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Clinical manifestations and diagnosis of hepatitis A virus infection.

Abstract

Hepatitis A is an acute, necroinflammatory disease of the liver which results from infection by the hepatitis A virus (HAV). The mean incubation period is approximately 30 days. Although the disease is usually self-limited, the severity of illness is age-dependent. In children, hepatitis A is usually asymptomatic, while in adults, symptomatic infection is characteristic and jaundice is common. Fulminant hepatitis A is rare and is also age-dependent. The onset of hepatitis A is often abrupt and characteristic prodromal symptoms are followed, within a few days to a week, by dark urine and jaundice. Mild to moderate tenderness over an enlarged liver is usually detected. Serum alanine and aspartate aminotransferase levels usually both rise rapidly during the prodromal period, reach peak levels and then decrease by approximately 75% per week. Serum bilirubin concentrations reach peak levels later and decline less rapidly than serum aminotransferases. Nonetheless, the period of jaundice persists for < 2 weeks in approximately 85% of cases. Nearly all adult patients with clinically apparent disease experience complete clinical recovery with restoration of normal serum bilirubin and aminotransferase values by 6 months. Relapses and prolonged cholestasis are unusual manifestations of hepatitis A, and even in these circumstances, recovery is the rule and chronic hepatitis is not seen. The diagnosis of hepatitis A requires the detection of immunoglobulin M antibody to HAV in a patient who presents with, or has recently had, clinical features of hepatitis (icteric or anicteric disease) or in an individual with inapparent, asymptomatic infection in whom serum aminotransferase elevations may be detected.(

ABSTRACT

TRUNCATED AT 250 WORDS)

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  • Publisher Full Text
  • Authors+Show Affiliations

    Department of Medicine, MetroWest Medical Center, MA 01701.

    Source

    Vaccine 10 Suppl 1: 1992 pg S15-7

    MeSH

    Adult
    Aging
    Alanine Transaminase
    Aspartate Aminotransferases
    Bilirubin
    Child
    Hepatitis A
    Hepatovirus
    Humans
    Immunoglobulin M
    Jaundice

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    1335649

    Citation

    Koff, R S.. "Clinical Manifestations and Diagnosis of Hepatitis a Virus Infection." Vaccine, vol. 10 Suppl 1, 1992, pp. S15-7.
    Koff RS. Clinical manifestations and diagnosis of hepatitis A virus infection. Vaccine. 1992;10 Suppl 1:S15-7.
    Koff, R. S. (1992). Clinical manifestations and diagnosis of hepatitis A virus infection. Vaccine, 10 Suppl 1, pp. S15-7.
    Koff RS. Clinical Manifestations and Diagnosis of Hepatitis a Virus Infection. Vaccine. 1992;10 Suppl 1:S15-7. PubMed PMID: 1335649.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Clinical manifestations and diagnosis of hepatitis A virus infection. A1 - Koff,R S, PY - 1992/1/1/pubmed PY - 1992/1/1/medline PY - 1992/1/1/entrez SP - S15 EP - 7 JF - Vaccine JO - Vaccine VL - 10 Suppl 1 N2 - Hepatitis A is an acute, necroinflammatory disease of the liver which results from infection by the hepatitis A virus (HAV). The mean incubation period is approximately 30 days. Although the disease is usually self-limited, the severity of illness is age-dependent. In children, hepatitis A is usually asymptomatic, while in adults, symptomatic infection is characteristic and jaundice is common. Fulminant hepatitis A is rare and is also age-dependent. The onset of hepatitis A is often abrupt and characteristic prodromal symptoms are followed, within a few days to a week, by dark urine and jaundice. Mild to moderate tenderness over an enlarged liver is usually detected. Serum alanine and aspartate aminotransferase levels usually both rise rapidly during the prodromal period, reach peak levels and then decrease by approximately 75% per week. Serum bilirubin concentrations reach peak levels later and decline less rapidly than serum aminotransferases. Nonetheless, the period of jaundice persists for < 2 weeks in approximately 85% of cases. Nearly all adult patients with clinically apparent disease experience complete clinical recovery with restoration of normal serum bilirubin and aminotransferase values by 6 months. Relapses and prolonged cholestasis are unusual manifestations of hepatitis A, and even in these circumstances, recovery is the rule and chronic hepatitis is not seen. The diagnosis of hepatitis A requires the detection of immunoglobulin M antibody to HAV in a patient who presents with, or has recently had, clinical features of hepatitis (icteric or anicteric disease) or in an individual with inapparent, asymptomatic infection in whom serum aminotransferase elevations may be detected.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0264-410X UR - https://www.unboundmedicine.com/medline/citation/1335649/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/0264-410X(92)90533-P DB - PRIME DP - Unbound Medicine ER -