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Viral Hepatitis

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Viral Hepatitis

  • See Also
  1. Acute Hepatitis
  2. Hepatotoxin
  3. Liver Function Test Abnormality
  4. Acute Hepatic Failure (Fulminant Hepatitis)
  5. Viral Hepatitis
  • Causes
  1. Hepatitis A
  2. Hepatitis B
  3. Hepatitis C
  4. Hepatitis D
  5. Hepatitis E
  6. Epstein Barr Virus (EBV)
  7. Cytomegalovirus (CMV)
  8. Coxsackie Virus
  • Symptoms
  • Prodrome
  1. Malaise
  2. Anorexia
  3. Nausea or Vomiting
  4. Diarrhea
  5. Low Grade fever
  • Signs
  • Advanced disease
  1. Dark Urine
  2. Jaundice
  3. Tender Hepatomegaly
  • Differential Diagnosis
  1. See Acute Hepatitis Causes
  2. Alcoholic Hepatitis
  3. Hepatotoxins
  4. Hypotension
  5. Ischemia
  6. Biliary tract disease
  • Labs
  1. See Acute Hepatitis
  2. Alkaline Phosphatase (up to twice normal)
  3. Serum Direct Bilirubin (Conjugated Bilirubin) increased
  4. Liver Aminotransferases increased (up to 10-20 fold above baseline)
    1. Alanine Aminotransferase (ALT)
    2. Aspartate Aminotransferase (AST)
  5. Viral Hepatitis Serology
    1. Hepatitis A
      1. xHAV IgM
    2. Hepatitis B
      1. HBsAg
      2. xHBc IgM
    3. Hepatitis C
      1. xHCV Antibody
  • Management
  1. See Acute Hepatitis
  2. Post-exposure Prophylaxis
    1. See Hepatitis A
    2. See Hepatitis B Postexposure Prophylaxis
    3. No Post-exposure Prophylaxis is available for Hepatitis C (as of 2015)
  3. Acute Viral Hepatitis
    1. Symptomatic management is primary treatment for Hepatitis A and Hepatitis B
    2. Consider early Interferon based monotherapy for Acute Hepatitis C (started within first 4 weeks)
      1. See Hepatitis C
  • Prevention
  1. See Prevention of Liver Disease Progression
  2. Vaccination
    1. Combined Hepatitis A and Hepatitis B Vaccine (Twinrix)
    2. Hepatitis A Vaccine
    3. Hepatitis B Vaccine
  • References
  1. Swencki (2015) Crit Dec Emerg Med 29(11):2-10