should be washed and peeled:
Patient Education
Mild flulike symptoms:
Prodrome
Dark urine, Pale stool, Jaundice, Pruritus and Abdominal pain:
Icteric phase
Occurs in most 70-85% of acute HAV infection:
Jaundice
Physical examination findings:
Fever, Scleral icterus and Hepatomegaly
Other Viral Hepatitis, Alcoholic Hepatitis, Autoimmune Hepatitis, Budd-Chiari Synd and Acute Drug-induced Liver Injury:
DDx
Gold standard for diagnosis:
Nucleic acid testing (NAT)
After establishing the diagnosis of HAV infection:
Notify local public health authorities
ALT/AST return to reference ranges levels over:
5-20 weeks
Serologic testing diagnosis for Acute HAV infection:
Anti-HAV IgM
Anti-HAV IgG+ and IgM-:
Past infection or Vaccination
If Fulminant Hepatic Failure:
Liver Transplantation
Treatment:
Supportive Care
% of Fulminant Hepatic Failure caused by HAV:
3-8%
individuals traveling to areas of high endemicity who have less than 2 weeks before departure, People with Chronic Liver Disease:
Immunization indications
