Hepatitis A

(ssRNA; 30–45% of acute viral hepatitis in U.S; MMWR 2018;67:1208)

• Transmission & RFs: fecal–oral route; contam. food, water, shellfish; daycare ctr; intl travel
• Incubation: 2–6 wk; no chronic carrier state; once antibody forms → lifelong immunity
• Sx: ↓ appetite, malaise, fever, N/V, RUQ pain, jaundice; rarely ALF (↑ w/ chronic HCV)
• Diagnosis:
  • acute hepatitis = ⊕ IgM anti-HAV;
  • past exposure = ⊕ IgG anti-HAV (⊖IgM)
• Rx for acute HAV: supportive care; refer to liver txplnt center if acute liver failure
• Vaccinate if: MSM, IVDU, chronic liver disease, international travel; Havrix (2 doses)