Hepatitis, Acute

Hepatitis, Acute

 

Hepatitis A virus (HAV), hepatitis B virus (HBV) and hepatitis C virus (HCV) cause 95% of viral hepatitis cases in the U.S. 

Epidemiology

  • Transmission – variable according to virus
    • HAV, HEV – fecal-oral
    • HBV, HCV – IV drug abuse, sexual transmission, blood transfusions

Organism

  • Diverse group of viruses that share a common ability to cause inflammation and necrosis of the liver
  • Virus may persist in a chronic state (HBV, HCV, HDV)
    • Patients may remain chronic carriers
    • May cause the development of cirrhosis

Etiologies

  • Viral
    • Hepatitis D virus (HDV) and hepatitis E virus (HEV) are very rare causes in the U.S.
    • Other viruses - Cytomegalovirus, EBV
  • Nonviral
    • Toxins (alcohol, drugs such as acetaminophen)
    • Obesity (steatohepatitis)
    • Granulomatous diseases (tuberculosis, sarcoid tumors)
    • Genetic disorders (Wilson disease, hemochromatosis)
  • Autoimmune

Risk Factors

  • Children in daycare settings (HAV)
  • IV drug abusers (HBV, HCV)
  • Hemophiliacs (HCV)
  • Men having sex with men (HBV, HCV)
  • HIV-positive patients (HBV, HCV)

Clinical Presentation

  • May be difficult to diagnose clinically
  • Frequently asymptomatic
    • May only have mild rise in aminotransferases
  • Mild symptoms (malaise, fever, chills, depressed appetite)
  • Similar symptoms among viral hepatitis types
  • Jaundice is not a predominant symptom

Diagnosis

  • Laboratory testing
    • Hepatitis screening panel

Prevention

  • Chronic hepatitis is a public health concern for transmission, as well as the development of cirrhosis and hepatocellular carcinoma
  • Vaccines available to immunize against HAV and HBV

Treatment

  • Acute disease – supportive
  • Chronic disease – reduce or eliminate viral loads

See Also