Viral hepatitis

Causes

Hepatitis A

• Most common form of transmission occurs from asymptomatic children to adults
• Incubation period: 15-50d
• Prodrome: N/V, malaise, fever, abd pain
  • 1wk later bilirubinuria, clay-colored stool, jaundice
• Death from hepatic failure is rare

Hepatitis B

• Incubation period: 1-3 months
• Presentation is similar to hep A
• Lab tests:
  • HBsAg: + implies infection
  • Anti-HBs: implies clearance or vaccination
  • Anti-HBc: Implies prior infection; IgM = acute & in flares; IgG always present
  • HBe-Ag: Implies active viral replication & infectivity
  • HBV DNA: Similar to HBe-Ag but more sensitive

Hepatitis C

• Unlike Hep A and B, most often asymptomatic in acute phase of infection
• >75% of pts advance to chronic stage

Disposition

Admit Criteria

1. INR >2
2. Unable tol POs
3. Pain control
4. Bilirubin >30
5. Hypoglycemia
6. Significant comorbid illness/immunocomp
7. >50 years

See Also

• Jaundice
• Acute Hepatitis

Source

Adapted from Stevens, Donaldson, Pani